Cognitive Integrated Motor Training to Improve Gait and Balance and Reduce Falls in Older Adults with Mild Cognitive Impairment - Falls are the second leading cause of unintentional injury deaths worldwide. Older adults with mild cognitive impairment (OaMCI) have an elevated fall risk, and the consequences tend to be more serious. Aging and cognitive impairment affect the sensorimotor and cognitive domains, leading to balance & gait deficits, decreased walking speed, control & coordination, and ultimately falls and limited community participation. The project goal is to improve balance & gait in OaMCI to reduce fall risk and facilitate improved quality of life and healthy aging through a novel personalized cognitive integrated motor training. Currently, fall-preventive interventions are multifactorial; targeting strength, flexibility, and endurance and have resulted in only modest improvements. Research suggests that training programs targeting motor and cognition together may be a better approach. Our objective is to incrementally increase the cognitive effort required to perform motor tasks in a game-playing setting using virtual reality/ mixed reality (VR/MR) to improve functional gait & balance in OaMCI. The project is an efficacy study (n=40) that uses customized VR/MR as a rehabilitative approach for inducing adaptive neuroplasticity. It comprehensively & objectively compares the effects of 4 weeks of personalized cognitive-motor VR/MR training (CM) with standard of care training (CTRL), using functional, biomechanical, neurophysiological, cognitive, and physical activity & community ambulation measures. Anticipated outcomes are improved functional balance & gait due to improved cognition, biomechanical characteristics, and neurophysiology, resulting in increased physical activity and community ambulation. The project aims to improve OaMCI gait & balance rehabilitation by shifting the focus from multifactorial motor-only training towards more comprehensive cognitive integrated motor training to better treat ambulation deficits, a major goal of NIDILRR.
