Mild cognitive impairment (MCI) is a pre-dementia state marked by a higher risk of conversion to dementia. Presently, strategies to delay the progression of MCI to dementia, such as routine exercise and cognitive activities, are limited and only moderately efficacious. Cognitive-motor dual task training, enhanced in a virtual reality environment, is a novel intervention for individuals with MCI.
A randomized controlled trial will be conducted. 54 patients with MCI will be recruited from an outpatient clinic. The participants will be randomly allocated to one of the three study arms. All three groups will participate in 2 training sessions per week for 7 weeks. Each session lasts 32 to 40 minutes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
54
For session 1 to 3, the training comprises of 4 cycles of the following: 2 min dual tasking, 2 min rest, 2 min dual tasking, 2 min rest. For session 4 to 6, the training comprises of 4 cycles of the following: 2.5 min dual tasking, 1.5 min rest, 2.5 min dual tasking, 1.5 min rest. For session 7 to 14, the training comprises of 4 cycles of the following: 3 min dual tasking, 1 min rest, 3 min dual tasking, 1 min rest. The treadmill speed is maintained at 40%, 50% and 60% of participant's original gait speed at session 1 to 3, 4 to 6, and 7 to 14 respectively. There are 10 levels in the VR game. Participant will start at level 1 of VR game at session 1 and can progress to the next level at the subsequent session if game percentage \> 80%.
For session 1 to 3, the training comprises of 4 cycles of the following: 2 min VR gaming, 2 min rest, 2 min VR gaming and 2 min rest. For session 4 to 6, the training comprises of 4 cycles of the following: 2.5 min VR gaming, 1.5 min rest, 2.5 min VR gaming and 1.5 min rest. For session 7 to 14, the training comprises of 4 cycles of the following: 3 min VR gaming, 1 min rest, 3 min VR gaming and 1 min rest. There are 10 levels in the VR game. Participant will start at level 1 of VR game at session 1 and can progress to the next level at the subsequent session if game percentage \> 80%.
Tan Tock Seng Hospital
Singapore, Singapore
RECRUITINGChange in dual-task gait cost measured using Optogait
Gait parameters collected include step length, single support time, double support time, step time, stride length, speed and cadence. Gait parameters are collected under both single and dual-task (serial seven subtraction and animal naming) conditions. Dual-task cost calculated as 100\*(single task parameter - dual-task parameter)/single task parameter
Time frame: Baseline, post-intervention after session 14 (week 7), 6 month
Change in dual-task cognitive cost measured using corrected response rate of cognitive tasks
Cognitive tasks include 30 seconds serial seven subtraction and animal naming, under both single and dual-task conditions (while walking)
Time frame: Baseline, post-intervention after session 14 (week 7), 6 month
Change in number of falls measured using a falls diary
Number of falls in the past 12 months
Time frame: Baseline, 6 month
Change in balance parameters and falls risk measured using Berg Balance Scale (BBS)
BBS is a 14-item tool which objectively assesses static balance and falls risk.
Time frame: Baseline, post-intervention after session 14 (week 7), 6 month
Change in falls risk measured using Timed Up and Go test (TUG)
TUG is a evaluative tool which assesses functional mobility and falls risk
Time frame: Baseline, post-intervention after session 14 (week 7), 6 month
Change in falls concerns scored using the Falls Efficacy Scale International (FES-I)
FES-I is a 16-item questionnaire used to measure the level of concern about falling during social and physical activities.
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For session 1 to 3, the training comprises of 4 cycles of the following: 8 min treadmill walking at 40% of participant's original gait speed followed by 2 min rest. For session 4 to 6, the training comprises of 4 cycles of the following: 8 min treadmill walking at 50% of participant's original gait speed followed by 2 min rest. For session 7 to 14, the training comprises of 4 cycles of the following: 8 min treadmill walking at 60% of the participant's original gait speed followed by 2 min rest.
Time frame: Baseline, post-intervention after session 14 (week 7), 6 month
Change in executive function measured using Chinese Frontal Assessment Battery
CFAB is brief tool used to assess frontal dysfunction via a series of neuropsychological tasks. A higher score indicates better performance with a total maximum of 18.
Time frame: Baseline, 6 month
Change in executive function scored using the Stroop color-word test - Victoria version (VST)
VST assess executive functioning using three conditions that consist in naming color of dots, of neutral words, and of color words printed in incongruent colors.
Time frame: Baseline, 6 month
Change in sustained and divided attention assessed using Color Trails Test 1 and 2
Color Trails Test is the language free version of Trails Making Test, developed for cross-cultural assessment of sustained and divided attention in adults
Time frame: Baseline, 6 month