Effects of Immersive Virtual Reality Puzzle Solving Video Games on Cognition, Motor Control, and Functional Behavior in People with Schizophrenia Spectrum Disorders

The purpose of this study was to examine the effects of immersive virtual reality puzzle-solving videogame (IVRPSVG) training on improving cognition, motor control, and functional behavior in people with Schizophrenia Spectrum Disorder (SSD). This study was carried out with a randomized control and a pre-posttest design. There was a total of 22 participants (12 in the experimental group and 10 in the control group). The experimental group received IVRPSVG training for 12 weeks, three times a week, and 30 to 40 min each time. The control group received work activities intervention. The outcome measures include Color Trails Test one and two (CTT1 &2), Left-hand and Right-hand Box and Block Test (BBTR and BTTL), Timed Up and Go Test (TUG), and Functional Reach Test (FRT). A repeated measured two-way analysis of covariance was used to test whether the training in this study caused significant changes with SPSS 23.0 statistical software package. Statistically significant differences were determined at $p < 0.05$. The statistical analysis results showed that IVRPSVG was effective in (1) shortening the time spent on CTT1 ($p=0.01$), and (2) improving the performance in BBTL and TUG ($p=0.01,\ p=0.01$). There was no significant difference in functional behavior between the groups. This result indicated that IVRPSVG had a significant effect on the cognitive-motor integration ability (including path-motor skills, perceptual tracking, number sorting, and sustained attention), upper and left-hand gross motor manipulation, and lower-extremity motor control in patients with SSD. In addition, the work activities training also improved the cognition and motor control of the upper and lower extremities. The improvement in cognition and movement obtained by 12 weeks of training was not sufficient to reflect the changes in cognition and motor control in changes of functional behavior.