It's More than Just a Game: Exploring the Benefits of Mixed Reality on Cognition in a Stroke Case Series

Abstract

Background: The chronic manifestations of stroke are commonly multisystemic, affecting motor function, perception, cognition, and more. Conventional interventions have limitations when it comes to cost and their mundane nature, which are often perceived as boring. A high prevalence of risk factors has resulted in the adult population experiencing a stroke, many of whom require medical intervention, whose limitations strain both the patient and the healthcare system. Recently, extended reality (XR) has demonstrated promise as a rehabilitative aid for cognition, proprioception, and motor function following stroke without conventional therapy constraints. Methods: This case series explores the relationship between mixed reality (MR; one modality of XR) and cognitive performance in three post-stroke patients. Three post-stroke participants completed 12, one-hour MR training sessions over 4 weeks. Cognitive performance was assessed and changes were compared across three timepoints: baseline, immediately following the intervention, and following a 90-day washout period. Results: Participants demonstrated improvement in memory, executive function, and processing speed. Additionally, two out of the three participants demonstrated trends for improvement in attention and working memory. Conclusions: While these promising results tentatively suggest that 12 h of mixed reality training may yield cognitive improvement in post-stroke patients, a larger sample size is needed before drawing definitive conclusions.

Keywords: cognitive rehabilitation; mixed reality; neurorehabilitation; stroke recovery.

Figure 1

Outline of study timeline.

Figure 2

Scores for Participant A compared to age-corrected normative average in five cognitive domains and across three timepoints (baseline, immediate post-intervention assessment, and following a 90-day washout period). The dotted line represented the average age-corrected standard score for the participant’s age group.

Figure 3

Scores for Participant B compared to age-corrected normative average in five cognitive domains and across three timepoints (baseline, immediate post-intervention assessment, and following a 90-day washout period). The dotted line represented the average age-corrected standard score for the participant’s age group.

Figure 4

Scores for Participant C compared to age-corrected normative average in five cognitive domains and across three timepoints (baseline, immediate post-intervention assessment, and following a 90-day washout period). The dotted line represented the average age-corrected standard score for the participant’s age group.