VR Hand Exercises: Impact on Cognition and Dexterity in MCI

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)

Interventions

BEHAVIORAL

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.

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.

Sponsors & Collaborators

• Istinye University

  lead OTHER

Principal Investigators

• Berrak Varhan · Istinye University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-10-16

Primary Completion

2026-01-25

Completion

2026-02-26

Countries

• Turkey (Türkiye)

Study Locations