{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:47:00Z","timestamp":1787244420909,"version":"build-2736575974"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults with cognitive impairment often present with balance deficits, reduced walking speed, and attentional difficulties\u2014particularly in executive function. These challenges increase fall risk and complicate traditional rehabilitation approaches. Eye-tracking technology offers an objective way to evaluate attention by analyzing oculomotor behavior during tasks, but its use in clinical rehabilitation contexts is still limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study is to investigate visual attention using eye-tracking metrics during a non-immersive virtual reality-based balance training program in older adults with mild to moderate cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was an exploratory pilot study with a prospective, descriptive cohort, based on a non-controlled, quasi-experimental design of seven older adults with mild to moderate cognitive impairment. Each patient underwent VR-based balance training using Rehametrics\n                      <jats:sup>\u24c7<\/jats:sup>\n                      software, while their attention was assessed via eye-tracking (Tobii Pro Glasses 2 Refurbished Wireless). Clinical assessments included the Mini-BESTest, Functional Gait Assessment, 6-Minute Walk Test, 4-Meter Walk Test, and Montreal Cognitive Assessment (MoCA). Eye-tracking data focused on fixation patterns, microsaccades, and pupil diameter as indicators of attentional processing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients showed a small numerical increase, without reaching statistical significance in task difficulty progression (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.016), lower limb endurance (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.016), and single-leg support time (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.031). Clinical tests revealed a slight increase, though results were not statistically significant in balance and walking speed (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.063). Eye-tracking data indicated increased fixation stability and decreased pupil diameter, suggesting more efficient attention allocation during motor tasks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Eye-tracking provided valuable metrics into attentional behavior during balance training in older adults with cognitive impairment. Its integration into non-immersive virtual reality rehabilitation may help better understand and address cognitive-motor interactions. Further studies with larger samples are needed to confirm these preliminary findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2025.1671477","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T05:37:17Z","timestamp":1761025037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Visual attention during non-immersive virtual reality balance training in older adults with mild to moderate cognitive impairment: an eye-tracking study"],"prefix":"10.3389","volume":"17","author":[{"given":"Marcos","family":"Maldonado-D\u00edaz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Jara-Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Gonz\u00e1lez-Seguel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1152\/jn.00640.2016","article-title":"Motor plan differs for young and older adults during similar movements","volume":"117","author":"Casamento-Moran","year":"2017","journal-title":"J. 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