Breaking Barriers in Rett Syndrome Rehabilitation: Innovative Technologies for Cognitive and Motor Treatment, from Tele-Rehabilitation to Virtual Reality and Serious Games

Abstract Rett Syndrome (RTT) is a rare and complex neurodevelopmental disorder that requires highly personalized and multidisciplinary rehabilitation approaches due to its profound cognitive, motor, and communicative impairments. Traditional rehabilitative methods, though essential, often face significant limitations, including restricted access, caregiver burden, and patient disengagement. This PhD thesis explores how innovative technologies—such as tele-rehabilitation, immersive virtual reality (VR), and serious games—can address these challenges by enhancing participation, motivation, and therapeutic outcomes. Through five experimental studies, the work demonstrates the feasibility and effectiveness of these tools in delivering consistent, engaging, and individualized cognitive and motor treatments for RTT. Starting with a telerehabilitation platform tailored for remote intervention, the research progresses to VR-based gait and upper limb training and concludes with the design of serious games for cognitive and language enhancement. These studies show that technological innovation not only overcomes traditional barriers but also contributes to neuroplasticity, functional improvement, and quality of life for individuals with RTT and their caregivers.