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Evaluation of the Impact of Virtual Park on Training Motivation in Adult Patients (VP_Adults)

25 мая 2026 г. обновлено: Marta Mondellini

Evaluation of the Impact of a Rehabilitation Intervention Based on Cycling With Virtual Park on Training Motivation in Adult Patients

The purpose of this clinical study is to evaluate the feasibility, usability, and motivational impact of VirtualPark, a virtual reality-based dual-task rehabilitation system, in adults with neurological and age-related conditions.

VirtualPark is a virtual reality application designed to deliver cognitive exercises during cycling training using a commercially available ergometer (THERA-Trainer Tigo). The system integrates physical and cognitive tasks in simulated real-life environments.

The intervention integrates motor and cognitive training tasks targeting domains such as attention, inhibition, working memory, and navigation.

This is a prospective, multicenter, randomized, cross-over pilot study. It will compare cycling training performed with and without virtual reality. Participants will complete both intervention conditions over a 4-week period separated by a wash-out phase with standard rehabilitation activities. The order of conditions will be randomized.

The study will assess motivation during rehabilitation training, usability and user experience of the system, as well as exploratory effects on cognitive and motor performance, functional abilities, perceived exertion, and safety.

The study will enroll adult participants (≥18 years) with conditions such as stroke, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, mild cognitive impairment, spinal cord injury, and frail older adults.

Обзор исследования

Статус

Еще не набирают

Условия

Вмешательство/лечение

Подробное описание

This study is a prospective, multicenter, randomized, cross-over pilot investigation evaluating the feasibility, usability, motivational impact, and preliminary clinical effects of a virtual reality-based dual-task rehabilitation system (VirtualPark) in adults with neurological and age-related conditions.

VirtualPark is a non-immersive virtual reality application developed by CNR-STIIMA to support multimodal rehabilitation through the integration of cognitive exercises with cycling training performed on a commercially available medical ergometer (THERA-Trainer Tigo). The system allows participants to perform motor and cognitive tasks simultaneously within simulated real-life virtual environments, including park and city scenarios. Cognitive exercises target attention, inhibition, working memory, and navigational abilities, with adjustable difficulty levels adapted to the participant's clinical condition and performance.

During the intervention, participants will undergo both experimental and control conditions according to a randomized cross-over design:

  • Virtual reality condition (VR): cycling training combined with VirtualPark serious games;
  • Non-virtual reality condition (No-VR): cycling training alone without virtual reality.

Each participant will complete a 4-week intervention period consisting of 2 weeks in one condition (VR or No-VR), followed by a wash-out period involving standard rehabilitation activities, and 2 weeks in the alternate condition. The order of conditions will be randomized using block randomization to reduce order effects.

Training sessions will be administered three times per week under supervision of trained healthcare professionals.

Each session will include a 5-10 minute warm-up phase, 20 minutes of active or active-assisted cycling training, and a 5-10 minute cool-down phase.

During the VR condition, cognitive tasks will be performed concurrently with cycling activity. Cycling speed detected by the ergometer will be translated into navigation speed within the virtual environment. Participants will interact with the system using Bluetooth buttons mounted on the ergometer handles.

Assessments will be conducted at baseline (T0), after the first intervention phase (T1), after the second intervention phase (T2), and at 1-month follow-up (T3, cognitive outcomes only).

The primary objective is to evaluate intrinsic and situational motivation associated with the use of virtual reality during rehabilitation training. Secondary objectives include assessment of usability, user experience, cognitive performance, motor performance, functional independence, perceived exertion, and device safety.

The study population includes adults aged 18 years or older with neurological or frailty-related conditions, including stroke, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, mild cognitive impairment, spinal cord injury, and frail older adults.

Тип исследования

Интервенционный

Регистрация (Оцененный)

70

Фаза

  • Непригодный

Контакты и местонахождение

В этом разделе приведены контактные данные лиц, проводящих исследование, и информация о том, где проводится это исследование.

Контакты исследования

  • Имя: Marta Mondellini, Psychologist
  • Номер телефона: 0039.0341.2350202
  • Электронная почта: marta.mondellini@cnr.it

Учебное резервное копирование контактов

Места учебы

  • Италия
    • Bari
      • Bari, Bari, Италия, 70124
        • Istituti a Carattere Scientifico Maugeri Bari
        • Контакт:
    • Benevento
      • Telese Terme, Benevento, Италия, 82037
        • Istituti a Carattere Scientifico Maugeri Telese
        • Контакт:
    • Lecco
      • Costa Masnaga, Lecco, Италия, 23845
        • Centro di Riabilitazione Villa Beretta
        • Контакт:
    • Milano
      • Milan, Milano, Италия, 20138
        • Istituti a Carattere Scientifico Maugeri Milano Camaldoli
        • Контакт:
    • Pavia
      • Montescano, Pavia, Италия, 27040
        • Istituti a Carattere Scientifico Maugeri Montescano
        • Контакт:
      • Pavia, Pavia, Италия, 27100
        • Istituti a Carattere Scientifico Maugeri Pavia
        • Контакт:
    • Pisa
      • Pisa, Pisa, Италия, 56126
        • Universita di Pisa
        • Контакт:
          • Carmelo Chisari
          • Номер телефона: 0039-050-2210901
          • Электронная почта: carmelo.chisari@unipi.it

Критерии участия

Исследователи ищут людей, которые соответствуют определенному описанию, называемому критериям приемлемости. Некоторыми примерами этих критериев являются общее состояние здоровья человека или предшествующее лечение.

Критерии приемлемости

Возраст, подходящий для обучения

  • Взрослый
  • Пожилой взрослый

Принимает здоровых добровольцев

Нет

Описание

Inclusion Criteria:

  • Informed consent to the study
  • subjects > 18 years and <85 years
  • diagnosis of MCI according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders VTh Edition (DSM V TR American Psychological Association 2013)
  • detection of ischemic stroke within 6 months preceding the study, frail elderly subjects (Gobbens RJ et al. 2010)
  • subjects affected by idiopathic Parkinson's disease according to the MDS-PD criteria (Postuma et al., 2015)
  • subjects affected by possible, probable and definite ALS according to the revised El Escorial criteria (Brooks Br, et al. 2000)
  • subjects affected by MS according to the McDonald criteria (2017) with disability measured with the EDSS (Expanded Disability Status Scale) <= 8
  • patients with spinal cord injury of different etiology with incomplete spinal cord injury, AIS (ASIA impairment scale) grade C and D, MMSE >18
  • subjects naïve to the use of the RV
  • no therapeutic changes or rehabilitation interventions in the month prior to inclusion in the study
  • no ongoing behavioral disorders.

Exclusion Criteria:

  • Other concomitant neurological pathologies in addition to the one under study
  • presence of visual disturbances that do not allow access to the experimental virtual reality protocol
  • presence of impaired cardiorespiratory function or other organic instabilities that contraindicate ergometer training
  • severe osteoporosis

Учебный план

В этом разделе представлена ​​подробная информация о плане исследования, в том числе о том, как планируется исследование и что оно измеряет.

Как устроено исследование?

Детали дизайна

  • Основная цель: Уход
  • Распределение: Рандомизированный
  • Интервенционная модель: Назначение кроссовера
  • Маскировка: Нет (открытая этикетка)

Оружие и интервенции

Группа участников / Армия
Вмешательство/лечение
Экспериментальный: Cycling with Virtual Park
Participants perform cycling training using a commercially available ergometer (THERA-Trainer Tigo) combined with the VirtualPark virtual reality system. The intervention includes simultaneous motor and cognitive training (dual-task), with cognitive exercises targeting attention, inhibition, working memory, and navigation during cycling.
Устройство: Dual-task training with Virtual Reality
Participants perform cycling training using a commercially available ergometer combined with a non-immersive virtual reality system. Virtual Reality offers cognitive exercises targeting attention, inhibition, working memory, and navigation during cycling.
Активный компаратор: Cycling withouth Virtual Park
Participants perform standard cycling training using the ergometer (THERA-Trainer Tigo) without virtual reality. This represents conventional motor rehabilitation (supportive care) without the addition of cognitive tasks delivered through VirtualPark.
Устройство: Cycling training
Participants perform standard cycling training without virtual reality-based tasks

Что измеряет исследование?

Первичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Intrinsic Motivation
Временное ограничение: Baseline, Week 2, Week 5
It is evaluated with the Interest/Enjoyment subscale of the Intrinsic Motivation Inventory (IMI). It is a part of a questionnaire, composed of 7 items to be answered on a 7-point Likert scale. For each statement, participants must provide a level of agreement on a scale of 1 to 7, where 1 equals "strongly disagree" and 7 equals "strongly agree." . Total scores range from 7 to 49, with higher scores indicating greater intrinsic motivation and enjoyment during rehabilitation training.
Baseline, Week 2, Week 5
Motivation
Временное ограничение: Baseline, Week 2, Week 5
the patient's motivational spectrum is assessed using the Situational Motivation Scale (SIMS), a self-report questionnaire. It consists of 16 items rated on a 7-point Likert scale and investigates four factors: intrinsic motivation, identified regulation, external regulation, and amotivation. For each statement, participants must provide a level of agreement on a scale of 1 to 7, where 1 equals "strongly disagree" and 7 equals "strongly agree." . Total scores range from 4 to 28 on each subscale, with higher scores indicating greater presence of that type of motivation towards rehabilitation activity.
Baseline, Week 2, Week 5

Вторичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Usability
Временное ограничение: Week 2 or Week 5
evaluated with the System Usability Scale (SUS); it is a post-study questionnaire consisting of 10 questions answered on a 5-point Likert scale. For each statement, participants must provide a level of agreement on a scale of 1 to 5, where 1 equals "strongly disagree" and 5 equals "strongly agree." The SUS results in a score ranging from 0 to 100, allowing not only an assessment of a system's usability but also its comparison with other systems. Higher scores indicate higher perceived usability of the system. For each statement, participants must provide a level of agreement on a scale of 1 to 5, where 1 equals "strongly disagree" and 5 equals "strongly agree."
Week 2 or Week 5
user experience in relation to the adoption of the proposed technology
Временное ограничение: Week 2 or Week 5
assessed with the Technology-Assisted Rehabilitation Patient Perception Questionnaire (TARPP-Q). The instrument consists of 29 items and explores the following factors: perceived usability, positive emotions, feelings of obstacle/difficulty, and feelings of stress. The items are to be answered on a 4-point Likert scale, where 1 corresponds to "not at all" and 4 to "very much". Higher scores indicate a more positive user experience.
Week 2 or Week 5
Cognitive Function
Временное ограничение: Baseline, week 2, week 5, week 9
Trail Making Test A-B is designed to assess selective, sustained, and divided attention, as well as any deficits in visual-motor coordination. In Trail Making Test A, the subject must match all 25 numbers on the sheet of paper in ascending order as quickly as possible. If the subject is able to complete the first part of the test, Trail Making Test B can be administered. It is administered in the same way, but the subject must match numbers and letters alternating between them as quickly as possible. This test allows for an assessment of psychomotor speed, visuospatial search ability, selective memory, and selective attention. Results include completion time in seconds. Lower completion times indicate better cognitive performance.
Baseline, week 2, week 5, week 9
Cognitive Function
Временное ограничение: Baseline, Week 2, Week 5, Week 9
The Short Stroop Test is one of the most commonly used tests to assess prefrontal functions such as cognitive flexibility and the control and inhibition of automatic responses. It is a timed test divided into three parts: in the first part, the subject must name the color of the squares presented to them; in the second part, they must simply read the words written on the board (color names); and in the third part, they are asked to name the color of the ink the words are written in (the board presents a series of color names, each printed in a different color than the one indicated by the name). The third part is reported by subjects as the most difficult. The Stroop effect emphasizes the interference that automatic word processing generates on the color-naming task, which is more demanding in terms of mental effort. Outcome include execution time and number of errors. Lower scores indicate better performance.
Baseline, Week 2, Week 5, Week 9
Cognitive Function
Временное ограничение: Baseline, Week 2, Week 5, Week 9
The Frontal Assessment Battery (FAB) is a screening test that assesses the presence and severity of a dysexecutive disorder affecting both cognition and motor behavior. The test consists of six subtests that explore, in order: the ability to conceptualize and abstract categories, mental flexibility, motor planning ability, sensitivity to interference, inhibition control, and environmental autonomy. The total score is the sum of the individual subtest scores and ranges from 0 to 18 (cut-off 13.50/18). Higher scores indicate better executive functioning.
Baseline, Week 2, Week 5, Week 9
Cognitive Function
Временное ограничение: Baseline, Week 2, Week 5, Week 9
Corsi Forward - Backward is a test designed to assess working memory and short-term visuospatial memory. The examiner places a board of nine cubes in front of the subject, which the subject will touch in sequences of increasing length. The subject must reproduce the sequence in the same order (Forward) or in reverse (Backward). Starting with a sequence of three cubes, the number of cubes the subject must memorize gradually increases. Outcome include the number of cubes correctly memorized. Higher scores indicate better visuospatial memory performance.
Baseline, Week 2, Week 5, Week 9

Другие показатели результатов

Мера результата
Мера Описание
Временное ограничение
Motor Function
Временное ограничение: Up to 5 weeks
Workload on the cycle ergometer
Up to 5 weeks
Motor Funcion
Временное ограничение: Up to 5 weeks
Cycling assistance level
Up to 5 weeks
Motor function
Временное ограничение: Up to 5 weeks
Cycling distance traveled during cycling training, measured in meters using ergometer-derived data
Up to 5 weeks
Functional abilities
Временное ограничение: Baseline, Week 2, Week 5
The Modified Barthel Index (MBI) is a clinical tool used to assess independence in activities of daily living (ADLs) in patients with physical disabilities. The MBI evaluates ten specific functions: Feeding, Bathing, Grooming, Dressing, Bowel control, Bladder control, Toileting, Transfers (e.g., bed to chair), Mobility (e.g., walking or wheelchair use), Stair climbing. Each item is scored on a 5-level ordinal scale. Interpretation: 0-20, Total dependency; 21-60, Severe dependency; 61-90, Moderate dependency; 91-99, Slight dependency; 100, Independence
Baseline, Week 2, Week 5
exercise tolerance
Временное ограничение: Up to 5 weeks
The Borg RPE scale (Rating of Perceived Exertion, 6-20) is used: ranges from 6 (minimal effort) to 20 (maximum effort) and is often used to assess the intensity of effort in sports and rehabilitation. This scale is widely used in the medical and sports fields to monitor patients' perceived exertion during rehabilitation exercises or physical activities.
Up to 5 weeks
exercise tolerance
Временное ограничение: Up to 5 weeks
Heart rate measured with finger pulse oximeter with medically certified devices
Up to 5 weeks
Exercise Tolerance
Временное ограничение: Up to 5 weeks
Oxygen saturation measured with finger pulse oximeter with medically certified devices
Up to 5 weeks
Device Security
Временное ограничение: Up to 5 weeks
The number and description of any adverse events that occurred and were attributable to the use of the device will be collected.
Up to 5 weeks

Соавторы и исследователи

Здесь вы найдете людей и организации, участвующие в этом исследовании.

Спонсор

Marta Mondellini

Соавторы

University of Pisa
Istituti Clinici Scientifici Maugeri SpA
Villa Beretta Rehabilitation Center

Следователи

  • Главный следователь: Marta Mondellini, Psychologist, Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato
  • Главный следователь: Cira Fundarò, MD, Istituti Clinici Scientifici Maugeri IRCCS Montescano
  • Главный следователь: Christian Lunetta, MD, Istituti Clinici Scientifici Maugeri IRCCS Milano Camaldoli
  • Главный следователь: Stefania De Trane, MD, Istituti Clinici Scientifici Maugeri IRCCS Bari
  • Главный следователь: Laura Marcuccio, MD, Istituti Clinici Scientifici Maugeri IRCCS Telese
  • Главный следователь: Chiara Pavese, MD, Istituti Clinici Scientifici Maugeri IRCCS Pavia
  • Главный следователь: Franco Molteni, MD, Centro di Riabilitazione Villa Beretta
  • Главный следователь: Carmelo Chisari, MD, University of Pisa

Публикации и полезные ссылки

Лицо, ответственное за внесение сведений об исследовании, добровольно предоставляет эти публикации. Это может быть что угодно, связанное с исследованием.

Общие публикации

Даты записи исследования

Эти даты отслеживают ход отправки отчетов об исследованиях и сводных результатов на сайт ClinicalTrials.gov. Записи исследований и сообщаемые результаты проверяются Национальной медицинской библиотекой (NLM), чтобы убедиться, что они соответствуют определенным стандартам контроля качества, прежде чем публиковать их на общедоступном веб-сайте.

Изучение основных дат

Начало исследования (Оцененный)

1 июня 2026 г.

Первичное завершение (Оцененный)

1 декабря 2026 г.

Завершение исследования (Оцененный)

1 января 2027 г.

Даты регистрации исследования

Первый отправленный

15 мая 2026 г.

Впервые представлено, что соответствует критериям контроля качества

25 мая 2026 г.

Первый опубликованный (Действительный)

29 мая 2026 г.

Обновления учебных записей

Последнее опубликованное обновление (Действительный)

29 мая 2026 г.

Последнее отправленное обновление, отвечающее критериям контроля качества

25 мая 2026 г.

Последняя проверка

1 мая 2026 г.

Дополнительная информация

Термины, связанные с этим исследованием

Ключевые слова

Дополнительные соответствующие термины MeSH

Другие идентификационные номера исследования

  • VirtualPark_Adults
  • 0006095 PRE BIO CEN (Другой идентификатор: Comitato Etico Nazionale per le sperimentazioni degli Enti Pubblici di Ricerca)

Планирование данных отдельных участников (IPD)

Планируете делиться данными об отдельных участниках (IPD)?

НЕТ

Описание плана IPD

Individual participant data (IPD) will not be shared due to data protection and privacy constraints, and in accordance with applicable GDPR regulations and institutional policies.

Информация о лекарствах и устройствах, исследовательские документы

Изучает лекарственный продукт, регулируемый FDA США.

Нет

Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.

Нет

Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .

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