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Clinical Trial ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Aging Neurosci. | doi: 10.3389/fnagi.2019.00162

Effects of virtual reality-based physical and cognitive training on executive function and dual-task gait performance in elderly individuals with mild cognitive impairment: a randomized control trial

 Yingyi Liao1, I-Hsuan Chen2, Yi-Jia Lin3,  Yue Chen3 and  Weichun Hsu3*
  • 1National Taipei University of Nursing and Health Sciences, Taiwan
  • 2Fooyin University, Taiwan
  • 3National Taiwan University of Science and Technology, Taiwan

Background: Performing cognitive and motor tasks simultaneously interferes with gait performance and may lead to falls in elderly individuals 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 elderly individuals 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 cost (DTC). Gait performance was evaluated during single-task walking, walking while performing serial subtraction (cognitive dual task), and walking while carrying a tray (motor dual task).
Results: Both groups showed significant improvements on 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 better performance than the CPC group in the TMT-B and DTC of cadence. Conclusion: A 12-week VR-based physical and cognitive training program led to significant improvements in dual-task gait performance in elderly individuals with MCI, which may be attributed to improvements in executive function.

Keywords: Mild Cognitive Impairment, virtual reality, Executive Function, ombined physical and cognitive training, dual-task gait,

Received: 01 Apr 2019; Accepted: 12 Jun 2019.

Edited by:

Helena Blumen, Albert Einstein College of Medicine, United States

Reviewed by:

Markus A. Hobert, University of Kiel, Germany
Mark Speechley, University of Western Ontario, Canada  

Copyright: © 2019 Liao, Chen, Lin, Chen and Hsu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Weichun Hsu, National Taiwan University of Science and Technology, Taipei City, 106, Taipei County, Taiwan, wchsu@mail.ntust.edu.tw