VR Hand Exercises: Impact on Cognition and Dexterity in MCI

NCT ID: NCT07005271

Last Updated: 2025-06-05

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-06-16
• Study Completion Date: 2026-03-26

Brief Summary

This study aims to investigate the effects of virtual reality (VR)-based hand exercises on cognitive functions and hand skills in older adults with mild cognitive impairment (MCI). Cognitive functions will be assessed by measuring brain activity using functional near-infrared spectroscopy (fNIRS) during the Stroop test. Additionally, hand functions will be evaluated using the Minnesota Manual Dexterity Test, grip strength measurement (via a Jamar dynamometer), and the Duruöz Hand Index. Hand dominance will be determined using the Edinburgh Handedness Inventory, and sociodemographic data will be collected through a form prepared by the researcher. Based on a G*Power analysis, a total of 30 participants-15 in each group-will be included in the study, with an effect size of 1.00094 and a power of 80%. Evaluations will be conducted twice, before and after the intervention. To avoid participant fatigue, assessments will be divided over two days. The intervention group will receive VR-based hand exercises twice a week for six weeks. These exercises will include activities such as MasterChef (cutting, mixing, and grasping in a virtual kitchen), PinchPeg (placing pegs using pinch grip), HoldAndPut (transporting cups or cans), and bPuzzle (color matching and puzzle completion). The control group will perform traditional exercises twice a week for six weeks, including 30-50 piece puzzle completion, the Nine-Hole Peg Test, shape cutting, and number-color matching tasks. The study will be conducted with volunteer participants at the Istanbul Metropolitan Municipality Darülaceze Directorate, and written and verbal informed consent will be obtained from all participants in accordance with the principles of the Declaration of Helsinki.

Conditions

Mild Cognitive Impairment (MCI)

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

virtual reality

Participants in this group will perform hand exercises using virtual reality. They will complete task-oriented hand exercises resembling activities of daily living through the ErgoActive system, which consists of four different games.

Group Type: EXPERIMENTAL

virtual reality

Intervention Type: BEHAVIORAL

The exercises in this group consist of four different games, including: (1) MasterChef, which involves performing daily living tasks in a virtual kitchen environment such as slicing tomatoes and cheese, adding salt, cracking and adding eggs, and stirring with a fork to prepare an omelet; (2) PinchPeg, where participants use a pinch grip to grasp rods generated in the center of a virtual environment and place them into holes on a pegboard, followed by removing and returning them to their original location; (3) Hold and Put, which requires the use of a standard palmar grasp to pick up virtual cups or cans and place them onto designated shelves; and (4) bPuzzle, a task that integrates cognitive and fine motor exercises by requiring participants to change the color of a puzzle using finger movements and place the pieces into the correct positions using hand gestures.

Conventional treatment

Participants in this group will perform exercises involving hand skills used in daily life. These exercises will be similar to those in the virtual reality group but will be carried out in their real-life form.

Group Type: ACTIVE_COMPARATOR

Conventional treatment

Intervention Type: BEHAVIORAL

Participants will be asked to complete puzzles consisting of 30 to 50 pieces, with 3 to 4 different puzzles used to eliminate the learning effect. They will perform the Nine-Hole Peg Test, which is similar to the PinchPeg game in the virtual reality group, by picking up pegs one by one from a container and placing them into holes on the board as quickly as possible using only the evaluated hand; this will be used for training purposes. Additionally, participants will be instructed to cut out geometric shapes with dotted outlines using scissors, aiming to follow the lines accurately. Finally, they will sort objects by placing the correct number and color of items into designated locations according to a predetermined pattern, and use a magnetic fishing rod to catch wooden fish, promoting both fine motor skills and task-oriented hand function.

Interventions

virtual reality

The exercises in this group consist of four different games, including: (1) MasterChef, which involves performing daily living tasks in a virtual kitchen environment such as slicing tomatoes and cheese, adding salt, cracking and adding eggs, and stirring with a fork to prepare an omelet; (2) PinchPeg, where participants use a pinch grip to grasp rods generated in the center of a virtual environment and place them into holes on a pegboard, followed by removing and returning them to their original location; (3) Hold and Put, which requires the use of a standard palmar grasp to pick up virtual cups or cans and place them onto designated shelves; and (4) bPuzzle, a task that integrates cognitive and fine motor exercises by requiring participants to change the color of a puzzle using finger movements and place the pieces into the correct positions using hand gestures.

Intervention Type: BEHAVIORAL

Conventional treatment

Participants will be asked to complete puzzles consisting of 30 to 50 pieces, with 3 to 4 different puzzles used to eliminate the learning effect. They will perform the Nine-Hole Peg Test, which is similar to the PinchPeg game in the virtual reality group, by picking up pegs one by one from a container and placing them into holes on the board as quickly as possible using only the evaluated hand; this will be used for training purposes. Additionally, participants will be instructed to cut out geometric shapes with dotted outlines using scissors, aiming to follow the lines accurately. Finally, they will sort objects by placing the correct number and color of items into designated locations according to a predetermined pattern, and use a magnetic fishing rod to catch wooden fish, promoting both fine motor skills and task-oriented hand function.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Aged between 65 and 75 years.
• Diagnosed with mild cognitive impairment by the institution's physician during routine examination.
• Ability to understand and follow verbal instructions.

Exclusion Criteria

• Presence of neurodegenerative diseases affecting cognitive functions.
• Auditory or visual impairments that could interfere with rehabilitation implementation and communication.
• Upper extremity disorders, including severe shoulder, elbow, wrist, or finger impairments, bilateral elbow, hand or wrist fractures, or advanced rheumatoid arthritis.
• Participation in any rehabilitation program during the study period.

• Minimum Eligible Age: 65 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Istinye University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Berrak Varhan

Role: STUDY_CHAIR

Istinye University

Central Contacts

lizge beyaztaş

Role: CONTACT

lizgebm@hotmail.com

+905372320930

References

Park JH. Effects of Cognitive-Physical Dual-Task Training on Executive Function and Activity in the Prefrontal Cortex of Older Adults with Mild Cognitive Impairment. Brain Neurorehabil. 2021 Sep 13;14(3):e23. doi: 10.12786/bn.2021.14.e23. eCollection 2021 Nov.

Reference Type: BACKGROUND

PMID: 36741221 (View on PubMed)

Liao YY, Tseng HY, Lin YJ, Wang CJ, Hsu WC. Using virtual reality-based training to improve cognitive function, instrumental activities of daily living and neural efficiency in older adults with mild cognitive impairment. Eur J Phys Rehabil Med. 2020 Feb;56(1):47-57. doi: 10.23736/S1973-9087.19.05899-4. Epub 2019 Oct 15.

Reference Type: BACKGROUND

PMID: 31615196 (View on PubMed)

Other Identifiers

24-326

Identifier Type: -

Identifier Source: org_study_id