Improving cognitive function after brain injury: The use of exercise and virtual reality

Objective: To assess the impact of exercise and virtual reality (VR) on the cognitive rehabilitation of persons with traumatic brain injury (TBI). Design: Before-after trial assessed cognitive function after a 4-week inter vention program. A random allocation crossover assessed changes in reaction and movement times after a single bout of VR exercise and a no-exercise co ntrol condition. Setting: Brain injury rehabilitation unit in Edinburgh, Scotland. Patients: (1) Four-week intervention: a consecutive sample of 13 suitable T BI adults were compared to control populations (n > 25) of previous TBI pat ients of similar age, severity, and time postinjury. (2) Single-bout interv ention: a consecutive sample of 13 suitable adults with moderate TBI, 6.29 to 202.86 weeks postinjury. Intervention: Nonimmersive VR exercise. Main Outcome Measures: (1) Tests of attention, information processing, lear ning, and memory. (2) Reaction and movement times. Results: After the 4-week intervention patients performed significantly bet ter than controls on the digit symbol (p <.01), verbal (p <.01), and visual learning tasks (p <.05). Significant improvements in reaction times (p <.0 1) and movement times (p <.05) were gained following a single bout of VR ex ercise. Conclusion: Exercising in a virtual environment offers the potential for si gnificant gains in cognitive function. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.