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Background/Objectives: Rett syndrome is a rare neurodevelopmental disorder that can severely affect motor functioning, particularly walking. Previous training programs proposed treadmills as tools to increase walking endurance of patients with Rett syndrome, but these trainings did not include virtual reality (VR). The aim of this study was to assess the feasibility of a short treadmill training coupled to VR in girls with Rett syndrome. Methods: Nine patients with Rett syndrome underwent a 3-day treadmill walking program performed in semi-immersive VR. During the training, the happiness index and performance metrics were collected. At the end of the training parents filled out the Suitability Evaluation Questionnaire (SEQ) and, when feasible, patients underwent a gait assessment. Results: All the subjects recruited performed the three GRAIL sessions and parents showed a good satisfaction and considered the integration of treadmill and VR a good possibility for future rehabilitative programs. Participants showed greater satisfaction in environments requiring walking and their attention increased during training sessions, hypothesizing the feasibility of longer trainings with treadmill and VR. Data collected from gait analysis provided insights, although preliminary, concerning differences in gait pattern amongst the recruited subjects. Conclusions: Despite the small sample size and limited training duration, the paper suggests that a walking training with a treadmill combined with VR can represent a new strategy for Rett rehabilitation. [ABSTRACT FROM AUTHOR]

The aims of the present pilot study were two: a) to investigate if learning and exercise in a virtual reality (VR) environment was motivating and emotionally positive for subjects with Rett Syndrome (RTT), and b) to examine if the speed of motor reaction was higher in a virtual or concrete environment. To achieve these aims, specific VR environments were developed to stimulate motor skills. Seven subjects with RTT were tested in three experimental conditions. In the concrete condition, real stimuli were placed on the table and the participants were invited to reach the stimulus. In the 2D and 3D conditions, a computer was placed on the table, and, through the developed software, stimuli were shown in 2D and 3D environments. The virtual system was able to recognize the reaching movements of participants. Thus, the object shown in the virtual environment moved towards the participant when the participant tried to grasp it. Results indicated that in the virtual environment the participants were more motivated and emotionally more involved in the proposed exercises. The motor speed was lower in concrete and 2D conditions than 3D conditions. This pilot study shows preliminary evidence on the usability of VR for RTT in improving learning, motivation and motricity. [ABSTRACT FROM AUTHOR]

The aim of this review was to investigate the tools used to identify pain in patients who are non-communicative and therefore unable to communicate pain to their caregivers. A systematic review of the studies published with predetermined eligibility criteria was undertaken. A total of 32 studies were identified and reviewed. Among the articles included, we observed two different types of outcome measures: physiological and behavioral measurements. Eleven articles referred to physiological measurements and 20 referred to behavioral measurements, with one article referring to both types of measurements. All the papers described at least one instrument or measure, which was implemented to measure pain in non-communicative patients. The results confirmed the agreement among behavioral measurements of pain, while physiological measurements should be studied more in depth. This review suggests that the use of frequent items in each scale and in each physiological instrument may help healthcare professionals and caregivers to overcome the barrier of prognosis uncertainty and to identify patients that could benefit from their use. [ABSTRACT FROM AUTHOR]

In recent years, much attention has been paid to motor impairment of persons with Rett Syndrome (RTT), with increasing literature aimed to describe gross motor functioning and musculoskeletal disorders of the RTT population. The aim of this systematic review is to describe clinical evaluation tools used in the last decade to assess motor functioning and musculoskeletal abnormalities of patients with RTT. Thirty-four studies were reviewed and 20 tools were presented. Results showed that only two tools were used to measure functional change after rehabilitative or therapeutic interventions. This review underlies the lack of adequate evaluation tools to assess musculoskeletal abnormalities and deformities in RTT population. The absence of these assessments could be due to a statistical difficulty as it is challenging to build an evaluation tool that can score the entities of the abnormalities related to the amount of disability they cause. [ABSTRACT FROM AUTHOR]