- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06155721
Development and Evaluation of Virtual Reality Experiences for Cognitive Stimulation at the Sociosanitary Center El Carme (RTCSSC)
Desarrollo y evaluación de Experiencias en Realidad Virtual Para la estimulación Cognitiva en el Centro Sociosanitario El Carme de Badalona Servicios Asistenciales (BSA)
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.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
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
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Barcelona
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Badalona, Barcelona, Spain, 08917
- Centro Socio Sanitario El Carmen
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Participants must be classified as having mild cognitive impairment with a Mini-Mental State Examination (MMSE) score greater than 23.
- Participants must be currently attending cognitive rehabilitation sessions at the Day Hospital of the Centro Sociosanitario El Carme (CSSC).
- Participants must be able to give informed consent or, in the case of incapacity, consent must be obtained from their legal representative.
Exclusion Criteria:
- Patients with a severe or unstable illness that could interfere with participation in the study.
- Patients with serious psychiatric disorders, such as psychotic disorders, delusions, or hallucinations that may be exacerbated by the use of virtual reality.
- Patients with severe visual limitations that would prevent the use of virtual reality.
- Presence of ocular diseases causing blurred vision that cannot be corrected with contact lenses or glasses.
- Presence of auditory pathologies that cause a significant decrease in hearing without hearing aids.
- High sensitivity to motion sickness.
- Subjects with epilepsy.
- Patients who are unable or unwilling to give informed consent.
Withdrawal Criteria
The emergence of health problems that could interfere with the continuity of participation in the study, or the withdrawal of consent by the participant.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Virtual Reality Cognitive Stimulation Program
Participants with MCI undergo 8 VR sessions, using Oculus Quest 2 headsets for immersive cognitive exercises. Activities include a Supermarket Shopping Task for memory, a Payment Task for cognitive flexibility, and a Recipe Sequencing Task for problem-solving. Additionally, 360-degree videos with visuo-verbal stimulation are used to engage attention and episodic memory, monitored by therapists. The investigators employ Oculus Quest 2 VR headsets with hand tracking technology to provide a seamless and immersive experience, especially beneficial for participants with Mild Cognitive Impairment (MCI). |
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.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Comfort of VR Headset as Measured by an 8-Item SUS:
Time Frame: immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Adapted 8-Item VR Headset Comfort Rating: Score Range: 0 to 100 points Interpretation: Lower scores indicate better comfort (as most items measure discomfort). |
immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Usability of VR Exercises as Measured by an Adapted 8-Item System Usability Scale (SUS)
Time Frame: immediately post-intervention, within 30 minutes after the last intervention session- 8th session (day 8)
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Adapted 8-Item System Usability Scale (SUS): Score Range: 0 to 100 points Interpretation: Higher scores indicate better usability. |
immediately post-intervention, within 30 minutes after the last intervention session- 8th session (day 8)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Professional´s Usability of VR Exercises as Measured by an Adapted 8-Item SUS:
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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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.
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Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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VR Headset Comfort Rating for Professionals as Measured by an Adapted 3-Item SUS:
Time Frame: immediately post-intervention, within 30 minutes after the 8th session (day 8)
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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.
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immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Global Cognition as Measured by the Mini-Mental State Examination (MMSE)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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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
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Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Global Cognition as Measured by the Montreal Cognitive Assessment (MoCA)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
|
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 |
Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Short-Term Memory as Measured by the Digit Span Test (DST Forward Span)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Forward Digit Span measures verbal short-term memory. Score Range: 0 to 9 points - Higher scores indicate better short-term verbal memory. |
Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Working Memory as Measured by the Digit Span Test (DST Backward Span)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Backward Digit Span assesses working memory and mental manipulation.
Score Range: 0 to 9 points.
Higher scores indicate better working memory.
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Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Visuospatial Attention as Measured by the Trail Making Test Part A (TMT-A)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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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. |
Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Executive Function as Measured by the Trail Making Test Part B (TMT-B)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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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. |
Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Processing Speed as Measured by the Symbol Digit Modalities Test (SDMT)
Time Frame: Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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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. |
Baseline and immediately post-intervention, within 30 minutes after the 8th session (day 8)
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Demographics Variables
Time Frame: Baseline
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Age: numeric
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Baseline
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Demographics Variables
Time Frame: Baseline
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Gender: 0=female, 1=male, 3=others
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Baseline
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jose Ferrer Costa, MD, Medical Researcher and Project Manager
Publications and helpful links
General Publications
- Munoz J, Mehrabi S, Li Y, Basharat A, Middleton LE, Cao S, Barnett-Cowan M, Boger J. Immersive Virtual Reality Exergames for Persons Living With Dementia: User-Centered Design Study as a Multistakeholder Team During the COVID-19 Pandemic. JMIR Serious Games. 2022 Jan 19;10(1):e29987. doi: 10.2196/29987.
- Bauer ACM, Andringa G. The Potential of Immersive Virtual Reality for Cognitive Training in Elderly. Gerontology. 2020;66(6):614-623. doi: 10.1159/000509830. Epub 2020 Sep 9.
- Liao YY, Chen IH, Lin YJ, Chen Y, Hsu WC. Effects of Virtual Reality-Based Physical and Cognitive Training on Executive Function and Dual-Task Gait Performance in Older Adults With Mild Cognitive Impairment: A Randomized Control Trial. Front Aging Neurosci. 2019 Jul 16;11:162. doi: 10.3389/fnagi.2019.00162. eCollection 2019.
- Gomez-Caceres B, Cano-Lopez I, Alino M, Puig-Perez S. Effectiveness of virtual reality-based neuropsychological interventions in improving cognitive functioning in patients with mild cognitive impairment: A systematic review and meta-analysis. Clin Neuropsychol. 2023 Oct;37(7):1337-1370. doi: 10.1080/13854046.2022.2148283. Epub 2022 Nov 23.
- Papaioannou T, Voinescu A, Petrini K, Stanton Fraser D. Efficacy and Moderators of Virtual Reality for Cognitive Training in People with Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2022;88(4):1341-1370. doi: 10.3233/JAD-210672.
- Perra A, Riccardo CL, De Lorenzo V, De Marco E, Di Natale L, Kurotschka PK, Preti A, Carta MG. Fully Immersive Virtual Reality-Based Cognitive Remediation for Adults with Psychosocial Disabilities: A Systematic Scoping Review of Methods Intervention Gaps and Meta-Analysis of Published Effectiveness Studies. Int J Environ Res Public Health. 2023 Jan 14;20(2):1527. doi: 10.3390/ijerph20021527.
- Qiu R, Gu Y, Xie C, Wang Y, Sheng Y, Zhu J, Yue Y, Cao J. Virtual reality-based targeted cognitive training program for Chinese older adults: A feasibility study. Geriatr Nurs. 2022 Sep-Oct;47:35-41. doi: 10.1016/j.gerinurse.2022.06.007. Epub 2022 Jul 12.
- Zuschnegg J, Schoberer D, Haussl A, Herzog SA, Russegger S, Ploder K, Fellner M, Hofmarcher-Holzhacker MM, Roller-Wirnsberger R, Paletta L, Koini M, Schussler S. Effectiveness of computer-based interventions for community-dwelling people with cognitive decline: a systematic review with meta-analyses. BMC Geriatr. 2023 Apr 12;23(1):229. doi: 10.1186/s12877-023-03941-y.
- Journal of Medical Extended RealityVol. 2, No. 1 Published Online: 21 March 2025 Virtual Reality in Cognitive Rehabilitation: A Pilot Study on Usability and Preliminary Clinical Outcomes in Seniors with Mild Cognitive Impairment Authors: Jose Ferrer Costa, Maria Jose Ciudad, Maribel González Abad, and José Luis Rodríguez García
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PI-23-195
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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