A Pilot Study of the Effect of Repeated Practice in Virtual Reality on Everyday Action Performance in Real Life

INTRODUCTION: In a prior case study of moderate dementia due to Alzheimer's disease, repeated performance of everyday tasks in a virtual environment demonstrated transfer of improvement in real world cooking tasks. The present pilot study sought to replicate and extend these findings by employing similar virtual training for improving real everyday task performance in older adults with various levels of cognitive and functional impairment. METHODS: Older participants (N = 6; age range = 66-93; six women, two men) with self-reported cognitive/functional decline underwent daily virtual reality (VR) training sessions on one of two different everyday tasks (i.e., Breakfast or Lunch) for 1 week. Baseline and post-training (within 48 hours of the last day of training and at 1 month post training) testing was done with real objects for both trained and comparable untrained tasks. Reliable change indices for each training outcome (i.e., task accomplishment, time to completion, time per step, overt errors, micro-errors) were calculated for each follow up. RESULTS: Significant improvement in the speed at which task steps were accomplished, time to completion, task accomplishment, or errors were noted in five of the six participants. The one participant who did not show improvement on the trained task showed significant declines on only the untrained task. CONCLUSIONS: Our results demonstrate the feasibility of training in a virtual environment, with transfer of improvement to real tasks, suggesting the potential of VR training for precluding functional disability in older adults with various levels of cognitive/functional impairment.