Xbox 360 Kinect Cognitive Games Improve Slowness, Complexity of EEG, and Cognitive Functions in Subjects with Mild Cognitive Impairment: A Randomized Control Trial

Abstract

Objectives: Physical activity and cognitive training are effective to enhance cognition in older patients with mild cognitive impairment (MCI). Xbox 360 Kinect cognitive games are a combination of physical activity and cognitive training. The objective of this study was to determine the short- and long-term effects of Xbox 360 Kinect cognitive games on slowness and complexity of electroencephalography (EEG) and cognitive functions in older subjects with MCI.

Materials and methods: A clinical trial was conducted on 44 MCI subjects. Both males and females were randomized into experimental group (participated in Xbox 360 Kinect cognitive games) and control group (range of motion exercises only and no Xbox 360 Kinect cognitive games). Subjects were assessed before and after one session of game intervention for short-term effects and after 6 weeks for long-term effects. The outcome measures were the mini-mental state examination (MMSE), Montreal cognitive assessment scale (MoCA), trail making test (TMT) A and B, and slowness and complexity of EEG.

Results: After one session of game intervention, delta (0.704 ± 0.025; P = 0.013), theta (0.128 ± 0.009; P = 0.00127) waves, and complexity of EEG (0.642 ± 0.042; P = 0.008) significantly improved, in eyes closed state. Whereas after 6 weeks intervention of games, delta (0.673 ± 0.029; P = 0.013), theta (0.129 ± 0.013; P = 0.002), beta2 waves (0.044 ± 0.009; P = 0.046), complexity of EEG (0.051 ± 0.042; P = 0.016), MMSE (26.25 ± 0.347 vs. 23.722 ± 0.731; P = 0.003), MoCA (25.65 ± 0.310 vs. 22.00 ± 0.504; P = 0.0001), TMT-A (1.429 ± 0.234 vs. 2.225 ± 0.259; P = 0.028), and TMT-B (2.393 ± 0.201 vs. 3.780 ± 0.195; P = 0.0001) improved significantly. These changes were not observed in the control group.

Conclusion: Xbox 360 Kinect games showed beneficial effects after short- and long-term intervention on MCI subjects. These games can serve as potential therapeutic candidates for MCI.

Keywords: Exergames; Mild cognitive impairment; Mini-mental state examination; Montreal cognitive assessment scale; Trail making test A and B.