The goal of this clinical trial is to test a virtual reality (VR)-based program designed for cognitive stimulation in individuals attending the conventional cognitive rehabilitation program at the Day Hospital of CSSC (Centro Sociosanitario El Carme) in Badalona, Spain. The trial will specifically assess VR's impact on declarative memory and executive functions through interactive exercises, as well as attention and episodic memory through VR video stimuli. The main questions it aims to answer are: * Will patients with mild cognitive impairment find the VR program enjoyable and easy to use? * Can VR interventions help improve patients' cognitive functions, specifically attention and memory? * Do healthcare professionals find VR a practical tool for cognitive stimulation in their clinical practice? Participants will undergo a series of 8 sessions, scheduled twice a week to coincide with the conventional rehabilitation appointments. The VR equipment used will be Oculus Quest 2 headsets, offering an immersive experience with hand-tracking technology that simplifies interactions, particularly beneficial for those with mild cognitive impairment (MCI). During the study, participants will: * Engage with a VR-based cognitive stimulation program. * Undergo assessments of the participants´ cognitive functions before and after the intervention. * Provide feedback on the participants´ experience with the VR program. Researchers will analyze the data to see if: * The VR program leads to noticeable improvements in the cognitive abilities of participants. * The program is well-received and deemed beneficial by both patients and healthcare professionals.
Background: Cognitive impairment affects a significant portion of the aging population, leading to challenges in daily functioning and a reduced quality of life. Traditional cognitive rehabilitation techniques have shown benefits, but patient engagement and adherence remain challenging. Innovations such as virtual reality (VR) offer new avenues for cognitive stimulation, potentially enhancing patient involvement and treatment outcomes. Study Design: This clinical trial aims to evaluate the acceptability and efficacy of a VR-based cognitive stimulation program among patients with mild to moderate cognitive impairment at Centro Sociosanitario El Carme in Badalona. It will employ a pretest-posttest design to assess cognitive changes, utilizing standardized cognitive scales and gathering qualitative feedback on user experience. Objectives: Primary Objective: To assess the acceptability of the VR-based cognitive stimulation program among patients with mild to moderate cognitive impairment. Secondary Objectives: To evaluate whether the VR interventions are perceived as engaging and motivating by the patients, which would suggest positive adherence to the cognitive stimulation program. To measure changes in cognitive performance, particularly in attention and memory, pre- and post-intervention, to determine the effectiveness of the program. To understand healthcare professionals' perceptions of the applicability of VR interventions in clinical practice for cognitive stimulation. To identify potential improvements for the implementation of the VR program based on patient and healthcare staff feedback. To gather data that could be useful for the development of future VR experiences aimed at patients with cognitive impairments. Methodology: Participants will be recruited from the Centro Sociosanitario El Carme and will undergo an initial assessment to establish a cognitive baseline. The participants will then engage in a series of VR sessions designed to provide cognitive stimulation. The program will focus on exercises to enhance attention and memory, incorporating interactive elements to maintain engagement. After completing the sessions, participants will be re-assessed using the same cognitive scales. Feedback on the VR experience will be collected through structured interviews and questionnaires to gauge acceptability, perceived usefulness, and motivation. Healthcare professionals involved in the administration of the VR program will also be interviewed to understand their views on the integration of VR into therapeutic practices. Expected Outcomes: It is hypothesized that the VR program will be well-received by patients, evidenced by high rates of program completion and positive subjective feedback. Post-intervention improvements in cognitive scale scores are expected, indicating the potential efficacy of VR-based stimulation. Insights from healthcare professionals are anticipated to highlight the practicality of VR in clinical settings and suggest improvements for future applications. Relevance: The findings from this trial could support the adoption of VR technologies in cognitive rehabilitation, offering a novel, scalable, and potentially more effective approach to managing cognitive impairments. The study may also contribute to the evidence base required for integrating technological innovations into standard healthcare practice. Conclusion: By exploring the intersection of VR technology and cognitive rehabilitation, this study seeks to advance the understanding of innovative treatments for cognitive impairments and foster improved patient outcomes through enhanced engagement and stimulation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
45
Intervention Type: Device Intervention Name: Virtual Reality Cognitive Stimulation Program Description: This program utilizes virtual reality to conduct cognitive stimulation exercises aimed at improving memory, executive functions, and attention in individuals with Mild Cognitive Impairment (MCI). It includes interactive tasks such as virtual shopping, payment simulations, and recipe sequencing, along with 360-degree video sessions for attention and episodic memory training.
Centro Socio Sanitario El Carmen
Badalona, Barcelona, Spain
Usability of VR Exercises as Measured by an Adapted 8-Item System Usability Scale (SUS)
Adapted 8-Item System Usability Scale (SUS): Score Range: 0 to 100 points Interpretation: Higher scores indicate better usability.
Time frame: immediately post-intervention, within 30 minutes after the last intervention session- 8th session (day 8)
Comfort of VR Headset as Measured by an 8-Item SUS:
Adapted 8-Item VR Headset Comfort Rating: Score Range: 0 to 100 points Interpretation: Lower scores indicate better comfort (as most items measure discomfort).
Time frame: immediately post-intervention, within 30 minutes after the 8th session (day 8)
Professional´s Usability of VR Exercises as Measured by an Adapted 8-Item SUS:
Scale Title: Professional System Usability Scale (SUS) Score Range: 0 to 100 points Interpretation: Higher scores indicate a professional's perception of better system usability for patient care.
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
VR Headset Comfort Rating for Professionals as Measured by an Adapted 3-Item SUS:
Scale Title: Professional System Usability Scale (SUS) Score Range: 0 to 100 points Interpretation: Higher scores indicate better comfort and ease of use for the VR headset; lower scores indicate greater discomfort and difficulty with use. This rating is based on a professional assessment of the VR headset's weight, design, and control scheme's impact on patient comfort during use.
Time frame: immediately post-intervention, within 30 minutes after the 8th session (day 8)
Global Cognition as Measured by the Mini-Mental State Examination (MMSE)
MMSE is a 30-point questionnaire evaluating orientation, attention, recall, language, and visual construction Score Range: 0 to 30 points. Higher scores means better global cognition function
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
Global Cognition as Measured by the Montreal Cognitive Assessment (MoCA)
MoCA is a 30-point screening tool for global cognitive function, assessing memory, attention, language, visuospatial skills, and executive function. Score Range: 0 to 30 points \- Higher scores means better global cognition function
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
Short-Term Memory as Measured by the Digit Span Test (DST Forward Span)
Forward Digit Span measures verbal short-term memory. Score Range: 0 to 9 points \- Higher scores indicate better short-term verbal memory.
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
Working Memory as Measured by the Digit Span Test (DST Backward Span)
Backward Digit Span assesses working memory and mental manipulation. Score Range: 0 to 9 points. Higher scores indicate better working memory.
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
Visuospatial Attention as Measured by the Trail Making Test Part A (TMT-A)
TMT-A measures visual attention and processing speed. The outcome is time to completion measured in seconds, typically ranging from several seconds to several minutes. Lower times (faster completion) indicate better visuospatial attention.
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
Executive Function as Measured by the Trail Making Test Part B (TMT-B)
TMTB: Trial Making Test B. Score Range: Time to complete the test measured in seconds, typically ranging from several seconds to several minutes. Lower times (faster completion) indicate better alternating attention.
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
Processing Speed as Measured by the Symbol Digit Modalities Test (SDMT)
SDMT: Symbol Digit Modalities Test. The Symbol Digit Modalities Test (SDMT) measures processing speed, attention, and visual-motor coordination. During the test, participants are required to match abstract symbols with corresponding numbers using a key. The total raw score is calculated as the number of correct symbol-digit pairs completed within a 90-second interval. There is no fixed maximum score, as it varies based on individual performance. Higher scores indicate better processing speed and cognitive performance.
Time frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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