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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.
Front Aging Neurosci. 2019; 11:162.FA

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.

Authors+Show Affiliations

Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31379553

Citation

Liao, Ying-Yi, et al. "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." Frontiers in Aging Neuroscience, vol. 11, 2019, p. 162.
Liao YY, Chen IH, Lin YJ, et al. 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. Front Aging Neurosci. 2019;11:162.
Liao, Y. Y., Chen, I. H., Lin, Y. J., Chen, Y., & Hsu, W. C. (2019). 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. Frontiers in Aging Neuroscience, 11, 162. https://doi.org/10.3389/fnagi.2019.00162
Liao YY, et al. 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. Front Aging Neurosci. 2019;11:162. PubMed PMID: 31379553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Liao,Ying-Yi, AU - Chen,I-Hsuan, AU - Lin,Yi-Jia, AU - Chen,Yue, AU - Hsu,Wei-Chun, Y1 - 2019/07/16/ PY - 2019/04/01/received PY - 2019/06/12/accepted PY - 2019/8/6/entrez PY - 2019/8/6/pubmed PY - 2019/8/6/medline KW - MCI KW - combined physical and cognitive training KW - dual-task gait KW - executive function KW - virtual reality SP - 162 EP - 162 JF - Frontiers in aging neuroscience JO - Front Aging Neurosci VL - 11 N2 - 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. SN - 1663-4365 UR - https://www.unboundmedicine.com/medline/citation/31379553/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_ DB - PRIME DP - Unbound Medicine ER -
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