Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study
Background: The society is aging in China, and the cognitive level of elderly post-stroke patients gradually declines. Face-to-face cognitive functional training is no longer sufficient. Immersive virtual reality (IVR) is a promising rehabilitation training device. In this study, we developed an IVR...
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MDPI AG
2022-12-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/13/1/79 |
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| author | Zhilan Liu Zhijie He Jing Yuan Hua Lin Conghui Fu Yan Zhang Nian Wang Guo Li Jing Bu Mei Chen Jie Jia |
| author_facet | Zhilan Liu Zhijie He Jing Yuan Hua Lin Conghui Fu Yan Zhang Nian Wang Guo Li Jing Bu Mei Chen Jie Jia |
| author_sort | Zhilan Liu |
| collection | DOAJ |
| description | Background: The society is aging in China, and the cognitive level of elderly post-stroke patients gradually declines. Face-to-face cognitive functional training is no longer sufficient. Immersive virtual reality (IVR) is a promising rehabilitation training device. In this study, we developed an IVR-based puzzle game to explore its effectiveness, feasibility, and safety in elderly stroke patients with cognitive dysfunction. Methods: A total of 30 patients with mild post-stroke cognitive impairment after stroke were randomly assigned to a control or IVR group. Patients in both groups received routine rehabilitation therapy. Patients in the control group received traditional cognitive training, and those in the IVR group received IVR-based puzzle game therapy. Before and after treatment, Montreal cognitive assessment (MOCA), trail-making test-A (TMT-A), digit symbol substitution test (DSST), digital span test (DST), verbal fluency test (VFT), and modified Barthel index (MBI) were evaluated in both groups. In addition, the IVR group was administered a self-report questionnaire to obtain feedback on user experience. Results: There was no significant difference in the baseline data between the two groups. After six weeks of treatment, the cognitive assessment scores were improved in both groups. Moreover, the IVR group showed more improvements than the control group in the DSST (Z = 2.203, <i>p</i> = 0.028 < 0.05, <i>η</i><sup>2</sup> = 0.16); MOCA (T = 1.186, <i>p</i> = 0.246 > 0.05, d = 0.44), TMT-A (T = 1.791, <i>p</i> = 0.084 > 0.05, d = 0.65), MBI (T = 0.783, <i>p</i> = 0.44 > 0.05, d = 0.28), FDST (Z = 0.78, <i>p</i> = 0.435 > 0.05, <i>η</i><sup>2</sup> = 0.02), BDST (Z = 0.347, <i>p</i> = 0.728 > 0.05, <i>η</i><sup>2</sup> = 0.004), and VFT(Z = 1.087, <i>p</i> = 0.277 > 0.05, <i>η</i><sup>2</sup> = 0.039) did not significantly improve. The significant difference in DSST represents an improvement in executive function and visual–spatial cognitive characteristics. The other assessment scores did not show such features. Therefore, we did not observe significant differences through this measure. According to the results of the self-report questionnaire, most of the patients were satisfied with the equipment stability and training content. Several individuals reported mild adverse reactions. Conclusions: This pilot study suggests that IVR-based puzzle games are a promising approach to improve post-stroke cognitive function, especially executive cognitive function, and visual–spatial attention in older adults. |
| first_indexed | 2024-03-09T13:23:11Z |
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| id | doaj.art-4670a0c3d2a341c8892f53c5f6f341a3 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T13:23:11Z |
| publishDate | 2022-12-01 |
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| series | Brain Sciences |
| spelling | doaj.art-4670a0c3d2a341c8892f53c5f6f341a32023-11-30T21:27:20ZengMDPI AGBrain Sciences2076-34252022-12-011317910.3390/brainsci13010079Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot StudyZhilan Liu0Zhijie He1Jing Yuan2Hua Lin3Conghui Fu4Yan Zhang5Nian Wang6Guo Li7Jing Bu8Mei Chen9Jie Jia10Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, ChinaDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, ChinaDepartment of Geriatric Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai 200040, ChinaDepartment of Geriatric Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai 200040, ChinaShanghai Jinshan Zhongren Aged Care Hospital, Shanghai 201501, ChinaNational Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, ChinaDepartment of Geriatric Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai 200040, ChinaDepartment of Geriatric Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai 200040, ChinaDepartment of Geriatric Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai 200040, ChinaShanghai Jinshan Zhongren Aged Care Hospital, Shanghai 201501, ChinaDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, ChinaBackground: The society is aging in China, and the cognitive level of elderly post-stroke patients gradually declines. Face-to-face cognitive functional training is no longer sufficient. Immersive virtual reality (IVR) is a promising rehabilitation training device. In this study, we developed an IVR-based puzzle game to explore its effectiveness, feasibility, and safety in elderly stroke patients with cognitive dysfunction. Methods: A total of 30 patients with mild post-stroke cognitive impairment after stroke were randomly assigned to a control or IVR group. Patients in both groups received routine rehabilitation therapy. Patients in the control group received traditional cognitive training, and those in the IVR group received IVR-based puzzle game therapy. Before and after treatment, Montreal cognitive assessment (MOCA), trail-making test-A (TMT-A), digit symbol substitution test (DSST), digital span test (DST), verbal fluency test (VFT), and modified Barthel index (MBI) were evaluated in both groups. In addition, the IVR group was administered a self-report questionnaire to obtain feedback on user experience. Results: There was no significant difference in the baseline data between the two groups. After six weeks of treatment, the cognitive assessment scores were improved in both groups. Moreover, the IVR group showed more improvements than the control group in the DSST (Z = 2.203, <i>p</i> = 0.028 < 0.05, <i>η</i><sup>2</sup> = 0.16); MOCA (T = 1.186, <i>p</i> = 0.246 > 0.05, d = 0.44), TMT-A (T = 1.791, <i>p</i> = 0.084 > 0.05, d = 0.65), MBI (T = 0.783, <i>p</i> = 0.44 > 0.05, d = 0.28), FDST (Z = 0.78, <i>p</i> = 0.435 > 0.05, <i>η</i><sup>2</sup> = 0.02), BDST (Z = 0.347, <i>p</i> = 0.728 > 0.05, <i>η</i><sup>2</sup> = 0.004), and VFT(Z = 1.087, <i>p</i> = 0.277 > 0.05, <i>η</i><sup>2</sup> = 0.039) did not significantly improve. The significant difference in DSST represents an improvement in executive function and visual–spatial cognitive characteristics. The other assessment scores did not show such features. Therefore, we did not observe significant differences through this measure. According to the results of the self-report questionnaire, most of the patients were satisfied with the equipment stability and training content. Several individuals reported mild adverse reactions. Conclusions: This pilot study suggests that IVR-based puzzle games are a promising approach to improve post-stroke cognitive function, especially executive cognitive function, and visual–spatial attention in older adults.https://www.mdpi.com/2076-3425/13/1/79immersive virtual realitystrokepost-stroke cognitive impairmentaging |
| spellingShingle | Zhilan Liu Zhijie He Jing Yuan Hua Lin Conghui Fu Yan Zhang Nian Wang Guo Li Jing Bu Mei Chen Jie Jia Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study Brain Sciences immersive virtual reality stroke post-stroke cognitive impairment aging |
| title | Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study |
| title_full | Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study |
| title_fullStr | Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study |
| title_full_unstemmed | Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study |
| title_short | Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study |
| title_sort | application of immersive virtual reality based puzzle games in elderly patients with post stroke cognitive impairment a pilot study |
| topic | immersive virtual reality stroke post-stroke cognitive impairment aging |
| url | https://www.mdpi.com/2076-3425/13/1/79 |
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