# Sex Differences in Elderly Multiple Sclerosis Patients Undergoing Neurorehabilitation: How Many Things are Taken for Granted? A Retrospective Study

## TL;DR

This study explores how gender affects cognitive rehabilitation outcomes in elderly multiple sclerosis patients using robotics and virtual reality.

## Contribution

The study introduces new insights into gender-specific responses to advanced neurorehabilitation techniques in elderly MS patients.

## Key findings

- The experimental group showed significantly better cognitive and functional outcomes compared to the control group.
- Women in the experimental group demonstrated stronger cognitive improvements as measured by MoCA scores.
- Males and females in the experimental group experienced significant improvements across all domains, unlike the control group.

## Abstract

Our aim is to evaluate the intricate dynamics of gender differences in cognitive rehabilitation outcomes among older adults with MS undergoing cognitive rehabilitation using robotics plus virtual reality.

This retrospective study included 80 RRMS patients aged >60 years, matched for demographic and clinical variables and divided into two groups. The experimental group (EG, n = 40) received Lokomat Free-D training with VR integration, while the control group (CG, n = 40) underwent traditional rehabilitation. Cognitive, functional, and emotional outcomes were assessed before and after treatment.

Intergroup analysis revealed significantly greater improvements in the EG compared to the CG in MoCA (P < 0.001 in males, P = 0.001 in females), FIM (P = 0.02 in females), and HRS-A (P = 0.01 in males, P = 0.005 in females). Within-group analyses showed that both males and females in the EG experienced significant improvements across all domains (P < 0.001), but in the CG, improvements were more limited, particularly in mood scores. Notably, a positive correlation between MoCA and gender was found in EG (r = 0.47; P = 0.002), suggesting stronger cognitive gains among women.

Our results provide preliminary data on the influence of gender differences on neurological rehabilitation outcomes, which should be evaluated and taken into due consideration to personalize and improve rehabilitation treatment.