Effects of Virtual Reality-Based Physical and Cognitive Training on Executive Function and Dual-Task Gait Performance in Older Adults With Mild Cognitive Impairment: A Randomized Control Trial

Abstract

Background : Walking while performing cognitive and motor tasks simultaneously interferes with gait performance and may lead to falls in older adults with mild cognitive impairment (MCI). Executive function, which seems to play a key role in dual-task gait performance, can be improved by combined physical and cognitive training. Virtual reality (VR) has the potential to assist rehabilitation, and its effect on physical and cognitive function requires further investigation. The purpose of this study was to assess the effects of VR-based physical and cognitive training on executive function and dual-task gait performance in older adults with MCI, as well as to compare VR-based physical and cognitive training with traditional combined physical and cognitive training. Method : Thirty-four community-dwelling older adults with MCI were randomly assigned into either a VR-based physical and cognitive training (VR) group or a combined traditional physical and cognitive training (CPC) group for 36 sessions over 12 weeks. Outcome measures included executive function [Stroop Color and Word Test (SCWT) and trail making test (TMT) A and B], gait performance (gait speed, stride length, and cadence) and dual-task costs (DTCs). Walking tasks were performed during single-task walking, walking while performing serial subtraction (cognitive dual task), and walking while carrying a tray (motor dual task). The GAIT Up system was used to evaluate gait parameters including speed, stride length, cadence and DTCs. DTC were defined as 100 * (single-task gait parameters − dual-task gait parameters)/single-task gait parameters. Results : Both groups showed significant improvements in the SCWT and single-task and motor dual-task gait performance measures. However, only the VR group showed improvements in cognitive dual-task gait performance and the DTC of cadence. Moreover, the VR group showed more improvements than the CPC group in the TMT-B and DTC of cadence with borderline significances. Conclusion : A 12-week VR-based physical and cognitive training program led to significant improvements in dual-task gait performance in older adults with MCI, which may be attributed to improvements in executive function.

Group Similarity Constraint Functional Brain Network Estimation for Mild Cognitive Impairment Classification

“…Of these, the DMN had the most significant discriminative ability. Changes in these subnetworks were consistent with the results of previous cognitive function studies such as those on spatial attention (Rolle et al, 2017), executive function (Liao et al, 2019), and auditory function (Bi et al, 2018) that reference subnetworks in MCI patients. Moreover, the DMN has been regarded as the core part of a functional center (Liu et al, 2019) that is involved in episodic memory and is thought to be the major cognitive domain impaired during early-stage AD (Eyler et al, 2019).…”

Group Similarity Constraint Functional Brain Network Estimation for Mild Congititive Impairment Classification

“…Especially, the DMN had the most significant discriminative ability. The changes of these subnetworks were consistent with the results of previous studies on cognitive function (i.e., spatial attention (Rolle et al 2017), executive function (Liao et al 2019)and auditory function (Bi et al 2018)) corresponding to subnetworks in MCI patients.…”

Virtual Reality-Based Cognitive Stimulation to Improve Cognitive Functioning in Community Elderly: A Controlled Study

“…3 This has motivated researchers to develop cognitive interventions for the elderly with the aim of improving cognitive performance in both normal and pathological aging. 4,5 Such interventions rely on the principles of neuroplasticity, which imply that cognitive stimulation in enriched environments will lead to the structural or functional reorganization of the brain, which in turn is crucial to support the ability to learn new skills and behaviors. Evidence of neuroplasticity following cognitive training has also been found in studies with healthy older adults 5 and individuals with mild cognitive impairment.…”