Accepted for/Published in: JMIR Serious Games
Date Submitted: Feb 6, 2020
Date Accepted: Sep 16, 2020
Cognitive Training Using Fully Immersive Enriched Environment Virtual Reality in Patients with Mild Cognitive Impairment and Mild Dementia: A Feasibility and Usability Study
ABSTRACT
Background:
Cognitive training using virtual reality (VR) may result in motivational and playful training in patients with mild cognitive impairment (MCI) 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 on enriched environments in physiatrists, occupational therapists (OTs) and patients with MCI and mild dementia.
Methods:
The VR interface system consisted of a commercialized head mount 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 MCI and mild dementia received 30 min 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 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 MCI and mild dementia. The overall satisfaction of the program score was 5.75 ± 1.00 in rehabilitation specialists and 5.64 ± 1.43. The response time of the dominant hand in patients decreased after the a single session of cognitive training using VR, but this was not statistically significant (P =.248). There was no significant change in finger tapping in either the right or left hand (P =.476 and P =.424, 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 MCI and mild dementia based on physiatrists, OTs, and patients’ positive satisfaction and their willingness to use the program. Although not statistically significant, a decreased response time without changing the rate of finger tapping 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.
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