Search Results (180)

Objectives: This study investigated fractional anisotropy (FA) differences within key white matter tracts across patient groups stratified by Montreal Cognitive Assessment (MoCA) scores, aiming to evaluate FA’s potential as a biomarker for cognitive impairment. Methods: Seventy participants (aged 57–96 years) were categorized into high (HP, MoCA ≥ 26), moderate (MP, MoCA 18–25), and low (LP, MoCA < 18) cognitive performance groups. Diffusion Tensor Imaging (DTI) was used to obtain FA values in corticospinal tracts, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, and cingulum. Statistical analyses included ANOVA and post-hoc tests. Results: Significant differences in FA values and normative percentiles were observed across cognitive groups in several tracts. Notably, the MP group exhibited significantly higher FA values in the Left Superior Longitudinal Fasciculus—Arcuate (mean FA 0.329 vs. LP 0.306, p = 0.033) and Right Superior Longitudinal Fasciculus—Arcuate (mean FA 0.329 vs. LP 0.306, p = 0.009), Left Inferior Fronto-Occipital Fasciculus (mean FA 0.308 vs. LP 0.283, p = 0.021), and Right Inferior Fronto-Occipital Fasciculus (mean FA 0.289 vs. LP 0.266, p = 0.017) compared to the LP group. Conclusions: Our findings reveal significant FA alterations across MoCA-defined cognitive groups, with moderate impairment showing higher FA than low performance. This suggests FA may reflect complex microstructural changes in early cognitive decline. While our modest sample size, particularly in the low-performance group, limits definitive conclusions, these results highlight the need for larger, multimodal studies to validate FA’s role as a sensitive, albeit complex, biomarker for cognitive impairment. Full article

Background: Cardiovascular diseases (CVD) are major contributors to global morbidity and mortality, and their association with cognitive impairment has gained increasing attention. Recent studies indicate that the prevalence of post-myocardial infarction (MI) cognitive impairment ranges from 22% to 37%, with attention being one of the most frequently affected domains. Moreover, novel approaches, such as normobaric hypoxic training in cardiac rehabilitation, show potential in improving both cardiovascular and cognitive outcomes. Aim: This narrative review aims to synthesize current evidence on the role of hypoxia in the development of cognitive dysfunction among patients with cardiac diseases, emphasizing shared mechanisms along the heart–brain axis. Methods: We performed a narrative search of PubMed, Scopus, and Web of Science databases using the keywords “hypoxia”, “cognitive impairment”, “myocardial infarction”, “heart failure”, and “CABG surgery”. We included original studies, reviews, and meta-analyses published between 2000 and up to the present in English. Priority was given to peer-reviewed human studies; animal models were included when providing mechanistic insights. Exclusion criteria included case reports, conference abstracts, and non-peer-reviewed sources. Narrative reviews, while useful for providing a broad synthesis, carry an inherent risk of selective bias. To minimize this limitation, independent screening of sources and discussions among multiple authors were conducted to ensure balanced inclusion of the most relevant and high-quality evidence. Results: Hypoxia contributes to cognitive decline through multiple pathophysiological pathways, including blood–brain barrier disruption, white matter degeneration, oxidative stress, and chronic neuroinflammation. The concept of “cardiogenic dementia”, although not yet formally classified, highlights cardiac-related contributions to cognitive impairment beyond classical vascular dementia. Clinical assessment tools such as the Stroop test, Trail Making Test (TMT), and Montreal Cognitive Assessment (MoCA) are useful in detecting subtle executive dysfunctions. Both pharmacological treatments (ACE inhibitors, ARBs) and innovative rehabilitation methods (including normobaric hypoxic training) may improve outcomes. Conclusions: Cognitive impairment in cardiac patients is common, clinically relevant, and often underdiagnosed. Routine cognitive screening after cardiac events and integration of cognitive rehabilitation into standard cardiology care are recommended. Future studies should incorporate cognitive endpoints into cardiovascular trials. Full article

Idiopathic normal-pressure hydrocephalus (iNPH) is clinically characterized by the Hakim–Adams triad: gait disturbance, cognitive decline, and urinary incontinence. Cognitive impairment in iNPH predominates as a subcortical syndrome, with deficits in executive functions, psychomotor slowing, and memory inefficiency. However, the cognitive profile is heterogeneous and often overlaps with other neurodegenerative conditions, complicating differential diagnosis. This study investigated the cognitive features of iNPH using the Rey Auditory Verbal Learning Test (RAVLT), comparing 29 iNPH patients to 28 healthy controls. Demographic and neuroimaging parameters—such as Evans Index and Callosal Angle—were assessed. Results indicated significantly lower Montreal Cognitive Assessment (MoCA) and RAVLT scores in iNPH patients compared to controls. Analysis of serial position effects revealed that, whereas healthy individuals exhibited typical primacy and recency effects in verbal memory, iNPH patients demonstrated a selective impairment of the primacy effect, likely reflecting hippocampal dysfunction. These findings underline the importance of detailed neuropsychological evaluation in differentiating iNPH from other dementias and suggest that damage to medial temporal lobe structures plays a prominent role in the verbal memory deficit observed in iNPH. Full article

Background/Objectives: Long-term cognitive outcomes after carotid surgery are influenced by diabetes and intraoperative changes. We aimed to analyze the postoperative cognitive changes in diabetic patients and nondiabetic patients after carotid endarterectomy (CEA). Additionally, major cardiovascular and cerebrovascular events (MACCEs) and the incidence of mortality at two years after surgery were assessed. Methods: We enrolled 37 diabetic and 67 nondiabetic patients undergoing elective carotid surgery. Intraoperatively, routine monitoring was completed with NIRS (near-infrared spectroscopy) and an Entropy monitor was used for neuromonitoring. The lowest cerebral tissue saturation levels during the cross-clamp period (rSO_2lowestclamp) and the degree of desaturation were calculated. We used MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) to assess cognitive function. Cognitive change was defined as one standard deviation (SD) change from the preoperative test scores. Results: The MMSE and MoCA were available for 103 patients at three months and for 90 patients at 12 months after discharge. Compared with nondiabetic patients, diabetic patients exhibited greater decreases in MoCA scores (p = 0.028 and p = 0.042 at the 3rd and 12th months, respectively). Cognitive improvement was lower in the DM group than in the control group at the 12th month (18.75% vs. 42.86%, respectively; p = 0.029). The mean rSO₂ in the pre-clamping period (67.4% vs. 74.6% in diabetic and in nondiabetic patients, respectively; p = 0.011) was lower in diabetic patients. Furthermore, MACCEs at the 24th month were observed at a higher rate in diabetic patients (p = 0.040). Conclusions: Diabetic patients demonstrated greater risks for cognitive decline, MACCEs, and mortality at two years after surgery. Full article

Aims: To investigate the nutritional status and feeding behaviours of nursing home residents and the impact of cognitive impairments and feeding difficulties on nutritional health. Design: A cross-sectional observational design was employed. Methods: The study assessed 51 nursing home residents using the Mini Nutritional Assessment Short-Form (MNA-SF) for nutritional status, the Feeding Difficulty Index (FDI) for mealtime behaviours, and the MoCA (Montreal Cognitive Assessment or The MoCA Test) for cognitive function. Results: The average age of participants was 87.8 years. Nearly half (47.1%) were at high risk of malnutrition, and 13.7% were classified as malnourished. The average MoCA score was 14, indicating moderate cognitive impairment, which was inversely associated with nutritional status. Feeding difficulties were common, as follows: 74.5% of residents paused feeding for over one minute, and 62.8% were distracted during meals. A longer duration of nursing home residency was associated with poorer nutritional outcomes. Overall, 65% of residents required mealtime assistance, with higher FDI scores correlating with greater support needs. Significant positive correlations were found between cognitive function and nutritional status (r = 0.401, p = 0.037) and between food intake and nutritional status (r = 0.392, p = 0.004). In contrast, residency duration (r = −0.292, p = 0.037) and feeding difficulties (r = −0.630, p < 0.001) were negatively associated with MNA-SF scores. FDI scores were strongly associated with the level of assistance required during meals (r = 0.763, p < 0.001). This study highlights the critical need for targeted nutritional assessments and interventions in nursing homes, especially for residents with dementia facing cognitive impairments and feeding difficulties. Enhancing staff training on recognising and addressing eating challenges and risk factors is essential for improving nutritional well-being. Conclusions: The study highlighted the profound impact of cognitive impairments and feeding difficulties on the nutritional health of nursing home residents, indicating a high prevalence of malnutrition and a need for comprehensive mealtime assistance. Full article

Background/Objectives: Neuromodulation is under investigation as a possibly effective add-on therapy in Alzheimer’s disease (AD). While transcranial pulse stimulation (TPS) has shown positive short-term effects, long-term effects have not yet been fully explored. This study aims to evaluate the long-term feasibility, safety, and potential cognitive benefits of TPS over one year in patients with Alzheimer’s disease, focusing on domains such as memory, speech, orientation, visuo-construction, and depressive symptoms. Methods: We analyzed preliminary data from the first ten out of thirty-five patients enrolled in a prospective TPS study who completed one year of follow-up and were included in a dedicated long-term database. The protocol consisted of six initial TPS sessions over two weeks, followed by monthly booster sessions delivering 6000 pulses each for twelve months. Patients underwent regular neuropsychological assessments using the Alzheimer Disease Assessment Scale (ADAS), Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Beck Depression Inventory (BDI-II). All adverse events (AEs) were documented and monitored throughout the study. Results: Adverse events occurred in less than 1% of stimulation sessions and mainly included mild focal pain or transient unpleasant sensations, as well as some systemic behavioral or vigilance changes, particularly in patients with underlying medical conditions, with some potentially related to the device’s stimulation as adverse device reactions (ADRs). Cognitive test results showed significant improvement after the initial stimulation cycle (ADAS total improved significantly after the first stimulation cycle (M_pre = 28.44, M_post = 18.56; p = 0.001, d = 0.80, 95% CI (0.36, 1.25)), with stable scores across all domains over one year. Improvements were most notable in memory, speech, and mood. Conclusions: TPS appears to be a generally safe and feasible add-on treatment for AD, although careful patient selection and monitoring are advised. While a considerable number of participants were lost to follow-up for various reasons, adverse events and lack of treatment effect were unlikely primary causes. A multifocal stimulation approach (F-TOP2) is proposed to enhance effects across more cognitive domains. Full article

Background/Objectives: Dystonia, traditionally regarded as a purely motor disorder, is now increasingly recognized as involving clinically significant non-motor symptoms (NMSs) that can adversely affect patients’ health-related quality of life (HRQoL). This study aimed to assess HRQoL in Romanian patients with isolated dystonia and to evaluate the impact of two key NMSs, depression and cognitive impairment, on their HRQoL. We hypothesized that depression would have a greater adverse effect on HRQoL than cognitive impairment. Methods: A cross-sectional study was conducted involving 65 adult Romanian patients with isolated dystonia. HRQoL was measured using the Short Form-36 Health Survey (SF-36), including the physical component summary (PCS) and mental component summary (MCS). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and cognitive impairment was assessed using the Montreal Cognitive Assessment (MoCA). Descriptive statistics, correlation analysis, and parametric and non-parametric tests were used. Multiple regression analysis was employed to evaluate associations between NMS and HRQoL. Results: The mean (SD) age was 56.6 (14.3) years, and 80% of participants were female. Depression and cognitive function were significantly associated with PCS (0.33 and −0.51, respectively) and MCS (0.26 and −0.78, respectively). Multiple regression analysis showed that the two NMS explained 38% of the variance in PCS and 58% of the variance in MCS. Depression had a greater impact on PCS and MCS than cognitive impairment (−0.47 vs. 0.33 and −0.72 vs. 0.16, respectively). Cognitive impairment (MoCA < 26) was present in 35.4% of patients, while 46.2% had at least mild depressive symptoms (PHQ-9 ≥ 5); 23.1% met criteria for moderate-to-severe depression (PHQ-9 ≥ 10). Depressive symptoms showed strong negative correlations with all SF-36 domains, while cognitive performance correlated modestly. Conclusions: Both depression and cognitive impairment have a significant negative impact on HRQoL in dystonia, with depression having a stronger effect, as we hypothesized. Routine screening for non-motor symptoms is essential to support better clinical outcomes and enhance patients’ quality of life. Full article

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, and preliminary effects of a VR-based road-crossing intervention for older adults. It investigates the use of virtual reality (VR) as an innovative training tool to support senior citizens in safely navigating everyday challenges such as crossing roads. By providing an immersive environment with realistic traffic scenarios, VR enables participants to practice in a safe and controlled setting, minimizing the risks associated with real-world road traffic. Methods: A VR training application called “Wegfest” was developed to facilitate targeted road-crossing practice. The application simulates various scenarios commonly encountered by older adults, such as crossing busy streets or waiting at traffic lights. The study applied a single-group pre-post design. Outcomes included the Timed Up and Go test (TUG), Falls Efficacy Scale-International (FES-I), and Montreal Cognitive Assessment (MoCA). Results: The development process of “Wegfest” demonstrates how a highly realistic street environment can be created for VR-based road-crossing training. Significant improvements were found in the Timed Up and Go test (p = 0.002, d = 0.784) and fall-related self-efficacy (FES-I, p = 0.005). No change was observed in cognitive function (MoCA, p = 0.56). Participants reported increased subjective safety (p < 0.001). Discussion: The development of the VR training application “Wegfest” highlights the feasibility of creating realistic virtual environments for skill development. By leveraging immersive technology, both physical and cognitive skills required for road-crossing can be effectively trained. The findings suggest that “Wegfest” has the potential to enhance the mobility and safety of older adults in road traffic through immersive experiences and targeted training interventions. Conclusions: As an innovative training tool, the VR application not only provides an engaging and enjoyable learning environment but also fosters self-confidence and independence among older adults in traffic settings. Regular training within the virtual world enables senior citizens to continuously refine their skills, ultimately improving their quality of life. Full article

Background: Patients with chronic kidney disease (CKD) have a substantially higher risk of developing cognitive impairment (CI) than the general population. Patients with CKD undergoing haemodialysis (HD) treatment also have an elevated risk of developing cerebrovascular and cardiovascular diseases. This study aims to investigate the relationship between the cognitive performance of haemodialysis patients and cerebral and carotid haemodynamic indices. Methods: This study was a non-interventional observational study; the sample consisted of 32 patients (age 65 ± 12 years) undergoing chronic HD treatment. The patients underwent neuropsychological and haemodynamic instrumental investigations, including Supra-Aortic Trunk Echodoppler (SAT) and Transcranial Doppler (TCD). Results: Patients were 17% deficient at Montreal Cognitive Assessment (MoCA), 45% deficient at Frontal Assessment Battery (FAB), 55% deficient at Trail-Making Test-A (TMT-A) and 65% deficient at TMT-B. The TCD investigation detected a decrease in flow (MFV) and an increase in Breath Hold Index (BHI) predominantly in the right cerebral arterial district. The SAT investigation revealed an altered IMT, plaques and the presence of severe carotid stenosis. A strong association between cerebral and carotid indices and cognitive scores was also observed. Correlation analyses reported statistically significant correlations between TMT-A and TMT-B and cerebral flow indices. Conclusions: Among haemodialysis patients, there is a high percentage of cognitive impairment associated and correlated with alterations in cerebral and carotid haemodynamics. Cerebral haemodynamics are a factor to be taken into consideration as a possible pathological mechanism underlying cognitive impairment in haemodialysis. Full article

Background: Primary aldosteronism is characterized by elevated aldosterone levels, leading to adverse effects such as hypertension, hypokalaemia and increased risk for cardiovascular and cerebrovascular events. Aldosterone impacts the central nervous system by promoting vascular remodelling and oxidative stress, potentially impairing cognitive function. The presence of mineralocorticoid receptors in the hippocampus, a key region for cognition, further suggest a link between primary aldosteronism and cognitive dysfunction. This study aims to further explore the association between hyperaldosteronism and cognitive impairment. Methods: In this pilot study we examined 15 individuals with primary aldosteronism and arterial hypertension alongside 15 age- and sex-matched controls with essential hypertension, all free of previous cerebrovascular events. Clinical and archival laboratory data were obtained. Cognitive function was assessed using the Mini-Mental State Examination and Montreal Cognitive Assessment. Results: Participants with primary aldosteronism had higher blood pressure values, longer duration of hypertension, lower serum potassium levels and higher 24 h urine albumin excretion rate compared to controls. Comorbidities, other characteristics and laboratory values were comparable across the two groups. No differences were observed in Mini-Mental State Examination scores, but Montreal Cognitive Assessment scores were significantly lower in the primary aldosteronism group (25.1 ± 2.2 vs. 27.1 ± 2.2, p = 0.021). Trends of poorer performance in language and attention/executive function domains were noted in primary aldosteronism individuals, as well as a higher number of pathological Montreal Cognitive Assessment scores (7 vs. 3). No significant correlations were found between cognitive test results and aldosterone concentrations or blood pressure in primary aldosteronism group. However, importantly, multiple regression analysis showed that aldosterone levels have a significant impact on Montreal Cognitive Assessment test, independent of blood pressure or duration of hypertension. Conclusions: This study supports an association between hyperaldosteronism and cognitive dysfunction, underscoring the need for more active detection and targeted treatment of primary aldosteronism. These findings warrant further research in larger cohorts to better elucidate this relationship. Full article

Objectives: Hyperuricaemia has been linked to cognitive decline, yet cerebral structural and haemodynamic changes in this population remain poorly defined. We evaluated transcranial colour-coded duplex (TCCD) sonography as a non-invasive screening tool for early mild cognitive impairment (MCI) in elderly hyperuricaemic men. Methods: In this cross-sectional study, 195 men aged ≥ 60 years with hyperuricaemia were stratified by the Montreal Cognitive Assessment (MoCA) into HUA + MCI (MoCA < 26, n = 46) and HUA (MoCA ≥ 26, n = 149) groups. TCCD measured third-ventricle width (TVW) and peak systolic/end-diastolic velocities to calculate resistive (RI) and pulsatility (PI) indices in the middle (MCA) and posterior (PCA) cerebral arteries. Serum uric acid was recorded. Kernel density plots and receiver operating characteristic (ROC) curves assessed diagnostic performance. Results: The HUA + MCI group exhibited higher serum uric acid (508.5 ± 36.3 vs. 492.9 ± 44.0 µmol/L; p = 0.031), greater TVW (0.55 ± 0.11 vs. 0.51 ± 0.08 cm; p = 0.037), and elevated left PCA RI (0.69 ± 0.07 vs. 0.64 ± 0.06) and PI (1.05 ± 0.17 vs. 0.95 ± 0.12; both p < 0.001). ROC analysis identified left PCA PI as the most specific marker (AUC = 0.701; specificity 90.6%; sensitivity 45.7%). Kernel density plots confirmed distinct distributions of key parameters. Conclusions: TCCD-detected ventricular enlargement and raised PCA pulsatility accurately distinguish MCI among hyperuricaemic men. As a non-invasive, accessible technique with high specificity, TCCD may complement MRI and cognitive testing in early screening of at-risk populations. Full article

Cognitive–motor integration is the coordination of cognitive and motor processes; it is commonly impaired among people living with dementia (PWD) and may be improved through exercise. This pilot randomized controlled trial (1:1) aimed to determine the effect of 6 months of exercise on cognitive–motor integration compared to usual care in n = 42 PWD at two residential care facilities. Participants completed single- and dual-task standing (30 s of standing while counting backward by 1 s), walking (4 m walk while naming words), and timed-up-and-go (TUG) tests (TUG with a category task), measured using APDM inertial sensors at baseline and 6 months (age = 82 years, 35% female, Montreal Cognitive Assessment = 10.2 ± 5.9, NCT05488951). The adapted Otago Exercise Program involved 60 min of lower-body strength and balance exercises and walking 3x/week for 6 months. Usual care involved regular social activities and healthcare appointments. Exercise provoked increased single-task stride length and increased dual-task TUG turn velocity compared to usual care (p < 0.05). Usual care may reduce the ability to appropriately select cautious gait, as the usual care group exhibited faster dual-task gait speed at 6 months compared to the OEP plus usual care (p < 0.05), which was faster than their single-task gait speed. Our results support implementing the OEP to improve cognitive–motor integration in PWD. Full article

Background: Prior studies have shown an association between jugular venous reflux and age-related neurological conditions, including cognitive decline and potentially incident dementia. However, a relationship between internal jugular vein (IJV) outflow disturbance and cognitive impairment has yet to be elucidated. This study evaluates the relationship between impaired IJV drainage and cognitive function. Methods: We recruited a prospective sample of 106 participants with subjective memory complaints. Subjects underwent neuropsychological assessments and ultrasound examination of IJV, including time-averaged mean velocity (TAMV) and the cross-sectional area of the IJV at the middle (J2) and distal (J3) segments. Impaired IJV drainage was defined by either of the following: (1) TAMV < 4 cm/s at the J2 or J3 segment on either side, or (2) IJV lumen collapse during inspiration at the J2 segment on either side. Results: The impaired cognition group had a significantly higher prevalence of both impaired flow velocity and impaired IJV drainage compared to the normal cognition group (34% vs. 16%, p = 0.032; 68% vs. 30%, p < 0.001). Furthermore, the impaired IJV drainage group demonstrated lower scores across all neuropsychological tests, with statistical significance observed in the Mini-Mental State Examination (median (IQR) 27 vs. 29, p = 0.013), Montreal Cognitive Assessment (median (IQR) 23 vs. 26, p < 0.001) and Chinese Version of the Verbal Learning Test (median (IQR) 23.5 vs. 27, p = 0.024). Notably, incorporating IJV lumen collapse during deep inspiration into the definition of impaired IJV drainage further increased its prevalence in the impaired cognition group. Conclusions: Our results revealed that the impaired cognition group exhibited a higher prevalence of impaired outflow in the bilateral IJV, while the impaired IJV drainage group scored lower on all neuropsychological tests compared to the normal group. These findings support the hypothesis that impaired IJV drainage is correlated with global cognitive decline. Full article

Dual-task paradigms that combine cognitive and motor tasks offer a valuable lens for detecting subtle impairments in cognitive and physical functioning, especially in older adults. This study used artificial neural network (ANN) modeling to predict clinical, cognitive, and psychosocial outcomes from integrated gait, speech-linguistic, demographic, physiological, and psychological data collected during single- and dual-task conditions. Forty healthy adults (ages 20–84) completed physical, cognitive, and psychosocial assessments and a dual-task walking task involving cell phone use. ANN models were optimized using hyperparameter tuning and k-fold cross-validation to predict outcomes such as the Montreal Cognitive Assessment (MOCA), Trail Making Tests (TMT A and B), Activities-Specific Balance Confidence (ABC) Scale, Geriatric Depression Scale (GDS), and measures of memory, affect, and social support. The models achieved high accuracy for MOCA (100%), ABC (80%), memory function (80%), and social support satisfaction (75%). Feature importance analyses revealed key predictors such as speech-linguistic markers and sensory impairments. First-person plural pronoun used and authenticity of internal thoughts during dual-task emerged as strong predictors of MOCA and memory. Models were less accurate for complex executive tasks like TMT A and B. These findings support the potential of ANN models for the early detection of cognitive and psychosocial changes. Full article

Background/Objectives: Individuals with chronic stroke often experience various impairments, including poor balance, reduced mobility, limited physical activity, and difficulty performing daily tasks. In the context of the COVID-19 pandemic, telerehabilitation (TR) can overcome the barriers of geographical and physical distancing, time, costs, and travel, as well as the anxiety about contracting COVID-19. In this retrospective case-control study, we aim to evaluate the motor and cognitive effects of balance TR training carried out with a sensor-based non-immersive virtual reality system compared to conventional rehabilitation in chronic stroke patients. Methods: Twenty chronic post-stroke patients underwent evaluation for inclusion in the analysis through an electronic recovery data system. The patients included in the study were divided into two groups with similar medical characteristics and duration of rehabilitation training. However, the groups differed in the type of rehabilitation approach used. The experimental group (EG) received TR with a sensor-based VR device, called VRRS—HomeKit (n. 10). In contrast, the control group (CG) underwent conventional home-based rehabilitation (n. 10). Results: At the end of the training, we observed significant improvements in the EG in the 10-m walking test (10MWT) (p = 0.01), Timed-Up-Go Left (TUG L) (p = 0.01), and Montreal Cognitive Assessment (MoCA) (p = 0.005). Conclusions: In our study, we highlighted the potential role of sensor-based virtual reality TR in chronic stroke patients for improving lower limb function, suggesting that this approach is feasible and not inferior to conventional home-based rehabilitation. Full article