Virtual Reality Dual Task Training in SCI: Effects on Cognition and Cortical Activation

Participants will perform the game consisting of 3 different stages during one session. The motor task will include crossing the street between cars and walking on the sidewalk without hitting people. The difference between the stages will be the cognitive task, which becomes more difficult with each stage. The cognitive task in the first stage of the game will involve the colors that the patient will see and the simultaneous sound of the colors. The cognitive task in the second stage of the game will involve writing the names of some colors with black paint and reading them simultaneously. In the third stage of the game, the patient will see color names written with some colors. Every 5 seconds a new match will appear and the number of errors made during the matches will be recorded. In addition, upper extremity strengthening with PNF methods such as hold relaxation, rhythmic stabilization and repetitive stretches will be studied.

The difference of this group from the first group is that they will see that they provide mobility with a wheelchair instead of walking, which is a motor task. In this case, there will be no motor imagery of walking. Simultaneously with the game, an environment where the wheelchair can move safely will be created in order to prevent symptoms such as dizziness and nausea in the patients and the wheelchair will be moved in this environment by the researcher. The difference between the stages will be the cognitive task that becomes more difficult at each stage and it will take a total of 20 minutes to complete all stages of the game. In addition, upper extremity strengthening will be practiced with PNF methods of hold and relax, rhythmic stabilization and repetitive stretches.

The patients in the group will be applied only the resistance band strengthening methods including the upper extremity proprioceptive neuromuscular facilitation (PNF) patterns and methods applied as standard in rehabilitation. Strengthening will be worked on in all upper extremity PNF patterns using the resistance band with the PNF methods of hold-relax, rhythmic stabilization and repetitive stretching.