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

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.