Cognitive Training Using Fully Immersive, Enriched Environment Virtual Reality for Patients With Mild Cognitive Impairment and Mild Dementia: Feasibility and Usability Study

Abstract

Background Cognitive training using virtual reality (VR) may result in motivational and playful training for patients with mild cognitive impairment and mild dementia. Fully immersive VR sets patients free from external interference and thus encourages patients with cognitive impairment to maintain selective attention. The enriched environment, which refers to a rich and stimulating environment, has a positive effect on cognitive function and mood. Objective The aim of this study was to investigate the feasibility and usability of cognitive training using fully immersive VR programs in enriched environments with physiatrists, occupational therapists (OTs), and patients with mild cognitive impairment and mild dementia. Methods The VR interface system consisted of a commercialized head-mounted display and a custom-made hand motion tracking module. We developed the virtual harvest and cook programs in enriched environments representing rural scenery. Physiatrists, OTs, and patients with mild cognitive impairment and mild dementia received 30 minutes of VR training to evaluate the feasibility and usability of the test for cognitive training. At the end of the test, the usability and feasibility were assessed by a self-report questionnaire based on a 7-point Likert-type scale. Response time and finger tapping were measured in patients before and after the test. Results Participants included 10 physiatrists, 6 OTs, and 11 patients with mild cognitive impairment and mild dementia. The mean scores for overall satisfaction with the program were 5.75 (SD 1.00) for rehabilitation specialists and 5.64 (SD 1.43) for patients. The response time of the dominant hand in patients decreased after the single session of cognitive training using VR, but this was not statistically significant (P=.25). There was no significant change in finger tapping in either the right or left hand (P=.48 and P=.42, respectively). None of the participants reported headaches, dizziness, or any other motion sickness after the test. Conclusions A fully immersive VR cognitive training program may be feasible and usable in patients with mild cognitive impairment and mild dementia based on the positive satisfaction and willingness to use the program reported by physiatrists, OTs, and patients. Although not statistically significant, decreased response time without a change in finger tapping rate may reflect a temporary increase in attention after the test. Additional clinical trials are needed to investigate the effect on cognitive function, mood, and physical outcomes.

A Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Diagnostic Accuracy Study

“…We observed that owing to the visual content and interaction style through VR, most subjects found the task more interesting than traditional screening tools and were more willing to take the test. Yun et al [ 46 ] also reported elderly people's interest in VR. Implementation studies are needed in the future to evaluate its rollout in clinical practice.…”

CogniViTra, a Digital Solution to Support Dual-Task Rehabilitation Training

“…Table 1 presents relevant studies [3,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] related to the use of digital solutions to support physical activities or cognitive and physical activities with different purposes (i.e., postural control and prevention of falls [51,53,54,58,59,65], assistance in physical exercises [52,56,61], physical activity adherence [55], improvement of physical performance [58][59][60]63,64], and improvement of cognitive performance [3,57,60,62,64]). The studies are supported in various types of technologies, namely exergames and virtual reality [51,53,54,[57][58][59][60][61][62][63]…”

“…The studies are supported in various types of technologies, namely exergames and virtual reality [51,53,54,[57][58][59][60][61][62][63]65], robotics [52,56,61], and mobile devices [3]. In turn, some of these articles report interactions mechanisms based on the recognition of body movements (e.g., using Kinect [51,52,57,58,65], Nintendo Wii Fit [53], or wearable devices [59,60]), feet movements using step training platforms [54,63], or leg movements on a training bicycle [55]. When compared with stat-of-the-art technological solutions, the study reported by this article presents two important advantages: (i) support tools and clinical information integration and (ii) automatic quantification of patient's cognitive performance during dual-task training.…”

Aplicación de "serious games" en el tratamiento de la demencia: revisión sistemática

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