• Giuseppa Maresca, Maria Grazia Maggio, Antonio Buda, Gianluca La Rosa, Alfredo Manuli, Placido Bramanti, Rosaria De Luca, and Rocco Salvatore Calabrò.
• IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.
• Medicine (Baltimore). 2018 Dec 1; 97 (50): e13559.

RationaleAim of this study is to evaluate the cognitive and motor outcomes after a combined rehabilitative training using a standard cognitive approach and virtual reality (VR), in a patient with spinal cord injury (SCI).Patient's ConcernsA 60-year-old right-handed man, affected by incomplete cervical SCI, came to our observation for a moderate tetraparesis, mainly involving the left side, after about 6-months from the acute event. The neurological examination showed imbalance with upper limb incoordination, besides the paresis mainly involving the left side. At a neuropsychological evaluation, he presented important impairment in cognitive and behavioural status, with temporal and spatial disorientation, a reduction of attention and memory process, deficit of executive function and a severe depression of mood, which was not detected during the previous recovery.DiagnosisMotor and cognitive deficits in SCI.InterventionsThe patient was 1st submitted to standard cognitive training and traditional physiotherapy, and then to a combined therapeutic approach, in which virtual reality training was provided by means of the virtual reality rehabilitation system (VRRS, Khymeia, Italy).OutcomesAfter the combined therapeutic approach with the VRRS training, we observed a significant improvement in different cognitive domains, a notable reduction of anxiety and depressive symptoms, as well as motor performance, and balance improvement.LessonsVirtual reality can be considered a promising tool for the rehabilitation of different neurological disorders, including patients with both motor and cognitive deficits following SCI.

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