Using a Virtual Reality Serious Game to Assess the Performance of Older Adults with Frailty

Memory, cognition, executive functioning, and spatial cognition loss are prevalent in the normal aging process, but these impairments are observed more extensively in individuals with dementia, specifically Alzheimer’s disease. To improve the impaired functions, serious games targeting the lost functions are commonly developed and used in training programs. In this study, we designed a virtual reality driving simulator (VRDS) as a serious game with different difficulty levels for improving the spatial cognition; we evaluated it on 11 participants with different levels of dementia for two weeks, every day except weekends (10 sessions of practice in total) and 30 min/day. We assessed the participants’ spatial cognition before and after the intervention by an independent assessment (the VR replica of Morris Water test) and also by their performance playing the VRDS during the intervention. We also assessed the participants’ mood by a standard depression scale as well as their plausible experience of simulation sickness. The results showed significant improvement in Morris water test. The participants’ normalized correct trajectory (to find the target) was improved significantly by 44.4% at post-intervention with respect to baseline. Furthermore, on average, the participants progressed to higher (more challenging) levels of the game, and their spatial learning score increased throughout the sessions. Their mood also showed improvement with respect to baseline. Overall, the results hold promise for the designed VRDS as a mood-lifting and enhancing spatial skills serious game for older adults if it is played regularly. Trial Registry name: Investigating the Effect of Training with a Virtual Reality Driving Simulator URL: https://clinicaltrials.gov/ct2/show/NCT04074655 Clinical Trials.gov ID: NCT04074655

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Virtual Reality Exercise as a Coping Strategy for Health and Wellness Promotion in Older Adults during the COVID-19 Pandemic

Journal of Clinical Medicine ◽

10.3390/jcm9061986 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1986 ◽

Cited By ~ 3

Author(s):

Zan Gao ◽

Jung Eun Lee ◽

Daniel J. McDonough ◽

Callie Albers

Keyword(s):

Physical Activity ◽

Older Adults ◽

Virtual Reality ◽

Health Outcomes ◽

Intervention Strategy ◽

Effective Intervention ◽

World Health ◽

Motor Ability ◽

Health Crisis ◽

Wellness Promotion

The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. Thus, given the secular increases in the older adult population, novel and effective intervention strategies are necessary to improve physical activity behaviors and health in this population. Virtual reality (VR)-integrated exercise is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. Therefore, the purpose of this editorial is to synthesize recent research examining the efficacy and effectiveness of VR exercise in the promotion of favorable health outcomes among the older adults. Results indicate the application of VR exercise to facilitate improved physical outcomes (e.g., enhanced motor ability, reduced obesity), cognition and psychological outcomes. VR exercise has also been observed to be an effective intervention strategy for fall prevention in this population. Future research should employ more rigorous research designs to allow for a more robust quantitative synthesis of the effect of VR exercise on the preceding outcomes to elucidate which type(s) of VR-based PA interventions are most effective in promoting improved health outcomes among older adults. Findings from this study will better inform the development of technology-savvy PA programs for wellness promotion in older adults who practice social distancing and exercise from home under the unprecedented global health crisis.

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Combining tDCS With a Motor-Cognitive Task to Reduce the Negative Impact of Dual-Tasking on the Gait of Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.921 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 287-288

Author(s):

Jeffrey Hausdorff ◽

Nofar Schneider ◽

Marina Brozgol ◽

Pablo Cornejo Thumm ◽

Nir Giladi ◽

...

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Executive Function ◽

Dual Task ◽

Gait Speed ◽

Negative Impact ◽

Virtual Reality Environment ◽

Dual Tasking ◽

Concurrent Performance ◽

Dual Task Cost

Abstract The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p<0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p>0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.

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Interrogating Social Virtual Reality as a Communication Medium for Older Adults

Proceedings of the ACM on Human-Computer Interaction ◽

10.1145/3359251 ◽

2019 ◽

Vol 3 (CSCW) ◽

pp. 1-24 ◽

Cited By ~ 4

Author(s):

Steven Baker ◽

Ryan M. Kelly ◽

Jenny Waycott ◽

Romina Carrasco ◽

Thuong Hoang ◽

...

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Communication Medium

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Virtual reality video game improves high-fidelity memory in older adults

Scientific Reports ◽

10.1038/s41598-021-82109-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Peter E. Wais ◽

Melissa Arioli ◽

Roger Anguera-Singla ◽

Adam Gazzaley

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Video Game ◽

Cognitive Abilities ◽

Environmental Enrichment ◽

Cognitive Intervention ◽

Therapeutic Interventions ◽

Placebo Control ◽

Long Term Memory ◽

High Fidelity

AbstractTherapeutic interventions have not yet been shown to demonstrate restorative effects for declining long-term memory (LTM) that affects many healthy older adults. We developed a virtual reality (VR) spatial wayfinding game (Labyrinth-VR) as a cognitive intervention with the hypothesis that it could improve detailed, high-fidelity LTM capability. Spatial navigation tasks have been used as a means to achieve environmental enrichment via exposure to and learning about novel and complex information. Engagement has been shown to enhance learning and has been linked to the vitality of the LTM system in the brain. In the current study, 48 older adults (mean age 68.7 ± 6.4 years) with average cognitive abilities for their age were randomly assigned to 12 h of computer game play over four weeks in either the Labyrinth-VR or placebo control game arms. Promptly before and after each participant’s treatment regimen, high-fidelity LTM outcome measures were tested to assess mnemonic discrimination and other memory measures. The results showed a post-treatment gain in high-fidelity LTM capability for the Labyrinth-VR arm, relative to placebo, which reached the levels attained by younger adults in another experiment. This novel finding demonstrates generalization of benefits from the VR wayfinding game to important, and untrained, LTM capabilities. These cognitive results are discussed in the light of relevant research for hippocampal-dependent memory functions.

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Immersive virtual reality as physical therapy in older adults: present or future (systematic review)

Virtual Reality ◽

10.1007/s10055-020-00495-x ◽

2021 ◽

Author(s):

Pablo Campo-Prieto ◽

José María Cancela ◽

Gustavo Rodríguez-Fuentes

Keyword(s):

Systematic Review ◽

Older Adults ◽

Virtual Reality ◽

Physical Therapy ◽

Immersive Virtual Reality

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Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review

Journal of Technology in Behavioral Science ◽

10.1007/s41347-021-00195-6 ◽

2021 ◽

Author(s):

Josca Van Houwelingen-Snippe ◽

Somaya Ben Allouch ◽

Thomas J. L. Van Rompay

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Technological Development ◽

Intervention Strategy ◽

Well Being ◽

Rapid Review ◽

Health Concern ◽

Psychological Processes ◽

Care Needs ◽

Representations Of Nature

Abstract Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.

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Virtual reality intervention to improve apathy in residential aged care: protocol for a multisite non-randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-046030 ◽

2021 ◽

Vol 11 (2) ◽

pp. e046030

Author(s):

Dimitrios Saredakis ◽

Hannah A D Keage ◽

Megan Corlis ◽

Tobias Loetscher

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Passive Control ◽

Aged Care ◽

Residential Aged Care ◽

Laptop Computer ◽

Reminiscence Therapy ◽

Increased Risk ◽

Secondary Outcomes

IntroductionApathy is a prevalent neuropsychiatric symptom for older adults residing in aged care. Left untreated, apathy has been associated with accelerated cognitive decline and increased risk of mortality. Reminiscence therapy is commonly used in aged care and has demonstrated to reduce apathy. Traditional methods of reminiscence use physical objects and more recently technology including tablets and laptop computers have demonstrated potential. Virtual reality (VR) has successfully been used to treat psychological disorders; however, there is little evidence on using VR for behavioural symptoms such as apathy in older adults. Using VR to deliver reminiscence therapy provides an immersive experience, and readily available applications provide access to a large range of content allowing easier delivery of therapy over traditional forms of therapy. This study aims to identify changes in apathy after a reminiscence therapy intervention using head-mounted displays (HMDs).Methods and analysisParticipants will be allocated to one of three groups; reminiscence therapy using VR; an active control using a laptop computer or physical items and a passive control. A total of 45 participants will be recruited from residential aged care (15 in each group). The three groups will be compared at baseline and follow-up. The primary outcome is apathy, and secondary outcomes include cognition and depression. Side effects from using HMDs will also be examined in the VR group. Primary and secondary outcomes at baseline and follow-up will be analysed using linear mixed modelling.Ethics and disseminationEthics approval was obtained from the University of South Australia Human Research Ethics Committee. The results from this study will be disseminated through manuscript publications and national/international conferences.Trial registration numberACTRN12619001510134.

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Short- and long-term learning of job interview with a serious game in virtual reality: influence of eyestrain, stereoscopy, and apparatus

Virtual Reality ◽

10.1007/s10055-021-00548-9 ◽

2021 ◽

Author(s):

Alexis D. Souchet ◽

Stéphanie Philippe ◽

Aurélien Lévêque ◽

Floriane Ober ◽

Laure Leroy

Keyword(s):

Virtual Reality ◽

Serious Game ◽

Job Interview ◽

Short And Long Term

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Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students’ learning outcome about approach to coma

BMC Medical Education ◽

10.1186/s12909-021-02771-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Meysam Siyah Mansoory ◽

Mohammad Rasool Khazaei ◽

Seyyed Mohsen Azizi ◽

Elham Niromand

Keyword(s):

Virtual Reality ◽

Medical Students ◽

Learning Outcomes ◽

Learning Outcome ◽

Serious Game ◽

Control Group ◽

Serious Gaming ◽

E Learning ◽

The Mean ◽

Lecture Instruction

Abstract Background New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma. Methods We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students’ learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software. Results Students’ familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = − 2.457, P = 0.019). Conclusion Students’ learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students’ learning.

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