OBJECTIVE: To assess the impact of exercise and virtual reality (VR) on the cognitive rehabilitation of persons with traumatic brain injury (TBI). DESIGN: Before-after trial assessed cognitive function after a 4-week intervention program. A random allocation crossover assessed changes in reaction and movement times after a single bout of VR exercise and a no-exercise control condition. SETTING: Brain injury rehabilitation unit in Edinburgh, Scotland. PATIENTS: (1) Four-week intervention: a consecutive sample of 13 suitable TBI adults were compared to control populations (n > 25) of previous TBI patients of similar age, severity, and time postinjury. (2) Single-bout intervention: a consecutive sample of 13 suitable adults with moderate TBI, 6.29 to 202.86 weeks postinjury. INTERVENTION: Nonimmersive VR exercise. MAIN OUTCOME MEASURES: (1) Tests of attention, information processing, learning, and memory. (2) Reaction and movement times. RESULTS: After the 4-week intervention patients performed significantly better than controls on the digit symbol (p < 0.01). verbal (p < 0.01), and visual learning tasks (p < 0.05). Significant improvements in reaction times (p < 0.01) and movement times (p < 0.05) were gained following a single bout of VR exercise. CONCLUSION: Exercising in a virtual environment offers the potential for significant gains in cognitive function.

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