Feasibility of a culturally adapted virtual reality cognitive rehabilitation program (COVERT) delivered via a hybrid model for stroke survivors in Singapore: A pilot study
TL;DR
A single-arm feasibility pilot study found that VR-based cognitive rehabilitation delivered through an experienced occupational therapy-led hybrid model is feasible and potentially effective for post-stroke cognitive impairment in Singapore.
Abstract
Virtual reality (VR) is an emerging modality for cognitive rehabilitation, but evidence in Singapore is limited. This pilot study examined the feasibility and preliminary effectiveness of a localized cognitive VR-based training program (COVERT) for individuals with post-stroke cognitive impairment, delivered using a hybrid model. Nine participants (mean age = 54.0, SD = 10.0) were recruited from Hospital A and Hospital B over 19 months. Participants completed a 4-week VR program through tele-rehabilitation and conventional therapy. This single-arm feasibility pilot study assessed feasibility, cognitive function (Montreal Cognitive Assessment, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT)), health-related quality of life (EuroQol Five-Dimension Questionnaire), usability (System Usability Scale), and motivation (Intrinsic Motivation Inventory, Virtual Reality Neuroscience Questionnaire). Feasibility was high with 100% retention. RBANS total scores improved significantly (73.4–78.9, p = 0.020), with all participants showing delayed memory gains. Processing speed improved (TMT-A) and there was a trend toward better executive function (TMT-B). EuroQuol-5D scores increased. Usability was moderate and declined with age, while motivation remained high. Recruitment was challenging. VR-based cognitive rehabilitation delivered through an experienced occupational therapy-led hybrid model is feasible and potentially effective for post-stroke cognitive impairment in Singapore. Larger trials are warranted to establish efficacy.