# The cognitive and motor effects of immersive virtual reality in individuals with neurocognitive disorder: randomized controlled trial protocol

## TL;DR

This study tests if immersive virtual reality games can improve thinking and movement in older adults with early brain disorders.

## Contribution

A novel randomized trial comparing IVR games to traditional exercises for mild neurocognitive disorder.

## Key findings

- IVR games may improve cognitive and motor function non-pharmacologically.
- IVR games could be an affordable and accessible rehab option for older adults.
- VRG participants are expected to show greater improvements than the exercise group.

## Abstract

•IVR games can enhance cognitive and motor training in mild neurocognitive disorders.•IVR games support cognitive and motor function non-pharmacologically.•Combining fun and rehab to boost motivation and tech inclusion in older adults.•IVR games offer an affordable and accessible option for middle-income countries.•IVR Games may help delay Alzheimer’s in mild neurocognitive disorder.

IVR games can enhance cognitive and motor training in mild neurocognitive disorders.

IVR games support cognitive and motor function non-pharmacologically.

Combining fun and rehab to boost motivation and tech inclusion in older adults.

IVR games offer an affordable and accessible option for middle-income countries.

IVR Games may help delay Alzheimer’s in mild neurocognitive disorder.

To assess the cognitive and motor effects of an intervention utilizing commercial immersive virtual reality (IVR) games in older adults diagnosed with mild neurocognitive disorder (mild NCD) or mild major neurocognitive disorder and compare these effects with those of a motor-cognitive integrated exercise program.

This randomized controlled trial will include volunteers aged 60 years and older diagnosed with mild NCD or mild major NCD. Participants will be randomly assigned to two groups, each undergoing two 45-minute sessions weekly for seven weeks. The Virtual Reality Group (VRG) will engage in six IVR games, while the Exercise Group (EG) will perform integrated motor-cognitive exercises. Outcomes will be measured using the mini-BESTest, Dynamic Gait Index, Box and Block Test, 1-minute sit-to-stand test, Grip Strength Test, Neurocognitive Battery, Word Accentuation Test, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Montreal Cognitive Assessment, and Functional Activities Questionnaire. Sample size calculation indicates 32 participants (16 per group) to achieve 80 % power with α = 0.05, accounting for 20 % attrition. The trial is registered at the Brazilian Clinical Trials Registry (RBR-2kk9vnh).

It is hypothesized that participants in the VRG will demonstrate greater improvements in cognitive and motor performance compared to the EG.

This study aims to determine whether commercial IVR games can serve as effective cognitive and motor interventions for individuals with mild NCD or mild major NCD.