# Implementation of an Intervention Program Based on Virtual Walking and Therapeutic Exercise in Cuba: A Feasibility Study

## TL;DR

A new rehabilitation program combining virtual walking and exercise was tested in Cuba, showing promise for low-resource settings despite infrastructure challenges.

## Contribution

A feasible, low-cost rehabilitation protocol integrating virtual walking and therapeutic exercise was implemented in a low-resource setting.

## Key findings

- The program showed significant improvements in gait endurance among participants.
- High participant satisfaction was reported despite infrastructural and connectivity limitations.
- The protocol demonstrated adaptability and acceptability in a real-world setting.

## Abstract

Background/Objectives: This article presents the feasibility and preliminary outcomes of an international cooperation project between the University of Valencia (Spain) and the University and health authorities of Pinar del Río (Cuba), designed to implement and evaluate an innovative rehabilitation protocol. Aligned with the United Nations Sustainable Development Goals (SDGs 3, 4, and 10), the initiative aims to implement a low-cost, evidence-based rehabilitation program combining mirror-neuron stimulation via Virtual Walking and therapeutic exercise. Methods: The program included multidisciplinary meetings and both digital and on-site training for healthcare professionals, caregivers, and educators, aimed at strengthening local capacities in evidence-based practice. The transferred protocol consisted of Virtual Walking (10 min) and therapeutic exercise (30 min), implemented three times per week, for eight weeks. Outcomes assessed included gait speed and endurance (10-Minute Walking Test, 6-Minute Walking Test), lower limb function (Timed Up and Go Test), frailty status (Fried criteria), pain (Visual Analog Scale), and satisfaction with the training program. Pre-post comparisons were conducted using the Wilcoxon signed-rank test for continuous data. Results: The program was successfully implemented in two polyclinics with high levels of participant satisfaction. Eleven patients completed the program, showing significant improvements in gait endurance (p < 0.05), while lower limb function and pain did not change significantly. Noteworthily, severe infrastructural and connectivity limitations were found. Overall, results demonstrate the feasibility, adaptability, and acceptability of the proposed protocol, which integrates technological innovation, clinical training, and community engagement to promote health quality and equity. Conclusions: This project provides a replicable framework for rehabilitation initiatives in low-resource settings and demonstrates the potential to achieve meaningful clinical results.