Evaluating The Impact Of VR-based Exergaming Systems On Cognitive And Mental Health In Trauma-exposed Veterans

PURPOSE: To examine the impact of a 3-week Virtual Reality Adventure Training Exergaming (V-RATE) intervention augmented by a 360-degree self-paced treadmill on cognitive and mental health outcomes among trauma-affected veterans. METHODS: Using a randomized controlled trial with a repeated measure design, participants were randomized into two groups: 1) a V-RATE intervention group (n = 6, Meanage = 29, SD = 3.09), and 2) a waitlist control group (n = 6, Meanage = 33, SD = 5.45). The intervention group completed six 30-minute sessions (twice/week), incorporating four VR rehab games (e.g., Nature Treks VR, Coin Rush). Cognitive function was assessed using the CANTAB® battery, including Multitasking Test ([MTT], executive function) and Motor Screening Task [MOT], attention/psychomotor speed). PTSD and anxiety were assessed via clinical-graded surveys, and Sagittal Abdominal Diameter (SAD) was measured to estimate central obesity and cardiometabolic risk. Heart rates was monitored to ensure implementation fidelity. RESULTS: Twelve Veterans (Meanage = 30.9, SD = 4.63, 58% female) completed the pre- and post-assessments, with 81.8% reporting at least one traumatic event (M = 2.63 SD = 2.46). SAD measures indicated that 66.7% of participants had elevated cardiometabolic risk. Results showed no significant group differences in brain and mental health outcomes at pre-assessment (Wilk’s Lambda = .846, F(2,6) = .545, p = .606). Heart rates were consistent (range: 100-112) with reduced session variability (SD reduced by 10) in the intervention group. The V-RATE was associated with reductions in PTSD symptoms (Mean_pre-PTSD = 19.5 vs. Mean_post-PTSD = 5; Cohen’s d = 21.33), and decreases in anxiety (Mean_pre-anxiety = 15.5 vs. Mean_post-anxiety = 2.5; Cohen’s d = 16.67). MTT scores showed larger mean changes in the intervention group compared to controls (Cohen’s d range: 33-98).The larger magnitude of the mean changes on PTSD (Meand = 14.5; Cohen’s d = 21.33) and anxiety (Meand = 13, Cohen’s d = 16.67) were also observed in the intervention group compared to the control group. CONCLUSIONS: This efficacy trial provided empirical evidence that VR-augmented exercise therapy for as little as 30 minutes per day can enhance cognitive function and reduce response errors among veterans with trauma experiences. Supported by: University of Texas at Arlington Research Enhancement Program