Comparative efficacy of vision-restricted vs. conventional cognitive-motor dual-task training for cognition improvement in type 2 diabetes: A randomized controlled trial

Background: Cognitive disorder is caused by hyperglycemia and insulin resistance in type 2 diabetes. Elevated glycemic levels contribute to neural damage and exacerbate cognitive decline, strict glucose control is required to maintain cognition. Vision-Feedback Restricted Cognitive motor dual-task training (VFR-CMDT) improves brain areas associated to memory and motor skills. Methods: In this randomized controlled experiment, 80 Type 2 Diabetes Mellitus adults (mean age 52 years; duration of diabetes more then 5 years) were randomized into two groups, Vision-Feedback Restricted Cognitive-Motor Dual Training (VFR-CMDT; (n = 40)) and Conventional Cognitive-Motor Dual Task Training (CV-CMT; (n = 40)). The Primary outcome measure were the Montreal Cognitive Assessment (MoCA) and Trail Making Test - Part B (TMT-B) and Secondary was Subjective Cognitive Complaints (SSCs). Evaluated at baseline, Week 4 (post-intervention), and Week 8 (follow-up). Results: Significant improvements were observed in all measures over time (p < 0.001). By Week 4, both groups’ MoCA ratings increased from 19 to 27, and by Week 8, they were unchanged. By Week 8, SCCs showed improvement from 58 to 30 in VFR-CMDT and 33 in CV-CMT, while TMT-B times improved from 210–215 s to 80–88s. Although VFR-CMDT demonstrated numerically greater improvements, the group × time interaction effects were not statistically significant (all p > 0.05), indicating no superiority of either intervention. Gains within the group were very significant (p < 0.001), however comparisons between groups were not (p > 0.15). At Week 8, the effect sizes for SCCs (d ~ 0.65) and MoCA (d ~ 0.50) were modest to moderate, while those for TMT B (d ~ 0.53) were moderate. Conclusion: Both cognitive training programs produced improvements in global cognition (MoCA), executive function (TMT-B), and subjective cognitive complaints (SCCs) among adults with T2DM over eight weeks. Outcomes appeared directly consistent with potential benefits, the differences were not statistically significant, even though VFR-CMDT showed numerically greater than CV-CMT. To draw more definitive conclusions about the comparative efficacy of VFR-CMDT, future research should use larger, stratified samples and extend follow-up periods to evaluate durability and generalizability of cognitive improvements.