Supplementary Material for: The Effectiveness of a Virtual Reality-Based Tai Chi Exercise on Cognitive and Physical Function in Older Adults with Cognitive Impairment

Background: Tai Chi (TC) is a Chinese mind-body exercise with proven physical and psychological benefits. A modified TC via virtual reality (VR) may be suitable for the elderly owing to the immediate guidance and feedback regarding movement accuracy. This study explored the cognitive and physical effects of a VR-based TC (VRTC) exercise program on older adults with cognitive impairment (CI). Methods: Sixty older adults with CI were cluster-assigned to either the VRTC or the control group; the intervention was conducted twice weekly for 6 months. Outcomes included cognitive and physical functions. The movement accuracy score and attendance were recorded. Generalized estimating equation (GEE) and multiple regression analyses were performed. Results: Adjusted GEE analysis showed significant interaction effects in the 6-min walk test, 30-s sit-to-stand test, functional reach, 5-m gait speed, and abstract thinking and judgment. Overall, medium to large effect sizes (d = 0.50–0.82) were found in favor of the VRTC group. The average movement accuracy score in the first 3 months significantly predicted improvement in cognitive performance (p = 0.011). Conclusions: The VRTC exercise posed a protective effect for some cognitive and physical functions in older adults with CI. The more engaging the program, the greater the improvement in the cognitive performance.