Date Presented 03/23/24
Cognitive remediation using a virtual reality (VR) platform with ecological environments and functional tasks is feasible in intensive care for people with serious mental illness (SMI) and improves functional capacity, participation, cognition, and symptom severity.
Primary Author and Speaker: LENA Lipskaya-Velikovsky
Contributing Authors: Reut Komemi, Hana Taubenblat, Dovrat Cohen
PURPOSE: Serious mental illness (SMI) affects people’s well-being and participation in daily life through, a mechanism of cognitive impairments. Ample evidence was found for cognitive remediation (CR) contribution for various outcomes in SMI. However, its effectiveness for promotion of participation has been little investigated. Virtual reality (VR) provides a platform for training functional tasks in an ecological environment, which could potentially overcome the limitations of CR. This study investigated feasibility and effectiveness of VR-based CR for improvement of functional capacity and participation among people with SMI in intensive care. Deign: Experimental with random allocation and convenience sampling.
METHOD: Forty-six individuals with SMI (schizophrenia: 52.2%; male: 79.2%; age: M=33.8, SD=8.7; and affective disorders: 47.8%; male: 40.9%; age: M=39, SD=13.4) completed 3-3.5 hours training with either VR- or pen-and-paper based CR. We used the Functional Brain Trainer (Intendu©), a body-controlled, interactive and adaptive tool with functional tasks and environments for training of range of cognitive skills. Pre-post assessment of cognition, functional capacity, symptoms severity and dimensions of participation was done using standard tools.
RESULTS: VR-based CR contributes to improvement in visual-motor skills, processing speed, memory and shifting (2<Z<2.89, p<.05), symptoms severity (-3.9<Z<-3.2, p<.001), functional capacity (-3<Z<-2.35, p<.01), participation diversity (t(22)= -2.9, p<.05) and satisfaction (Z=-1.9, p<.01), by diagnoses. Standard CR contributes to executive functions (Z=2.33, p<.05) and functional capacity (Z=-2.35, p<.05).
CONCLUSION: The study provides evidence for feasibility of short VR-based CR in intensive settings and its effectiveness for promotion of cognitive functioning, symptoms severity and participation.
IMPACT STATEMENT: The results suggest specific pathways for improvement range of health outcomes in SMI.
References
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