Efficacy of Mixed Reality Motor-Cognitive Exercise Interventions

A two‐arm randomized controlled trial was conducted with ≥30 older adults aged 60+ withcognitive frailty during the winter semester of 2026.This study aimed to enroll a minimum of 30 community‐dwelling older adults with cognitivefrailty to participate in this study, which took place in School of Kinesiologyfacilities from February 16 to May 8, 2026.Participants in the intervention group engaged in an 8‐week MR‐MCT intervention,consisting of two 45‐minute MR‐MCT sessions per week, starting from March 13 through May2.Participants in the active comparison group engaged in an 8‐week Tai Chi andmulticomponent exercise group sessions, one 45‐minute Tai Chi group session, and one45‐minute multicomponent exercise group session each week, starting from March 10 throughApril 30.The study outcomes were assessed at baseline and post‐intervention assessment. 1. Cognitive function: The participant's cognitive function including attention,memory, processing speed, and executive function was measured by taking theNIH‐Toolbox Cognition Battery Fluid test. 2. Physical function: The participant's physical function including gait speed,lower‐extremity strength, and balance was assessed by taking the Short PhysicalPerformance Battery test. 3. Daily physical activity minutes: The participant's daily physical activity minuteswere objectively measured by wearing the ActiGraph activity monitor for 7 days in arow at the baseline and the end of the intervention. A minimum wear time of 10hours/day four days a week will be required for analysis. 4. Demographics: age, sex, race/ethnicity, education, marital status, and healthconditions were collected from each participant. 5. Biomarkers of Exercise Outcomes in Blood (optional for participants). Blood sampleswere obtained by venipuncture at baseline and the post‐intervention test. Each blooddraw will be no more than 5 ml. The total volume of blood drawn over the entirestudy period will be no more than 10 ml. 6. Feasibility was measured by using recruitment rates, adherence rates, and retentionrates measured during and at the end of the interventions. Additionally, eachparticipant will complete the Assessing Acceptability, and Appropriateness, andFeasibility of the Intervention Questionnaire, consisting of 12 questions rated on a5‐point Likert scale.Descriptive statistics for demographic information and the study outcomes were conductedfirst. To examine the effects of the interventions on cognitive function, physicalfunction, and daily physical activity minutes, repeated measures ANOVA was performedwithin subjects (time: baseline vs. post‐intervention tests) and between groups (MR‐MCTgroup vs. active comparison group). Additionally, recruitment, adherence, and retentionrates were calculated by means of percentage, respectively. All data analysis wasperformed using the IBM SPSS statistics 30.0 version with a significant level set as α≤0.5.