Improving cognitive function after brain injury: the use of exercise and virtual reality.
ABSTRACT To assess the impact of exercise and virtual reality (VR) on the cognitive rehabilitation of persons with traumatic brain injury (TBI).
Before-after trial assessed cognitive function after a 4-week intervention program. A random allocation crossover assessed changes in reaction and movement times after a single bout of VR exercise and a no-exercise control condition.
Brain injury rehabilitation unit in Edinburgh, Scotland.
(1) Four-week intervention: a consecutive sample of 13 suitable TBI adults were compared to control populations (n > 25) of previous TBI patients of similar age, severity, and time postinjury. (2) Single-bout intervention: a consecutive sample of 13 suitable adults with moderate TBI, 6.29 to 202.86 weeks postinjury.
Nonimmersive VR exercise.
(1) Tests of attention, information processing, learning, and memory. (2) Reaction and movement times.
After the 4-week intervention patients performed significantly better than controls on the digit symbol (p < .01). verbal (p < .01), and visual learning tasks (p < .05). Significant improvements in reaction times (p < .01) and movement times (p < .05) were gained following a single bout of VR exercise.
Exercising in a virtual environment offers the potential for significant gains in cognitive function.
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ABSTRACT: A web-based virtual environment in the use of community facilities like automatic teller machine (ATM), mass transit railway (MTR), and convenient store was designed for assessment and training in people with cognitive disabilities in Hong Kong. A previous study in people with acquired brain injury (ABI) has shown that virtual environment can facilitate the generalization of learned skills to real life. The objective of this study was to examine the usability of a newly designed virtual reality (VR) environment that stimulated the operation of automatic teller machine (ATM) for training in the healthy older persons. Methods: 126 participants, who were healthy older people, resided in community dwellings, were consecutively recruited by convenience sampling from a regional elderly social centre – the ELCHK Shatin Multi-service Centre for the Elderly in Hong Kong in one year. All participants received a two hour group training session for a total of 2 sessions, 2 hours per session, at the ELCHK Shatin Multi-service Centre for the elderly over one year period. They were trained by a qualified IT instructor using the VR-ATM programme for cash withdrawals, money transfers and electronic bill payment tasks. Results: Significant differences were found in average reaction time, total time use, and correctness before and after training in the VR-ATM. There was also improvement in self-efficacy in using the ATM in real life. Conclusion: We found the VR-ATM to be usable as a valid assessment and training tool for relearning the use of ATMs prior to real-life practice in the healthy elderly population. Web-based VR system, which can be openly accessed anywhere through the internet, is important for training skills in a protective environment, increasing the confidence of clients, and providing training opportunities for people with or without cognitive disabilities prior to real-life practice in the community.Social Research in Transport (SORT) Clearinghouse.
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ABSTRACT: Grounded in social facilitation theory, this study compared the impact on exercise intensity of a virtual versus a live competitor, when riding a virtual reality-enhanced stationary bike ("cybercycle"). It was hypothesized that competitiveness would moderate effects. Twenty-three female college students were exposed to three conditions on a cybercycle: solo training, virtual competitor, and live competitor. After training without a competitor (solo condition for familiarization with equipment), participants competed against a virtual avatar or live rider (random order of presentation). A repeated-measures analysis revealed a significant condition (virtual/live) by competitiveness (high/low) interaction for exercise intensity (watts). More competitive participants exhibited significantly greater exercise intensity when competing against a live versus virtual competitor. The implication is that live competitors can have an added social facilitation effect and influence exercise intensity, although competitiveness moderates this effect.Journal of Sport and Exercise Psychology 04/2012; 34(2):252-9. · 2.45 Impact Factor
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ABSTRACT: Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or "exergames" may elicit greater participation. To test the following hypotheses: (1) stationary cycling with virtual reality tours ("cybercycle") will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase. Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function in older adults. Data were collected in 2008-2010; analyses were conducted in 2010-2011. 102 older adults from eight retirement communities enrolled; 79 were randomized and 63 completed. A recumbent stationary ergometer was utilized; virtual reality tours and competitors were enabled on the cybercycle. Executive function (Color Trails Difference, Stroop C, Digits Backward); clinical status (mild cognitive impairment; MCI); exercise effort/fitness; and plasma BDNF. Intent-to-treat analyses, controlling for age, education, and cluster randomization, revealed a significant group X time interaction for composite executive function (p=0.002). Cybercycling yielded a medium effect over traditional exercise (d=0.50). Cybercyclists had a 23% relative risk reduction in clinical progression to MCI. Exercise effort and fitness were comparable, suggesting another underlying mechanism. A significant group X time interaction for BDNF (p=0.05) indicated enhanced neuroplasticity among cybercyclists. Cybercycling older adults achieved better cognitive function than traditional exercisers, for the same effort, suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline. This study is registered at Clinicaltrials.gov NCT01167400.American journal of preventive medicine 02/2012; 42(2):109-19. · 4.24 Impact Factor