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Adcock M, Thalmann M, Schättin A, Gennaro F, de Bruin ED. A Pilot Study of an In-Home Multicomponent Exergame Training for Older Adults: Feasibility, Usability and Pre-Post Evaluation. Front Aging Neurosci 2019; 11:304. [PMID: 31824295 PMCID: PMC6882741 DOI: 10.3389/fnagi.2019.00304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with sensory, motor and cognitive impairments that may lead to reduced daily life functioning including gait disturbances, falls, injuries and mobility restrictions. A strong need exists for implementing effective evidence-based interventions for healthy aging. Therefore, the aim of this study was to (i) evaluate the feasibility and usability of an in-home multicomponent exergame training and (ii) explore its effects on physical functions, cognition and cortical activity. Twenty-one healthy and independently living older adults were included (11 female, 74.4 ± 7.0 years, range: 65-92 years) and performed 24 trainings sessions (each 40 min) over eight weeks. The first part was conducted in a living lab (home-like laboratory environment), the second part at participants' home. The multicomponent exergame included Tai Chi-inspired exercises, dance movements and step-based cognitive games to train strength, balance and cognition. Attendance and attrition rates were calculated and safety during training was evaluated to determine feasibility. Participants rated the usability of the exergame (System Usability Scale) and reported on their game experience (Game Experience Questionnaire). Physical and cognitive functions and cortical activity (resting state electroencephalopathy) were assessed pre and post intervention. Results showed a high training attendance rate for the living lab and the home-based setting (91.7 and 91.0%, respectively) with a rather high attrition rate (28.6%, six drop-outs). Half of the drop-out reasons were related to personal or health issues. System usability was rated acceptable with a mean score of 70.6/100. Affective game experience was rated favorable. Significant improvements were found for minimal toe clearance, short-term attentional span, and information processing speed (p < 0.05). No significant pre-post differences were found for cortical activity. To summarize, the exergame is generally feasible and usable for healthy older adults applied in an in-home setting and provides an overall positive emotional game experience. Nevertheless, flawless technical functionality should be a mandatory consideration. Additionally, the training might have potential positive influence on specific functions in older adults. However, the efficacy has to be evaluated in a future randomized controlled trial assessing the behavioral and neuroplastic changes in a larger population after a longer training period.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Melanie Thalmann
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Alexandra Schättin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Federico Gennaro
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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de Bruin ED, Patt N, Ringli L, Gennaro F. Playing Exergames Facilitates Central Drive to the Ankle Dorsiflexors During Gait in Older Adults; a Quasi-Experimental Investigation. Front Aging Neurosci 2019; 11:263. [PMID: 31616287 PMCID: PMC6763617 DOI: 10.3389/fnagi.2019.00263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/05/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose Gait training might be of particular importance to reduce fall risk in older adults. In the present study we explore the hypothesis that video game-based training will increase tibialis anterior (TA) muscle EMG-EMG coherence and relates to functional measures of lower limb control. Methods We focus on video game-based training performed in standing position, where the subjects have to lift their toes to place their feet on different target zones in order to successfully play the game. This type of training is hypothesized leading to progressive changes in the central motor drive to TA motor neurons and, consequently, improved control of ankle dorsiflexion during gait. Results Twenty older adults, 79 ± 8 years old, 13 females/7 males, participated. Results showed a significant difference against 0 in the experimental ΔPOST condition in dual-task walking and beta Frequency Of Interest (p = 0.002). Walking under dual task condition showed significant change over time in minimal Toe Clearance for both the left [χ2(2) = 7.46, p = 0.024, n = 20] and right [χ2(2) = 8.87, p = 0.012, n = 20] leg. No change in lower extremity function was detectable. Conclusion Overall we conclude that the initiation of an exergame-based training in upright standing position improves neural drive to the lower extremities in older adults, effects on minimal Toe Clearance and seems an acceptable form of physical exercise for this group.
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Affiliation(s)
- Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nadine Patt
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Lisa Ringli
- SRH Hochschule für Gesundheit, Gera, Germany
| | - Federico Gennaro
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
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Ofori EK, Subramaniam S, Wang S, Bhatt T. Kinematic analysis of dance-based exergaming: effect of song pace on center of mass and joint mobility. J Phys Ther Sci 2019; 31:708-716. [PMID: 31631943 PMCID: PMC6751052 DOI: 10.1589/jpts.31.708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 05/15/2019] [Indexed: 12/01/2022] Open
Abstract
[Purpose] To establish a quantitative kinematic assessment method for examining postural
stability and physical mobility during dance-based exergaming. [Participants and Methods]
Fifteen young adults participated in one session of dance-based exergaming assessment
using segments from Kinect ‘Just Dance 3’ consisting of slow-, medium-, and fast-paced
songs. A motion capture system was used to record full body kinematics, and a customized
MATLAB code was used to compute the variables of interest, such as center of mass sway
area, excursion, and peaks, as well as step count and joint excursions. [Results] Total
center of mass sway area and excursion were significantly greater for slow-paced (total
sway area=1,077.6 ± 209.9 cm2; total excursion=629.8 ± 380.5 cm) and fast-paced
(total sway area=314.1 ± 133.6 cm2; total excursion=478.5 ± 149.0 cm) songs
than for the medium-paced song (total sway area=212.9 ± 346.0 cm2; total
excursion=311.2 ± 119.5 cm). Joint excursion was greater for the knee (ranging from: (slow
to fast-paced songs: 55.5°–83.1°) and hip (slow to fast-paced: 40.6°–50.4°) than for the
ankle (slow to fast-paced: 32.2°–46.7°) for all three dance paces. Additionally, step
count was significantly, positively correlated with song pace (r=0.52). [Conclusion] The
current study was able to quantify and provide normative values for postural control and
joint mobility among healthy young adults during dance-based exergaming with 3 hip-hop
songs of different paces from the Microsoft Kinect ‘Just Dance 3’. The results indicated
that different paces (intensities) of dance songs corresponded to distinct movement
kinematic trends, particularly with slow-paced song having the maximum center of mass
excursion and lowest joint excursion, while fast-paced song exhibits the reverse, along
with medium-paced song exhibiting the highest hip and ankle joint angle excursions, while
the fast-paced song had increased knee joint angle excursions.
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Affiliation(s)
- Ernest Kwesi Ofori
- Department of Physical Therapy, University of Illinois at Chicago: 1919 W Taylor St., Chicago, Illinois 60612, USA
| | - Savitha Subramaniam
- Department of Physical Therapy, University of Illinois at Chicago: 1919 W Taylor St., Chicago, Illinois 60612, USA
| | - Shuaijie Wang
- Department of Physical Therapy, University of Illinois at Chicago: 1919 W Taylor St., Chicago, Illinois 60612, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago: 1919 W Taylor St., Chicago, Illinois 60612, USA
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Sturnieks DL, Menant J, Valenzuela M, Delbaere K, Sherrington C, Herbert RD, Lampit A, Broadhouse K, Turner J, Schoene D, Lord SR. Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: protocol for the smart±step randomised controlled trial. BMJ Open 2019; 9:e029409. [PMID: 31377709 PMCID: PMC6687022 DOI: 10.1136/bmjopen-2019-029409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/23/2019] [Accepted: 06/11/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Physical and cognitive impairments are important risk factors for falls in older people. However, no studies have been adequately powered to examine whether cognitive or cognitive-motor training can prevent falls in older people. This is despite good evidence of improvements in fall-related cognitive and physical functions following both intervention types. This manuscript describes the study protocol for a three-arm randomised controlled trial to evaluate the effectiveness of home-based cognitive and cognitive-motor training interventions, compared to a minimal-intervention control group, in preventing falls in older people. This trial was prospectively registered with the Australia New Zealand Clinical Trial Registry, number ACTRN12616001325493. METHODS AND ANALYSIS Community-dwelling adults aged 65 years and over, residing in Sydney Australia, will be recruited. Participants (n=750) will be randomly allocated to (1) cognitive-only training, (2) cognitive-motor training or (3) control groups. Both training interventions involve the use of the smart±step home-based computerised game playing system for a recommended 120 min/week for 12 months. Cognitive training group participants will use a desktop electronic touch pad to play games with the smart±step system while seated and using both hands. The cognitive-motor training group participants will use a wireless electronic floor step mat that requires accurate stepping using both legs for playing the same smart±step games, hence incorporating balance exercises. All groups will receive an education booklet on fall prevention. The primary outcome will be rate of falls, reported by monthly diaries during the 12-month duration of the study and analysis will be by intention-to-treat. Secondary outcomes include the proportion of fallers, physical and cognitive performance in 300 participants, and brain structure and function in 105 participants who will undertake MRI scans at baseline and 6 months. Cost-effectiveness will be determined using intervention and health service costs. ETHICS AND DISSEMINATION Ethical approval was obtained from UNSW Ethics Committee in September 2015 (ref number HC15203). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. TRIAL REGISTRATION NUMBER ACTRN12616001325493.
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Affiliation(s)
- Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Valenzuela
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert D Herbert
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Victoria, Australia
| | - Kathryn Broadhouse
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
- Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Turner
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Daniel Schoene
- Institute for Medical Physics, Friedrich-Alexander University Erlangen-Nuremberg University Library Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Schättin A, Baier C, Mai D, Klamroth-Marganska V, Herter-Aeberli I, de Bruin ED. Effects of exergame training combined with omega-3 fatty acids on the elderly brain: a randomized double-blind placebo-controlled trial. BMC Geriatr 2019; 19:81. [PMID: 30866834 PMCID: PMC6416848 DOI: 10.1186/s12877-019-1084-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 02/25/2019] [Indexed: 12/31/2022] Open
Abstract
Background Older adults often suffer from age- and behavior-related brain changes affecting neuronal functioning and, therefore, cognitive and motor functions. The improvement of these functions might decrease falls and improve mobility. Previous studies indicate that video game-based physical exercise, so-called exergames, or omega-3 fatty acids (FAs) improve motor and cognitive functioning through brain adaptations. The aim of this study was to assess the effects of exergame training combined with fish oil supplementation on neuronal system levels in the brain and behavioral measurements in older adults. We hypothesized that the combination would differently affect these factors compared to the sole administration of exergame. Methods Fifty-eight participants were randomly assigned to one of two groups (N = 29 each group) in a parallel, double-blind, randomized controlled trial lasting 26 weeks. The experimental group received daily fish oil, whereas the control group received daily olive oil. After 16 weeks, both groups started with an exergame training. Measurements were performed pre, during, and post intervention. Primary outcomes were recruitment curves using transcranial magnetic stimulation and response-locked potentials using electroencephalography. Secondary outcomes included executive functions and gait parameters. Blood samples were taken to control for FAs. Results Forty-three individuals (mean age 69.4 ± 4.6 years) completed the study (Nexperimental = 22, Ncontrol = 21). The results showed no significant time × group interaction effects for any parameters. Blood samples demonstrated significant time × group interaction effects. Post-hoc tests showed a significant increase of omega-3 FAs (p < .001) and a significant decrease of omega-6 FAs (p < .001) for the experimental group. Conclusion The combination of exergame training and fish oil did not lead to additional beneficial effects. To trigger possible effects, future studies should carefully consider study design aspects; e.g. study duration, individual nutritional supplementation dose, omega-3 FAs supplementation composition, and placebo. Furthermore, studies should consider neuroimaging methods as these might be more sensitive to assess early brain adaptations. Thus, future studies should be aware of several aspects running a combinatory study that includes omega-3 FAs according to their expected effects. Trial registration Swiss National Clinical Trials SNCTP000001623 and ISRCTN12084831 registered 30 November 2015.
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Affiliation(s)
- Alexandra Schättin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, HCP, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland.
| | - Corinne Baier
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, HCP, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland
| | - Domenique Mai
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, HCP, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland
| | | | - Isabelle Herter-Aeberli
- Department of Health Sciences and Technology, Laboratory of Human Nutrition, ETH Zurich, LFV D22, Schmelzbergstrasse 7, 8092, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, HCP, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle 23, 141 83, Huddinge, Sweden
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Taylor LM, Kerse N, Frakking T, Maddison R. Active Video Games for Improving Physical Performance Measures in Older People: A Meta-analysis. J Geriatr Phys Ther 2019; 41:108-123. [PMID: 26974212 PMCID: PMC5895114 DOI: 10.1519/jpt.0000000000000078] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background and Purpose: Participation in regular physical activity is associated with better physical function in older people (>65 years); however, older people are the least active of all age groups. Exercise-based active video games (AVGs) offer an alternative to traditional exercise programs aimed at maintaining or enhancing physical performance measures in older people. This review systematically evaluated whether AVGs could improve measures of physical performance in older people. Secondary measures of safety, game appeal, and usability were also considered. Methods: Electronic databases were searched for randomized controlled trials published up to April 2015. Included were trials with 2 or more arms that evaluated the effect of AVGs on outcome measures of physical performance in older people. Results: Eighteen randomized controlled trials (n = 765) were included. Most trials limited inclusion to healthy community-dwelling older people. With the exception of 1 trial, all AVG programs were supervised. Using meta-analyses, AVGs were found to be more effective than conventional exercise (mean difference [MD], 4.33; 95% confidence intervals [CIs], 2.93-5.73) or no intervention (MD, 0.73; 95% CI, 0.17-1.29) for improving Berg Balance scores in community-dwelling older people. Active video games were also more effective than control for improving 30-second sit-to-stand scores (MD, 3.99; 95% CI, 1.92-6.05). No significant differences in Timed Up and Go scores were found when AVGs were compared with no intervention or with conventional exercise. Conclusions: Active video games can improve measures of mobility and balance in older people when used either on their own or as part of an exercise program. It is not yet clear whether AVGs are equally suitable for older people with significant cognitive impairments or balance or mobility limitations. Given the positive findings to date, consideration could be given to further development of age-appropriate AVGs for use by older people with balance or mobility limitations.
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Affiliation(s)
- Lynne M Taylor
- National Institute for Health Innovation, the University of Auckland, Auckland, New Zealand.,Auckland University of Technology, Auckland, New Zealand
| | - Ngaire Kerse
- General Practice and Primary Health Care, the University of Auckland, Auckland, New Zealand
| | - Tara Frakking
- The University of Groningen, Groningen, the Netherlands
| | - Ralph Maddison
- National Institute for Health Innovation, the University of Auckland, Auckland, New Zealand
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Vázquez FL, Otero P, García-Casal JA, Blanco V, Torres ÁJ, Arrojo M. Efficacy of video game-based interventions for active aging. A systematic literature review and meta-analysis. PLoS One 2018; 13:e0208192. [PMID: 30533015 PMCID: PMC6289420 DOI: 10.1371/journal.pone.0208192] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/13/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Due to the appeal and recent technological advances of video games, the games have gained interest as an intervention tool for active aging. The aim of this systematic literature review and meta-analysis was to determine the efficacy of video games for active aging and to examine the influence of potential moderator variables. METHODS A systematic search was done using the following databases: Medline, PsycINFO, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. In addition, previous reviews and meta-analyses were used to identify randomized controlled trials (RCT) of video game-based interventions for active aging published through February 28, 2018. An evaluation of the methodological quality of the articles and a meta-analysis and moderator analysis was conducted. RESULTS A total of 22 articles depicting 21 RCT with 1125 participants were included. The results indicated that video game-based interventions produced positive effects on objectively measured physical health, negative affect and social health, with small effect sizes (d = 0.41, d = 0.26 and d = 0.40, respectively). The magnitude of this effect was moderated by the presence of subclinical conditions of participants, the type of game (exergames), the presence of physical activity, the type of prevention (indicated), non-blinded assignation, and older age of participants. The methodological quality of the studies was acceptable, the weakest area being external validity. CONCLUSION These finding indicate that video game-based interventions may assist adults in leading active aging processes and preventing secondary aging. Although more research is needed, video game-based interventions are a promising and accessible tool for active aging promotion.
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Affiliation(s)
- Fernando L. Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - J. Antonio García-Casal
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángela J. Torres
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela, SERGAS, Santiago de Compostela, Spain
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Silva PA, Cochrane A, Farrell H. The Effectiveness of Technology-Mediated Dance Interventions and Their Impact on Psychosocial Factors in Older Adults: A Systematic Review and Meta-Analysis. Games Health J 2018; 7:347-361. [PMID: 30044127 DOI: 10.1089/g4h.2017.0197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
| | - Andy Cochrane
- Andy Cochrane, School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Helen Farrell
- Helen Farrell, Maynooth Library, Maynooth University, Maynooth, Ireland
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Rodrigues EV, Gallo LH, Guimarães ATB, Melo Filho J, Luna BC, Gomes ARS. Effects of Dance Exergaming on Depressive Symptoms, Fear of Falling, and Musculoskeletal Function in Fallers and Nonfallers Community-Dwelling Older Women. Rejuvenation Res 2018; 21:518-526. [PMID: 29669458 DOI: 10.1089/rej.2017.2041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to evaluate the effects of a pop dance exergaming protocol on fall risk factors-depressive symptoms, fear of falling, and musculoskeletal function-in community-dwelling older female fallers and nonfallers. There were 47 community-dwelling older women assigned to the intervention group (IG) [fallers (n = 10, 69.8 ± 4.3 years); nonfallers (n = 12, 68.9 ± 3.3 years)] and the control group (CG) [fallers (n = 12, 73.6 ± 5.4 years); nonfallers (n = 13, 68.7 ± 4.8 years)]. The CG maintained their lifestyle and the IG performed a videogame dance training three times per week for 12 weeks. The Dance Central game for Xbox 360® and Kinect motion sensor were used. The primary outcomes were geriatric depressive symptoms, fear of falling, and concentric and eccentric isokinetic peak torque (PT) of quadriceps and hamstrings. Secondary outcomes included cross-sectional area of quadriceps and hamstring muscles, functionality (Timed Up and Go test, gait speed, the Five Times Sit-to-Stand test), and a fall circumstances and outcomes recording. The depressive symptoms decreased in the Intervention Fallers Group. The eccentric hamstrings PT at 180°/s increased in the Intervention Nonfallers Group. There were no significant differences between groups for the other variables analyzed. The training attendance was 83% for the Intervention Fallers Group and 88% for the Intervention Nonfallers Group. Dance exergaming can be indicated to decrease depressive symptoms in fallers and increase the PT in nonfallers among community-dwelling older women.
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Affiliation(s)
- Elisângela Valevein Rodrigues
- 1 Massage Therapy Department, Federal Institute of Parana, Curitiba, Parana, Brazil
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
| | - Luiza Herminia Gallo
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
| | | | - Jarbas Melo Filho
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
| | - Bruna Cavon Luna
- 4 Prevention and Rehabilitation in Physiotherapy Department, Federal University of Parana, Curitiba, Parana, Brazil
| | - Anna Raquel Silveira Gomes
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
- 4 Prevention and Rehabilitation in Physiotherapy Department, Federal University of Parana, Curitiba, Parana, Brazil
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Htut TZC, Hiengkaew V, Jalayondeja C, Vongsirinavarat M. Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial. Eur Rev Aging Phys Act 2018; 15:10. [PMID: 30305852 PMCID: PMC6169073 DOI: 10.1186/s11556-018-0199-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background Physical exercise (PE), virtual reality-based exercise (VRE), and brain exercise (BE) can influence physical and cognitive conditions in older persons. However, it is not known which of the three types of exercises provide the best effects on physical and cognitive status, and which exercise is preferred by older persons. This study compared the effects of PE, VRE, and BE on balance, muscle strength, cognition, and fall concern. In addition, exercise effort perception and contentment in older persons was evaluated. Methods Eighty-four older persons (n = 84) were randomly selected for PE, VRE, BE, and control groups. The exercise groups received 8-week training, whereas the control group did not. Balance was assessed by Berg Balance Scale (BBS) and Timed Up and Go test (TUG), muscle strength by 5 Times Sit to Stand (5TSTS) and left and right hand grip strength (HGS), cognition by Montreal Cognitive Assessment (MoCA) and Timed Up and Go test Cognition (TUG-cog), fall concern by Fall Efficacy Scale International (FES-I), exercise effort perception by Borg category ratio scale (Borg CR-10), and exercise contentment by a questionnaire. Results After exercise, PE significantly enhanced TUG and 5TSTS to a greater extent than VRE (TUG; p = 0.004, 5TSTS; p = 0.027) and BE (TUG; p = 0,012, 5TSTS; p < 0.001). VRE significantly improved MoCA (p < 0.001) and FES-I (p = 0.036) compared to PE, and 5TSTS (p < 0.001) and FES-I (p = 0.011) were improved relative to BE. MoCA was significantly enhanced by BE compared to PE (p < 0.001) and both MoCA and TUG-cog were improved compared to VRE (p = 0.04). PE and VRE significantly (p < 0.001) increased Borg CR-10 in all exercise sessions, whereas BE showed a significant improvement (p < 0.001) in the first 4 sessions. Participants had a significantly greater satisfaction with BE than controls (p = 0.006), and enjoyed VRE and BE more than PE (p < 0.001). Subjects in all exercise groups exhibited benefits compared to the control group (p < 0.001). Conclusions PE provided the best results in physical tests, VRE produced measurable improvements in physical and cognition scores, while BE enhanced cognition ability in older persons. Older persons preferred VRE and BE compared to PE. Both exercises are suggested to older persons to improve physical and cognitive conditions.
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Affiliation(s)
- Thwe Zar Chi Htut
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
| | - Vimonwan Hiengkaew
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
| | - Chutima Jalayondeja
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
| | - Mantana Vongsirinavarat
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
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Wiloth S, Werner C, Lemke NC, Bauer J, Hauer K. Motor-cognitive effects of a computerized game-based training method in people with dementia: a randomized controlled trial. Aging Ment Health 2018; 22:1124-1135. [PMID: 28682124 DOI: 10.1080/13607863.2017.1348472] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine the effects of a computerized, game-based training on motor-cognitive performances, the transfer of training effects on untrained tasks, and the sustainability of training gains in people with dementia. METHOD Ninety-nine individuals with a mean age of 82.9 (5.8) and dementia participated in a 10-week randomized controlled trial with three-month follow-up. The intervention group (IG) received a motor-cognitive training on (Physiomat®) including concurrent dual-tasks of balance control with cognitive demands (Physiomat®-Trail Making Tasks (PTMTs)). The control group (CG) performed non-specific, low-intensity exercises. Duration and accuracy at different complexity levels of trained and untrained PTMTs and the number of successfully performed tasks (PTMT score) were assessed. RESULTS Physiomat® training significantly improved the duration and accuracy at almost all complexity levels of trained (P ≤ 0.001-0.047, ηp2 = 0.065-0.589) and untrained PTMTs (P < 0.001-0.005, ηp2 = 0.073-0.459). Significant effects were also found for the PTMT score of trained (P < 0.001, ηp2 = 0.211) and untrained PTMTs (P < 0.001, ηp2 = 0.184). Training gains were partly sustained at follow-up. CONCLUSION Physiomat® is feasible and has the potential to sustainably improve motor-cognitive performances in people with dementia.
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Affiliation(s)
- Stefanie Wiloth
- a The Institute for the Study off Christian Social Service , University of Heidelberg , Heidelberg , Germany
| | - Christian Werner
- b AGAPLESION Bethanien Hospital , Geriatric Centre of the University of Heidelberg , Heidelberg , Germany
| | - Nele Christin Lemke
- b AGAPLESION Bethanien Hospital , Geriatric Centre of the University of Heidelberg , Heidelberg , Germany
| | - Jürgen Bauer
- b AGAPLESION Bethanien Hospital , Geriatric Centre of the University of Heidelberg , Heidelberg , Germany
| | - Klaus Hauer
- b AGAPLESION Bethanien Hospital , Geriatric Centre of the University of Heidelberg , Heidelberg , Germany
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Schättin A, Gennaro F, Egloff M, Vogt S, de Bruin ED. Physical Activity, Nutrition, Cognition, Neurophysiology, and Short-Time Synaptic Plasticity in Healthy Older Adults: A Cross-Sectional Study. Front Aging Neurosci 2018; 10:242. [PMID: 30214406 PMCID: PMC6125692 DOI: 10.3389/fnagi.2018.00242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/24/2018] [Indexed: 12/15/2022] Open
Abstract
The aging brain undergoes remodeling processes because of biological and environmental factors. To counteract brain aging, neuronal plasticity should be preserved. The aim of this study was to test if the capacity of generating short-time synaptic plasticity in older adults may be related to either physical activity, nutritional status, cognition, or neurophysiological activity. Thirty-six participants (mean age 73.3 ± 5.9 years) received transcranial magnetic stimulation in combination with peripheral nerve stimulation to experimentally induce short-time synaptic plasticity by paired associative stimulation (PAS). Adaptations in neuronal excitability were assessed by motor-evoked potential (MEP) in the right m. tibialis anterior before and after PAS. The Physical Activity Questionnaire 50+ and the StepWatchTM captured physical activity levels. Nutritional status was assessed by the Mini Nutritional Assessment. Cognition was assessed by reaction time for a divided attention test and with the Montreal Cognitive Assessment. Neurophysiological activity was assessed by electroencephalography during the divided attention test. MEPs of the highest stimulation intensity resulted significantly different comparing before, 5 min, or 30 min after PAS (p < 0.05). Data-driven automatic hierarchical classification of the individual recruitment curve slopes over the three-time points indicated four different response types, however, response groups did not significantly differ based on physical activity, nutritional status, cognition, or neurophysiological activity. In a second-level analysis, participants having an increased slope showed a significant higher energy expenditure (z = -2.165, p = 0.030, r = 0.36) and revealed a significant higher power activity in the alpha frequency band (z = -2.008, p = 0.046, r = 0.37) at the prefrontal-located EEG electrodes, compared to the participants having a decreased slope. This study hints toward older adults differing in their neuronal excitability which is strongly associated to their short-time synaptic plasticity levels. Furthermore, a physically active lifestyle and higher EEG power in the alpha frequency band seem to be connected to the capacity of generating long-term potentiation-like synaptic plasticity in older adults. Future studies should consider more sensitive assessments and bigger sample sizes to get a broad scope of the older adults' population.
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Affiliation(s)
- Alexandra Schättin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
| | - Federico Gennaro
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
| | - Martin Egloff
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
| | - Simon Vogt
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
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Sápi M, Domján A, Fehérné Kiss A, Pintér S. Is Kinect Training Superior to Conventional Balance Training for Healthy Older Adults to Improve Postural Control? Games Health J 2018; 8:41-48. [PMID: 30153062 DOI: 10.1089/g4h.2018.0027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate the effects of balance training to improve postural control in adults older than 60. Our aim was to find out if Kinect training is superior to the conventional balance training in aspects of functional balance tests and posturography measurements testing postural stability through visual feedback. MATERIALS AND METHODS Thirty subjects participated in the Kinect training group (29 women and 1 man), practiced Kinect Adventures and Sports, 23 volunteers (22 women and 1 man) attended the conventional balance training, and 22 participants (18 women and 4 men) were allocated to the no-intervention control group. Both interventions lasted for 6 weeks, three times a week, and 30 minutes per session. The Four-Square Step Test, Functional Reach Test, Timed Up and Go test, Timed Up and Go cognitive dual-task test were measured, and for the assessment of the limit of stability (LOS), we used computerized posturography. Measurements were taken before the training at baseline and 6 weeks after (follow-up) the interventions. Statistical analysis was done through two-factor mixed analysis of variance and Newman-Keuls post hoc test. RESULTS Both training groups showed progress in the follow-up measurements; however, more statistically significant improvements were found in favor of the Kinect balance training group (Timed Up and Go test [P < 0.05], Timed Up and Go cognitive dual-task test [P < 0.05], Four-Square Step Test [P < 0.05], Functional Reach Test [P < 0.05], LOS movement velocity [P < 0.05]). CONCLUSION Our results suggest that Kinect balance training may be a preferable and safe method for the healthy older adults to improve postural control and reduce the possibility of falling.
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Affiliation(s)
- Mariann Sápi
- 1 Department of Orthopaedics, Physiotherapy Centre, University of Szeged, Szeged, Hungary
| | - Andrea Domján
- 2 Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Anna Fehérné Kiss
- 1 Department of Orthopaedics, Physiotherapy Centre, University of Szeged, Szeged, Hungary
| | - Sándor Pintér
- 3 Department of Traumatology, Faculty of Medicine, University of Szeged, Szeged, Hungary
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Herold F, Hamacher D, Schega L, Müller NG. Thinking While Moving or Moving While Thinking - Concepts of Motor-Cognitive Training for Cognitive Performance Enhancement. Front Aging Neurosci 2018; 10:228. [PMID: 30127732 PMCID: PMC6089337 DOI: 10.3389/fnagi.2018.00228] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/09/2018] [Indexed: 12/17/2022] Open
Abstract
The demographic change in industrial countries, with increasingly sedentary lifestyles, has a negative impact on mental health. Normal and pathological aging leads to cognitive deficits. This development poses major challenges on national health systems. Therefore, it is necessary to develop efficient cognitive enhancement strategies. The combination of regular physical exercise with cognitive stimulation seems especially suited to increase an individual's cognitive reserve, i.e., his/her resistance to degenerative processes of the brain. Here, we outline insufficiently explored fields in exercise-cognition research and provide a classification approach for different motor-cognitive training regimens. We suggest to classify motor-cognitive training in two categories, (I) sequential motor-cognitive training (the motor and cognitive training are conducted time separated) and (II) simultaneous motor-cognitive training (motor and cognitive training are conducted sequentially). In addition, simultaneous motor-cognitive training may be distinguished based on the specific characteristics of the cognitive task. If successfully solving the cognitive task is not a relevant prerequisite to complete the motor-cognitive task, we would consider this type of training as (IIa) motor-cognitive training with additional cognitive task. In contrast, in ecologically more valid (IIb) motor cognitive training with incorporated cognitive task, the cognitive tasks are a relevant prerequisite to solve the motor-cognitive task. We speculate that incorporating cognitive tasks into motor tasks, rather than separate training of mental and physical functions, is the most promising approach to efficiently enhance cognitive reserve. Further research investigating the influence of motor(-cognitive) exercises with different quantitative and qualitative characteristics on cognitive performance is urgently needed.
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Affiliation(s)
- Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Dennis Hamacher
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Notger G. Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
- Department of Neurology, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Ji L, Pearlson GD, Zhang X, Steffens DC, Ji X, Guo H, Wang L. Physical exercise increases involvement of motor networks as a compensatory mechanism during a cognitively challenging task. Int J Geriatr Psychiatry 2018; 33:1153-1159. [PMID: 29851152 DOI: 10.1002/gps.4909] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/13/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Neuroimaging studies suggest that older adults may compensate for declines in cognitive function through neural compensation and reorganization of neural resources. While neural compensation as a key component of cognitive reserve is an important factor that mediates cognitive decline, the field lacks a quantitative measure of neural compensatory ability, and little is known about factors that may modify compensation, such as physical exercise. METHODS Twenty-five healthy older adults participated in a 6-week dance training exercise program. Gait speed, cognitive function, and functional magnetic resonance imaging during a challenging memory task were measured before and after the exercise program. In this study, we used a newly proposed data-driven independent component analysis approach to measure neural compensatory ability and tested the effect of physical exercise on neural compensation through a longitudinal study. RESULTS After the exercise program, participants showed significantly improved memory performance in Logical Memory Test (WMS(LM)) (P < .001) and Rey Auditory Verbal Learning Test (P = .001) and increased gait speed measured by the 6-minute walking test (P = .01). Among all identified neural networks, only the motor cortices and cerebellum showed greater involvement during the memory task after exercise. Importantly, subjects who activated the motor network only after exercise (but not before exercise) showed WMS(LM) increases. CONCLUSIONS We conclude that physical exercise improved gait speed, cognitive function, and compensatory ability through increased involvement of motor-related networks.
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Affiliation(s)
- Lanxin Ji
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China.,Olin Neuropsychiatry Research Center, Hartford Hospital/Institute of Living, Hartford, CT, USA.,Departments of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Hartford Hospital/Institute of Living, Hartford, CT, USA.,Departments of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Departments of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Xue Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Xiaoqing Ji
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
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Ko SU, Jerome GJ, Simonsick EM, Studenski S, Hausdorff JM, Ferrucci L. Differential associations between dual-task walking abilities and usual gait patterns in healthy older adults-Results from the Baltimore Longitudinal Study of Aging. Gait Posture 2018; 63:63-67. [PMID: 29723649 PMCID: PMC6106773 DOI: 10.1016/j.gaitpost.2018.04.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND It is well established that facing a cognitive challenge while carrying out a motor task interferes with the motor task performance, and in general the ability of handling a dual-task declines progressively with aging. However, the reasons for this decline have not been fully elucidated. Understanding the association between usual-walking gait patterns and dual-task walking performance may provide new insights into the mechanisms that lead to gait deterioration in normal aging and its link to motor and cognitive function. RESEARCH QUESTION Our aim was to assess usual gait parameters in kinematics and kinetics to understand how these parameters are related with a specific task in dual-task walking. METHODS We hypothesized that difficulty in dual-task walking would be associated with gait deteriorations as reflected in range of motion and mechanical work expenditure. We tested this hypothesis by quantifying the gait of 383 participants in the Baltimore Longitudinal Study of Aging (68% of whom successfully completed the dual-task walk, 21% failed the motor task, and 11% failed the cognitive task). RESULTS Compared to successful performers, participants who failed the single motor task had slower gait speed, shorter stride length, higher cadence, and lower range of motion in the knee and ankle joints (p < 0.05, for all), while the participants who failed the cognitive task while walking had longer double support time (p = 0.003), and greater knee absorptive mechanical work (p = 0. 001) and lower ankle generative mechanical work (p < 0. 001). SIGNIFICANCE These results suggest that dual-task walking may be useful for monitoring subtle and diverse gait deteriorations in aging and possibly for designing interventions for maintaining and regaining proper gait patterns in older adults.
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Affiliation(s)
- Seung-Uk Ko
- Department of Mechanical Engineering, Chonnam National University, Yeosu, South Korea.
| | - Gerald J Jerome
- Department of Kinesiology, Towson University, Towson, MD, USA
| | - Eleanor M Simonsick
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Stephanie Studenski
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition, Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, 64239 Tel Aviv, Israel; Department of Physical Therapy and Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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Impact of age and obstacle negotiation on timing measures of gait initiation. J Bodyw Mov Ther 2018; 22:361-365. [DOI: 10.1016/j.jbmt.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/04/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023]
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68
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Einfluss von computerbasiertem kognitivem Training auf Mobilität bei gesunden Älteren. Z Gerontol Geriatr 2018; 51:184-192. [DOI: 10.1007/s00391-018-1369-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/14/2017] [Accepted: 01/05/2018] [Indexed: 11/25/2022]
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Taylor L, Kerse N, Klenk J, Borotkanics R, Maddison R. Exergames to Improve the Mobility of Long-Term Care Residents: A Cluster Randomized Controlled Trial. Games Health J 2018; 7:37-42. [DOI: 10.1089/g4h.2017.0084] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Lynne Taylor
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Ngaire Kerse
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jochen Klenk
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Department of Clinical Gerontology, Robert-Bosch Hospital, Stuttgart, Germany
| | - Robert Borotkanics
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Ralph Maddison
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Faculty of Health, Deakin University, Melbourne, Australia
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Hirao T, Masaki H. Modulation of Spatial Attentional Allocation by Computer-Based Cognitive Training during Lacrosse Shooting Performance. Front Psychol 2018; 8:2271. [PMID: 29354085 PMCID: PMC5758553 DOI: 10.3389/fpsyg.2017.02271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/14/2017] [Indexed: 11/14/2022] Open
Abstract
It has been reported that repetitive execution of a stimulus–response compatibility (SRC) task attenuates the interference effect of a choice reaction time task, known as a Simon task. We investigated whether attentional control, enhanced by repetitive execution of an SRC task, would reduce the interference effect of a Simon task and could be transferred to lacrosse shooting skills, increasing the likelihood that players would shoot in the direction opposite to the goalie’s initial movement. Female lacrosse players who were matched in terms of age, handedness score, competitive lacrosse playing experience, and playing position, were allocated to the SRC task group (n = 15) or the 2-back training group (n = 14). Participants underwent 10 sessions of 180 trials of a computer-based version of either a Type 2 SRC task or the 2-back task, within four consecutive weeks. Eight practice trials were completed prior to the execution of each task in every training session, during which feedback was provided to confirm accurate mapping between the stimulus and response. Before and after the training phase, both the magnitude of the Simon effect and the lacrosse shooting performance were assessed. After participating in computer-based cognitive training, players did indeed increase the number of shots toward the direction opposite to that of the movement of the goalie. In conclusion, these findings indicate that computer-based cognitive training is beneficial for improving the shooting ability of lacrosse players.
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Affiliation(s)
- Takahiro Hirao
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Hiroaki Masaki
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Valenzuela T, Okubo Y, Woodbury A, Lord SR, Delbaere K. Adherence to Technology-Based Exercise Programs in Older Adults: A Systematic Review. J Geriatr Phys Ther 2018; 41:49-61. [DOI: 10.1519/jpt.0000000000000095] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review. Eur Rev Aging Phys Act 2017; 14:20. [PMID: 29276545 PMCID: PMC5738846 DOI: 10.1186/s11556-017-0189-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/05/2017] [Indexed: 01/11/2023] Open
Abstract
The decline in cognitive and motor functions with age affects the performance of the aging healthy population in many daily life activities. Physical activity appears to mitigate this decline or even improve motor and cognitive abilities in older adults. The current systematic review will focus mainly on behavioral studies that look into the dual effects of different types of physical training (e.g., balance training, aerobic training, strength training, group sports, etc.) on cognitive and motor tasks in older adults with no known cognitive or motor disabilities or disease. Our search retrieved a total of 1095 likely relevant articles, of which 41 were considered for full-text reading and 19 were included in the review after the full-text reading. Overall, observations from the 19 included studies conclude that improvements on both motor and cognitive functions were found, mainly in interventions that adopt physical-cognitive training or combined exercise training. While this finding advocates the use of multimodal exercise training paradigms or interventions to improve cognitive-motor abilities in older adults, the sizeable inconsistency among training protocols and endpoint measures complicates the generalization of this finding.
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Howes SC, Charles DK, Marley J, Pedlow K, McDonough SM. Gaming for Health: Systematic Review and Meta-analysis of the Physical and Cognitive Effects of Active Computer Gaming in Older Adults. Phys Ther 2017; 97:1122-1137. [PMID: 29077911 DOI: 10.1093/ptj/pzx088] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 08/29/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Active computer gaming (ACG) is a method of facilitating physical activity in older people to improve health outcomes. PURPOSE The purpose of this study was to update and extend a systematic review of the evidence for ACG to determine its effects on physical and cognitive health in older adults. DATA SOURCES MEDLINE, EMBASE, CENTRAL in the Cochrane Library, and PsycINFO databases were searched from the date of the previous review (2011) to May 2016. STUDY SELECTION Eligible articles were randomized controlled trials (RCTs) investigating the effect of ACG in adults aged 65 and older. DATA EXTRACTION Thirty-five studies were eligible for inclusion. Two review authors independently conducted data extraction, risk-of-bias assessment, and coding of behavior change techniques. Outcomes of interest were analyzed as continuous data and pooled as standardized mean differences (SMD) and 95% confidence intervals (CI). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the quality of the evidence. DATA SYNTHESIS Behavior change techniques (N = 106) were coded in the included studies (mean = 3.02). Data were pooled for 5 main outcomes of interest. Significant moderate effects in favor of ACG were observed for balance (SMD = 0.52, 95% CI = 0.24 to 0.79; 17 studies; 743 participants), for functional exercise capacity when intervention delivery was >120 minutes per week (SMD = 0.53, 95% CI = 0.15 to 0.90; 5 studies; 116 participants), and for cognitive function (SMD = -0.48, 95% CI = -0.80 to 0.17; 8 studies; 459 participants). There was no significant effect observed for functional mobility or fear of falling. LIMITATIONS The quality of the evidence for all comparisons was graded low or very low. CONCLUSIONS At present there is very little confidence that ACG improves physical and cognitive outcomes in older adults.
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Affiliation(s)
- Sarah C Howes
- S.C. Howes, BSc, Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, Antrim, United Kingdom of Great Britain and Northern Ireland
| | - Darryl K Charles
- D.K. Charles, PhD, Computer Science Research Institute, School of Computing and Information Engineering, Ulster University
| | - Joanne Marley
- J. Marley, PhD, Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, and Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Katy Pedlow
- K. Pedlow, PhD, Brain Injury Matters (NI), Belfast, Northern Ireland
| | - Suzanne M McDonough
- S.M. McDonough, PhD, Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Room 01F118, Jordanstown, United Kingdom; UKCRC Centre of Excellence for Public Health, Belfast, Northern Ireland; and School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Ling Y, Ter Meer LP, Yumak Z, Veltkamp RC. Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study. JMIR Serious Games 2017; 5:e19. [PMID: 29025696 PMCID: PMC5658642 DOI: 10.2196/games.7969] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/07/2017] [Accepted: 08/28/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. OBJECTIVE The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient's personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient's medical status. METHODS This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. RESULTS The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game system useful and easy to use, felt that it would be a useful tool in their further rehabilitation, and expressed that they would like to use the game in the future. The therapists indicated that the exercise games highly meet the criteria of motor rehabilitation, and they intend to continue using the game as part of their rehabilitation treatment of patients. Comments from the patients and physiotherapists suggest that real-time corrective feedback when patients perform the exercises wrongly and a more personalized user interface with options for increasing or decreasing cognitive load are needed. CONCLUSIONS The results suggest that Fietsgame can be used as an alternative tool to traditional motor rehabilitation for patients with hip surgery. Lunges and squats are found to be more beneficial for patients who have relatively better balance skills. A follow-up randomized controlled study will be conducted to test the effectiveness of the Fietsgame to investigate how motivating it is over a longer period of time.
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Affiliation(s)
- Yun Ling
- Utrecht University, Utrecht, Netherlands
| | - Louis P Ter Meer
- Erasmus School of Health Policy and Management, Rotterdam, Netherlands
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Veronese N, Maggi S, Schofield P, Stubbs B. Dance movement therapy and falls prevention. Maturitas 2017; 102:1-5. [DOI: 10.1016/j.maturitas.2017.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
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Balance and mobility training with or without concurrent cognitive training improves the timed up and go (TUG), TUG cognitive, and TUG manual in healthy older adults: an exploratory study. Aging Clin Exp Res 2017; 29:711-720. [PMID: 27538832 DOI: 10.1007/s40520-016-0618-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS The purpose was to explore the impact of balance and mobility training (BMT), balance and mobility plus cognitive training (BMT + C) and no training on the timed up and go (TUG), TUG cognitive (TUGcog), and TUG manual (TUGman) in older adults. A preliminary experiment examined the stability of these TUG measures over a 5-week period in older adults. METHODS Fifteen participants in the BMT group (70.2 ± 3.2 years) and 14 participants in the BMT + C group (68.7 ± 5.5 years) trained one-on-one, 3×/week for 12 weeks on a balance obstacle course. The BMT group and the BMT + C group completed two or three tasks simultaneously, respectively. Fifteen participants in the control group received no training (66.7 ± 4.2 years). The TUG, TUGcog, and TUGman were measured in seconds at baseline, after the 12-week training, and after the 12-week follow-up. During the preliminary experiment, ten participants (67.0 ± 6.9 years) completed the three TUG measures 1/week for 5 weeks. RESULTS Both the BMT and BMT + C groups, but not the control group, exhibited significantly faster TUG, TUGcog, and TUGman after the intervention and maintained these improvements at the 12-week follow-up. No differences between the BMT and BMT + C groups emerged. The preliminary experiment showed that the three TUG measures were stable across five testing sessions. DISCUSSION AND CONCLUSION Both training groups improved functional mobility after the interventions and sustained these improvements over 12 weeks. This is likely not a function of repeating the TUG, TUGcog, and TUGman tests since no repeated exposure effect was shown.
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Acute effects of exergames on cognitive function of institutionalized older persons: a single-blinded, randomized and controlled pilot study. Aging Clin Exp Res 2017; 29:387-394. [PMID: 27256080 DOI: 10.1007/s40520-016-0595-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Improvements on balance, gait and cognition are some of the benefits of exergames. Few studies have investigated the cognitive effects of exergames in institutionalized older persons. AIMS To assess the acute effect of a single session of exergames on cognition of institutionalized older persons. METHODS Nineteen institutionalized older persons were randomly allocated to Wii (WG, n = 10, 86 ± 7 year, two males) or control groups (CG, n = 9, 86 ± 5 year, one male). The WG performed six exercises with virtual reality, whereas CG performed six exercises without virtual reality. Verbal fluency test (VFT), digit span forward and digit span backward were used to evaluate semantic memory/executive function, short-term memory and work memory, respectively, before and after exergames and Δ post- to pre-session (absolute) and Δ % (relative) were calculated. Parametric (t independent test) and nonparametric (Mann-Whitney test) statistics and effect size were applied to tests for efficacy. RESULTS VFT was statistically significant within WG (-3.07, df = 9, p = 0.013). We found no statistically significant differences between the two groups (p > 0.05). Effect size between groups of Δ % (median = 21 %) showed moderate effect for WG (0.63). DISCUSSION Our data show moderate improvement of semantic memory/executive function due to exergames session. It is possible that cognitive brain areas are activated during exergames, increasing clinical response. CONCLUSION A single session of exergames showed no significant improvement in short-term memory, working memory and semantic memory/executive function. The effect size for verbal fluency was promising, and future studies on this issue should be developed. PROTOCOL NUMBER OF BRAZILIAN REGISTRY OF CLINICAL TRIALS RBR-6rytw2.
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Transfer effects of step training on stepping performance in untrained directions in older adults: A randomized controlled trial. Gait Posture 2017; 54:50-55. [PMID: 28259039 DOI: 10.1016/j.gaitpost.2017.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 02/07/2017] [Accepted: 02/18/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although step training improves the ability of quick stepping, some home-based step training systems train limited stepping directions and may cause harm by reducing stepping performance in untrained directions. This study examines the possible transfer effects of step training on stepping performance in untrained directions in older people. METHODS Fifty four older adults were randomized into: forward step training (FT); lateral plus forward step training (FLT); or no training (NT) groups. FT and FLT participants undertook a 15-min training session involving 200 step repetitions. Prior to and post training, choice stepping reaction time and stepping kinematics in untrained, diagonal and lateral directions were assessed. RESULTS Significant interactions of group and time (pre/post-assessment) were evident for the first step after training indicating negative (delayed response time) and positive (faster peak stepping speed) transfer effects in the diagonal direction in the FT group. However, when the second to the fifth steps after training were included in the analysis, there were no significant interactions of group and time for measures in the diagonal stepping direction. CONCLUSIONS Step training only in the forward direction improved stepping speed but may acutely slow response times in the untrained diagonal direction. However, this acute effect appears to dissipate after a few repeated step trials. Step training in both forward and lateral directions appears to induce no negative transfer effects in diagonal stepping. These findings suggest home-based step training systems present low risk of harm through negative transfer effects in untrained stepping directions. TRIAL REGISTRATION ANZCTR 369066.
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Ordnung M, Hoff M, Kaminski E, Villringer A, Ragert P. No Overt Effects of a 6-Week Exergame Training on Sensorimotor and Cognitive Function in Older Adults. A Preliminary Investigation. Front Hum Neurosci 2017; 11:160. [PMID: 28420973 PMCID: PMC5378780 DOI: 10.3389/fnhum.2017.00160] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/17/2017] [Indexed: 01/09/2023] Open
Abstract
Several studies investigating the relationship between physical activity and cognition showed that exercise interventions might have beneficial effects on working memory, executive functions as well as motor fitness in old adults. Recently, movement based video games (exergames) have been introduced to have the capability to improve cognitive function in older adults. Healthy aging is associated with a loss of cognitive, as well as sensorimotor functions. During exergaming, participants are required to perform physical activities while being simultaneously surrounded by a cognitively challenging environment. However, only little is known about the impact of exergame training interventions on a broad range of motor, sensory, and cognitive skills. Therefore, the present study aims at investigating the effects of an exergame training over 6 weeks on cognitive, motor, and sensory functions in healthy old participants. For this purpose, 30 neurologically healthy older adults were randomly assigned to either an experimental (ETG, n = 15, 1 h training, twice a week) or a control group (NTG, n = 15, no training). Several cognitive tests were performed before and after exergaming in order to capture potential training-induced effects on processing speed as well as on executive functions. To measure the impact of exergaming on sensorimotor performance, a test battery consisting of pinch and grip force of the hand, tactile acuity, eye-hand coordination, flexibility, reaction time, coordination, and static balance were additionally performed. While we observed significant improvements in the trained exergame (mainly in tasks that required a high load of coordinative abilities), these gains did not result in differential performance improvements when comparing ETG and NTG. The only exergaming-induced difference was a superior behavioral gain in fine motor skills of the left hand in ETG compared to NTG. In an exploratory analysis, within-group comparison revealed improvements in sensorimotor and cognitive tasks (ETG) while NTG only showed an improvement in a static balance test. Taken together, the present study indicates that even though exergames might improve gaming performance, our behavioral assessment was probably not sensitive enough to capture exergaming-induced improvements. Hence, we suggest to use more tailored outcome measures in future studies to assess potential exergaming-induced changes.
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Affiliation(s)
- Madeleine Ordnung
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
| | - Maike Hoff
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
| | - Elisabeth Kaminski
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
- Mind and Brain Institute, Charité and Humboldt UniversityBerlin, Germany
| | - Patrick Ragert
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
- Institute for General Kinesiology and Exercise Science, University of LeipzigLeipzig, Germany
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80
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Neri SG, Cardoso JR, Cruz L, Lima RM, de Oliveira RJ, Iversen MD, Carregaro RL. Do virtual reality games improve mobility skills and balance measurements in community-dwelling older adults? Systematic review and meta-analysis. Clin Rehabil 2017; 31:1292-1304. [PMID: 28933612 DOI: 10.1177/0269215517694677] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To summarize evidence on the effectiveness of virtual reality games and conventional therapy or no-intervention for fall prevention in the elderly. DATA SOURCES An electronic data search (last searched December 2016) was performed on 10 databases (Web of Science, EMBASE, PUBMED, CINAHL, LILACS, SPORTDiscus, Cochrane Library, Scopus, SciELO, PEDro) and retained only randomized controlled trials. REVIEW METHOD Sample characteristics and intervention parameters were compared, focusing on clinical homogeneity of demographic characteristics, type/duration of interventions, outcomes (balance, reaction time, mobility, lower limb strength and fear of falling) and low risk of bias. Based on homogeneity, a meta-analysis was considered. Two independent reviewers assessed the risk of bias. RESULTS A total of 28 studies met the inclusion criteria and were appraised ( n: 1121 elderly participants). We found that virtual reality games presented positive effects on balance and fear of falling compared with no-intervention. Virtual reality games were also superior to conventional interventions for balance improvements and fear of falling. The six studies included in the meta-analysis demonstrated that virtual reality games significantly improved mobility and balance after 3-6 and 8-12 weeks of intervention when compared with no-intervention. The risk of bias revealed that less than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. CONCLUSION Our review suggests positive clinical effects of virtual reality games for balance and mobility improvements compared with no-treatment and conventional interventions. However, owing to the high risk of bias and large variability of intervention protocols, the evidence remains inconclusive and further research is warranted.
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Affiliation(s)
- Silvia Gr Neri
- 1 College of Physical Education, Universidade de Brasília, Brasília, Brazil
| | - Jefferson R Cardoso
- 2 Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, PR, Brazil
| | - Lorena Cruz
- 1 College of Physical Education, Universidade de Brasília, Brasília, Brazil
| | - Ricardo M Lima
- 1 College of Physical Education, Universidade de Brasília, Brasília, Brazil
| | | | - Maura D Iversen
- 3 Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University and Brigham & Women's Hospital, Boston, MA, USA
| | - Rodrigo L Carregaro
- 4 School of Physical Therapy, Universidade de Brasília (UnB), Brasília, Brazil.,5 Graduate Program in Rehabilitation Sciences, Universidade de Brasília (UnB), Brasília, Brazil
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81
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Schättin A, de Bruin ED. Combining Exergame Training with Omega-3 Fatty Acid Supplementation: Protocol for a Randomized Controlled Study Assessing the Effect on Neuronal Structure/Function in the Elderly Brain. Front Aging Neurosci 2016; 8:283. [PMID: 27965570 PMCID: PMC5126064 DOI: 10.3389/fnagi.2016.00283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/11/2016] [Indexed: 11/13/2022] Open
Abstract
A common problem in the older population is the risk of falling and related injury, immobility, and reduced survival. Age-related neuronal changes, e.g., decline in gray-and white-matter, affect neuronal, cognitive, and motor functioning. The improvement of these factors might decrease fall events in elderly. Studies showed that administration of video game-based physical exercise, a so-called exergame, or omega-3 fatty acid (FA) may improve motor and/or cognitive functioning through neuronal changes in the brain of older adults. The aim of this study is to assess the effects of a combination of exergame training with omega-3 FA supplementation on the elderly brain. We hypothesize that an intervention using a combination approach differently affects on the neuronal structure and function of the elderly's brain as compared to the sole administration of exergame training. The study is a parallel, double-blinded, randomized controlled trial lasting 26 weeks. Sixty autonomous living, non-smoking, and right-handed healthy older (>65 years) adults who live independently or in a senior residency are included, randomized, and allocated to one of two study groups. The experimental group receives a daily amount of 13.5 ml fish oil (including 2.9 g of omega-3 FA), whereas the control group receives a daily amount of 13.5 ml olive oil for 26 weeks. After 16 weeks, both groups start with an exergame training program three times per week. Measurements are performed on three time-points by treatment blinded investigators: pre-intervention measurements, blood sample after 16 week, and post-intervention measurements. The main outcomes are motor evoked potentials of the right M. tibialis anterior (transcranial magnetic stimulation) and response-related potentials (electroencephalography) during a cognitive test. For secondary outcomes, reaction time during cognitive tests and spatio-temporal parameters during gait performance are measured. Statistics will include effect sizes and a 2 × 2-ANOVA with normally distributed data or the non-parametric equivalent for data not fulfilling normal distribution. The randomized controlled study is the first to investigate the effectiveness of exergame training combined with omega-3 FA in counteracting age- and behavioral-dependent neuronal changes in the brain. This study has been registered in the Swiss National Clinical Trials (SNCTP000001623) and the ISRCTN (ISRCTN12084831) Portals.
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Affiliation(s)
- Alexandra Schättin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland
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82
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Serra MM, Alonso AC, Peterson M, Mochizuki L, Greve JMD, Garcez-Leme LE. Balance and Muscle Strength in Elderly Women Who Dance Samba. PLoS One 2016; 11:e0166105. [PMID: 27906984 PMCID: PMC5132314 DOI: 10.1371/journal.pone.0166105] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/24/2016] [Indexed: 11/18/2022] Open
Abstract
Considering the growth of the aging population, and the increasing risk for falls and related morbidity, it is vital to seek efficient, comprehensive, and culturally relevant prevention programs for elderly people to reduce risks for falls. The aim of the present study was to evaluate the postural balance and muscle strength among women participating in the "Wing of Baianas" in the carnival parades. One hundred and ten women, with an average age of 67.4±5.9 years, were divided into two groups: Baianas group—elderly participants of the carnival parades in the “Wing of Baianas”, and a Control group of women who do not dance samba. Assessments included a physical activity questionnaire, isokinetic muscle strength testing for the knee extensors and flexors, and a postural balance assessment completed on a force platform. There were no differences between groups, for postural balance outcomes, during the eyes open condition; however, with eyes closed, there was a significant effect between groups (Baianas vs Control) in all variables. The Baianas group showed less medio-lateral displacement (p < 0.04); and anteroposterior displacement (p < 0.007); larger amplitudes of medio-lateral displacement (p < 0.001); and anteroposterior displacement (p < 0.001); increased mean velocity (p < 0.01); and elliptical area (p < 0.01) There were no differences in the isokinetic peak torque corrected by body weight, total work and flexor/extensor ratio. Participation in the Wing of Baianas is associated with better balance with closed eyes, but there were no differences between dancers and non-dancers for muscle strength.
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Affiliation(s)
- Marcos Maurício Serra
- Laboratory for the Study of Movement, Institute of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Angelica Castilho Alonso
- Laboratory for the Study of Movement, Institute of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
- Departament of Pos Graduate Program in Aging Science, São Judas Tadeu University (USJT), São Paulo, Brazil
- * E-mail:
| | - Mark Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Luis Mochizuki
- Laboratory for the Study of Movement, Institute of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Júlia Maria D'Andréa Greve
- Laboratory for the Study of Movement, Institute of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luiz Eugênio Garcez-Leme
- Laboratory for the Study of Movement, Institute of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
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83
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Liebherr M, Schubert P, Schiebener J, Kersten S, Haas CT. Dual-tasking and aging—About multiple perspectives and possible implementations in interventions for the elderly. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1261440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Magnus Liebherr
- Faculty of Health and Social Sciences, Institute of Complex Health Research, Hochschule Fresenius, University of Applied Sciences, Idstein, Germany
- Department of General Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - Patric Schubert
- Faculty of Health and Social Sciences, Institute of Complex Health Research, Hochschule Fresenius, University of Applied Sciences, Idstein, Germany
| | - Johannes Schiebener
- Department of General Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - Stephanie Kersten
- Faculty of Health and Social Sciences, Institute of Complex Health Research, Hochschule Fresenius, University of Applied Sciences, Idstein, Germany
| | - Christian T. Haas
- Faculty of Health and Social Sciences, Institute of Complex Health Research, Hochschule Fresenius, University of Applied Sciences, Idstein, Germany
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84
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Schättin A, Arner R, Gennaro F, de Bruin ED. Adaptations of Prefrontal Brain Activity, Executive Functions, and Gait in Healthy Elderly Following Exergame and Balance Training: A Randomized-Controlled Study. Front Aging Neurosci 2016; 8:278. [PMID: 27932975 PMCID: PMC5120107 DOI: 10.3389/fnagi.2016.00278] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/07/2016] [Indexed: 12/20/2022] Open
Abstract
During aging, the prefrontal cortex (PFC) undergoes age-dependent neuronal changes influencing cognitive and motor functions. Motor-learning interventions are hypothesized to ameliorate motor and cognitive deficits in older adults. Especially, video game-based physical exercise might have the potential to train motor in combination with cognitive abilities in older adults. The aim of this study was to compare conventional balance training with video game-based physical exercise, a so-called exergame, on the relative power (RP) of electroencephalographic (EEG) frequencies over the PFC, executive function (EF), and gait performance. Twenty-seven participants (mean age 79.2 ± 7.3 years) were randomly assigned to one of two groups. All participants completed 24 trainings including three times a 30 min session/week. The EEG measurements showed that theta RP significantly decreased in favor of the exergame group [L(14) = 6.23, p = 0.007]. Comparing pre- vs. post-test, EFs improved both within the exergame (working memory: z = -2.28, p = 0.021; divided attention auditory: z = -2.51, p = 0.009; divided attention visual: z = -2.06, p = 0.040; go/no-go: z = -2.55, p = 0.008; set-shifting: z = -2.90, p = 0.002) and within the balance group (set-shifting: z = -2.04, p = 0.042). Moreover, spatio-temporal gait parameters primarily improved within the exergame group under dual-task conditions (speed normal walking: z = -2.90, p = 0.002; speed fast walking: z = -2.97, p = 0.001; cadence normal walking: z = -2.97, p = 0.001; stride length fast walking: z = -2.69, p = 0.005) and within the balance group under single-task conditions (speed normal walking: z = -2.54, p = 0.009; speed fast walking: z = -1.98, p = 0.049; cadence normal walking: z = -2.79, p = 0.003). These results indicate that exergame training as well as balance training positively influence prefrontal cortex activity and/or function in varying proportion.
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Affiliation(s)
- Alexandra Schättin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland
| | - Rendel Arner
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland
| | - Federico Gennaro
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich Zurich, Switzerland
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85
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Wiloth S, Lemke N, Werner C, Hauer K. Validation of a Computerized, Game-based Assessment Strategy to Measure Training Effects on Motor-Cognitive Functions in People With Dementia. JMIR Serious Games 2016; 4:e12. [PMID: 27432746 PMCID: PMC4969551 DOI: 10.2196/games.5696] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/26/2016] [Accepted: 07/04/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Exergames often used for training purpose can also be applied to create assessments based on quantitative data derived from the game. A number of studies relate to these use functionalities developing specific assessment tasks by using the game software and provided good data on psychometric properties. However, (1) assessments often include tasks other than the original game task used for training and therefore relate to similar but not to identical or integrated performances trained, (2) people with diagnosed dementia have insufficiently been addressed in validation studies, and (3) studies did commonly not present validation data such as sensitivity to change, although this is a paramount objective for validation to evaluate responsiveness in intervention studies. OBJECTIVE Specific assessment parameters have been developed using quantitative data directly derived from the data stream during the game task of a training device (Physiomat). The aim of this study was to present data on construct validity, test-retest reliability, sensitivity to change, and feasibility of this internal assessment approach, which allows the quantification of Physiomat training effects on motor-cognitive functions in 105 multimorbid patients with mild-to-moderate dementia (mean age 82.7±5.9). METHODS Physiomat assessment includes various tasks at different complexity levels demanding balance and cognitive abilities. For construct validity, motor-cognitive Physiomat assessment tasks were compared with established motor and cognitive tests using Spearman's rank correlations (rs). For test-retest reliability, we used intra-class correlations (ICC3,1) and focused on all Physiomat tasks. Sensitivity to change of trained Physiomat tasks was tested using Wilcoxon statistic and standardized response means (SRMs). Completion rate and time were calculated for feasibility. RESULTS Analyses have mostly shown moderate-to-high correlations between established motor as well as cognitive tests and simple (rs=-.22 to .68, P ≤.001-.03), moderate (rs=-.33 to .71, P ≤.001-.004), and complex motor-cognitive Physiomat tasks (rs=-.22 to .83, P ≤.001-.30) indicating a good construct validity. Moderate-to-high correlations between test and retest assessments were found for simple, moderate, and complex motor-cognitive tasks (ICC=.47-.83, P ≤.001) indicating good test-retest reliability. Sensitivity to change was good to excellent for Physiomat assessment as it reproduced significant improvements (P ≤.001) with mostly moderate-to-large effect sizes (SRM=0.5-2.0) regarding all trained tasks. Completion time averaged 25.8 minutes. Completion rate was high for initial Physiomat measures. No adverse events occurred during assessment. CONCLUSIONS Overall, Physiomat proved to have good psychometric qualities in people with mild-to-moderate dementia representing a reliable, valid, responsive, and feasible assessment strategy for multimorbid older adults with or without cognitive impairment, which relates to identical and integrated performances trained by using the game.
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Affiliation(s)
- Stefanie Wiloth
- AGAPLESION Bethanien Hospital, Geriatric Centre of the University of Heidelberg, Heidelberg, Germany.
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86
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Short and long-term effects of exergaming for the elderly. SPRINGERPLUS 2016; 5:793. [PMID: 27390634 PMCID: PMC4916104 DOI: 10.1186/s40064-016-2379-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/20/2016] [Indexed: 12/25/2022]
Abstract
Objective Exergaming has been introduced in safe and beneficial intervention for the elderly. However, no study has examined exergaming-based interventions for the elderly that last several years. Therefore, we investigated the effectiveness and safety of a 12-week intervention using step training with exergaming for the elderly (12-week study). Moreover, we conducted an exergaming-based intervention for 3 years (3-year study). Materials and methods 12-week study: Forty-two elderly persons participated in this study. Using an in-house developed exergaming protocol, a step training was performed for 15 min/session twice a week for 12 weeks. We investigated post-intervention changes in motor functions, successful step-rate, the intensity of exercise, which was evaluated using Borg scale (Rating of Perceived Exertion). 3-year study: An intervention using exergaming was conducted for 12 weeks by 20 elderly participants. Two courses/year of exercise were performed at 3-month intervals. This was continued for 3 years. The exercise continuation rate, its influence on motor functions were investigated. Results 12-week study: Lower-limb muscle strength, balancing capacity, and whole body reaction time significantly improved in the exercise group. The mean score on Borg scale was 12 ± 2 on the first day of the step exercise and 9 ± 2 on the final day. 3-year study: Exercise was continued in 16 out of the 20 subjects. The Timed Up and Go Test, duration of one-footed standing, and quadriceps strength significantly improved. Conclusion The results of the present study showed that exergaming provided an appropriate exercise intensity for the elderly and safely improved motor functions. The exercise continuation rate in the 3-year study was high. Improvements in motor functions may contribute to the prevention of falls.
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87
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Rogan S, Radlinger L, Baur H, Schmidtbleicher D, de Bie RA, de Bruin ED. Sensory-motor training targeting motor dysfunction and muscle weakness in long-term care elderly combined with motivational strategies: a single blind randomized controlled study. Eur Rev Aging Phys Act 2016; 13:4. [PMID: 27239241 PMCID: PMC4884400 DOI: 10.1186/s11556-016-0164-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 05/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study evaluated the effects of a combined innovative training regime consisting of stochastic resonance whole-body vibration (SR-WBV) and a dance video game (DVG) on physical performance and muscle strength in long-term-care dwelling elderly. METHODS Thirthy long-term-care elderly were randomly allocated to an intervention group (IG; n = 16) receiving combined SR-WBV training and DVG, or a sham group (SG; n = 14). IG performed five sets one minute of SR-WBV, with one minute rest between sets (base frequency 3 Hz up to 6 Hz, Noise 4) during the first five weeks on three days per week. From week five to eight a DVG was added to SR-WBV for IG on three days per week. SG performed a five-set SR-WBV program (1 Hz, Noise 1) lasting five times one minute, with one minute rest in between, three days a week. From week five to eight stepping exercises on a trampoline were added on three days per week. PRIMARY OUTCOME Short physical performance battery (SPPB). Secondary outcome: isometric maximal voluntary contraction (IMVC), and sub phases of IMVC (Fsub), isometric rate of force development (IRFD) and sub time phases of IRFD (IRFDsub) were measured at baseline, after four and eight weeks. ANOVA with repeated measures was used for analyses of time and interaction effects and MANOVA determined between group intervention effects. RESULTS Between group effects revealed significant effects on the SPPB primary outcome after four weeks F(1, 27) = 6.17; p = 0.02) and after eight weeks F(1,27) = 11.8; p = 0.002). Secondary muscle function related outcome showed significant between group effects in IG on IRFD, Fsub 30 ms, 100 ms, 200 ms and IRFDsub 0-30 ms, 0-50 ms, 0-100 ms and 100-200 ms compared to SG (all p < 0.05). CONCLUSIONS Eight weeks SR-WBV and DVG intervention improved lower extremity physical function and muscle strength compared to a sham intervention in long-term-care elderly. SR-WBV and DVG seems to be effective as a training regime for skilling up in long-term-care elderly.
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Affiliation(s)
- Slavko Rogan
- Discipline Physiotherapy, Health, Bern University of Applied Sciences, Bern, Switzerland ; Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Lorenz Radlinger
- Discipline Physiotherapy, Health, Bern University of Applied Sciences, Bern, Switzerland
| | - Heiner Baur
- Discipline Physiotherapy, Health, Bern University of Applied Sciences, Bern, Switzerland
| | | | - Rob A de Bie
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands ; Centre for Evidence Based Physiotherapy, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Eling D de Bruin
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands ; Centre for Evidence Based Physiotherapy, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands ; Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Switzerland Wolfgang-Pauli-Str. 27, HIT J 31.2, CH-8093 Zurich, Switzerland
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88
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Marston HR, Freeman S, Bishop KA, Beech CL. A Scoping Review of Digital Gaming Research Involving Older Adults Aged 85 and Older. Games Health J 2016; 5:157-74. [PMID: 27096726 DOI: 10.1089/g4h.2015.0087] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Interest in the use of digital game technologies by older adults is growing across disciplines from health and gerontology to computer science and game studies. The objective of this scoping review was to examine research evidence involving the oldest old (persons 85 years of age or greater) and digital game technology. MATERIALS AND METHODS PubMed, CINHAL, and Scopus were searched, and 46 articles were included in this review. RESULTS Results highlighted that 60 percent of articles were published in gerontological journals, whereas only 8.7 percent were published in computer science journals. No studies focused directly on the oldest old population. Few studies included sample sizes greater than 100 participants. Seven primary and 34 secondary themes were identified, of which Hardware Technology and Assessment were the most common. CONCLUSIONS Existing evidence demonstrates the paucity of studies engaging older adults 85 years of age and above regarding the use of digital gaming and highlights a new understudied cohort for further research focus. Recommendations for future research include intentional recruitment and proportionate representation of participants ≥85 years of age, large sample sizes, and explicit mention of specific numbers of participants ≥85 years of age, which are necessary to advance knowledge in this area. Integrating a rigorous and robust mixed-methods approach including theoretical perspectives would lend itself to further in-depth understanding and knowledge generation in this field.
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Affiliation(s)
- Hannah R Marston
- 1 Faculty of Mathematics, Centre for Research in Computing, The Open University , Walton Hall, Milton Keynes, United Kingdom .,2 Institute of Movement and Sport Gerontology, German Sport University Cologne , Cologne, Germany
| | - Shannon Freeman
- 3 School of Nursing, University of Northern British Columbia , Prince George, British Columbia, Canada
| | - Kristen A Bishop
- 4 Faculty of Health Sciences, Health and Rehabilitation Sciences, Western University , London, Ontario, Canada
| | - Christian L Beech
- 5 Centre for Innovative Ageing, Swansea University , Swansea, Wales, United Kingdom
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Monteiro-Junior RS, Vaghetti CAO, Nascimento OJM, Laks J, Deslandes AC. Exergames: neuroplastic hypothesis about cognitive improvement and biological effects on physical function of institutionalized older persons. Neural Regen Res 2016; 11:201-4. [PMID: 27073355 PMCID: PMC4810966 DOI: 10.4103/1673-5374.177709] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were (1) to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and (2) to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.
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Affiliation(s)
- Renato Sobral Monteiro-Junior
- Physical Education and Sport Department of the Universidade Estadual de Montes Claros, Minas Gerais, Brazil; Post Graduation Program (PhD) in Medicine (Neurology-Neuroscience), Universidade Federal Fluminense, Niterói, Brazil; Neuroscience Laboratory of Exercise, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Jerson Laks
- Programa de Pós-graduação em Biomedicina Translacional - Biotrans, Universidade Unigranrio, Brazil; Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Centro de Estudos e Pesquisa do Envelhecimento, Instituto Vital Brasil, Rio de Janeiro, Brazil
| | - Andrea Camaz Deslandes
- Institute of Physical Education and Sport, Universdiade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Neuroscience Laboratory of Exercise, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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90
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Eggenberger P, Wolf M, Schumann M, de Bruin ED. Exergame and Balance Training Modulate Prefrontal Brain Activity during Walking and Enhance Executive Function in Older Adults. Front Aging Neurosci 2016; 8:66. [PMID: 27148041 PMCID: PMC4828439 DOI: 10.3389/fnagi.2016.00066] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/21/2016] [Indexed: 11/13/2022] Open
Abstract
Different types of exercise training have the potential to induce structural and functional brain plasticity in the elderly. Thereby, functional brain adaptations were observed during cognitive tasks in functional magnetic resonance imaging studies that correlated with improved cognitive performance. This study aimed to investigate if exercise training induces functional brain plasticity during challenging treadmill walking and elicits associated changes in cognitive executive functions. Forty-two elderly participants were recruited and randomly assigned to either interactive cognitive-motor video game dancing (DANCE) or balance and stretching training (BALANCE). The 8-week intervention included three sessions of 30 min per week and was completed by 33 participants (mean age 74.9 ± 6.9 years). Prefrontal cortex (PFC) activity during preferred and fast walking speed on a treadmill was assessed applying functional near infrared spectroscopy pre- and post-intervention. Additionally, executive functions comprising shifting, inhibition, and working memory were assessed. The results showed that both interventions significantly reduced left and right hemispheric PFC oxygenation during the acceleration of walking (p < 0.05 or trend, r = 0.25-0.36), while DANCE showed a larger reduction at the end of the 30-s walking task compared to BALANCE in the left PFC [F (1, 31) = 3.54, p = 0.035, r = 0.32]. These exercise training induced modulations in PFC oxygenation correlated with improved executive functions (p < 0.05 or trend, r = 0.31-0.50). The observed reductions in PFC activity may release cognitive resources to focus attention on other processes while walking, which could be relevant to improve mobility and falls prevention in the elderly. This study provides a deeper understanding of the associations between exercise training, brain function during walking, and cognition in older adults.
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Affiliation(s)
- Patrick Eggenberger
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich Zurich, Switzerland
| | - Martin Wolf
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich Zurich, Switzerland
| | - Martina Schumann
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH ZurichZurich, Switzerland; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht UniversityMaastricht, Netherlands; Centre for Evidence Based Physiotherapy, Maastricht UniversityMaastricht, Netherlands
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91
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Hamacher D, Hamacher D, Rehfeld K, Schega L. Motor-cognitive dual-task training improves local dynamic stability of normal walking in older individuals. Clin Biomech (Bristol, Avon) 2016; 32:138-41. [PMID: 26682629 DOI: 10.1016/j.clinbiomech.2015.11.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 11/30/2015] [Accepted: 11/30/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Extreme levels of gait variability and local dynamic stability of walking are associated with risk of falling and reduced executive functions. However, it is not sufficiently investigated how gait variability and local dynamic stability of human walking develop in the course of a motor-cognitive intervention. As dancing implies high demands on (and therewith trains) executive functioning and motor control, it might increase local dynamic stability or reduce gait variability. METHODS 32 older healthy participants were randomly assigned to either a health-related exercise group (age: mean=68.33 years, standard deviation=3.17 years; BMI: mean=27.46, standard deviation=2.94; female/male: 10/6) or a dancing group (age: mean=66.73 years, standard deviation=3.33 years; BMI: mean=26.02, standard deviation=3.55; female/male: 11/5). Based on angular velocity data of trunk kinematics, local dynamic stability and stride-to-stride variability in level overground walking were assessed prior to and after the specific intervention. The data were analysed by a blinded observer using two-way repeated measures ANOVAs. Based on one-way ANOVAs, time and group effects were determined. FINDINGS Regarding the variability of trunk movements, no interaction effect was observed (F 1,30=0.506, P=.482; η2=0.017). For local dynamic stability of trunk movements, an interaction effect in favour of the dancing group was observed (F 1,30=5,436; P=.026; η2=0.146). INTERPRETATION Our data indicate that a dancing programme (which combines cognitive and motor efforts) might increase local dynamic stability in older people.
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Affiliation(s)
- Dennis Hamacher
- Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Daniel Hamacher
- Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Kathrin Rehfeld
- Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
| | - Lutz Schega
- Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany.
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92
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Okubo Y, Schoene D, Lord SR. Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. Br J Sports Med 2016; 51:586-593. [PMID: 26746905 DOI: 10.1136/bjsports-2015-095452] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine the effects of stepping interventions on fall risk factors and fall incidence in older people. DATA SOURCE Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015. STUDY SELECTION Randomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors. RESULTS Meta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, p<0.0001, I2=0%) and the proportion of fallers (risk ratio=0.51, 95% CI 0.38 to 0.68, p<0.0001, I2=0%). Subgroup analyses stratified by reactive and volitional stepping interventions revealed a similar efficacy for rate of falls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36-416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (p<0.05), but not measures of strength. CONCLUSIONS The findings indicate that both reactive and volitional stepping interventions reduce falls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required. SYSTEMATIC REVIEWS REGISTRATION NUMBER CRD42015017357.
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Affiliation(s)
- Yoshiro Okubo
- Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia.,The Japan Society for the Promotion of Science, Tokyo, Japan
| | - Daniel Schoene
- Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany
| | - Stephen R Lord
- Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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93
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Rendón-Torres L, Salazar-González BC, Gallegos-Cabriales E, Hernández-Cortés PL, López-Ramirez EO, Gómez-Meza MV. Motor-Cognitive Intervention in Mexican Older Adults. Health (London) 2016. [DOI: 10.4236/health.2016.813137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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94
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Schoene D, Valenzuela T, Toson B, Delbaere K, Severino C, Garcia J, Davies TA, Russell F, Smith ST, Lord SR. Interactive Cognitive-Motor Step Training Improves Cognitive Risk Factors of Falling in Older Adults - A Randomized Controlled Trial. PLoS One 2015; 10:e0145161. [PMID: 26673919 PMCID: PMC4682965 DOI: 10.1371/journal.pone.0145161] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 11/29/2015] [Indexed: 12/11/2022] Open
Abstract
Purpose Interactive cognitive-motor training (ICMT) requires individuals to perform both gross motor movements and complex information processing. This study investigated the effectiveness of ICMT on cognitive functions associated with falls in older adults. Methods A single-blinded randomized controlled trial was conducted in community-dwelling older adults (N = 90, mean age 81.5±7) without major cognitive impairment. Participants in the intervention group (IG) played four stepping games that required them to divide attention, inhibit irrelevant stimuli, switch between tasks, rotate objects and make rapid decisions. The recommended minimum dose was three 20-minute sessions per week over a period of 16 weeks unsupervised at home. Participants in the control group (CG) received an evidence-based brochure on fall prevention. Measures of processing speed, attention/executive function (EF), visuo-spatial ability, concerns about falling and depression were assessed before and after the intervention. Results Eighty-one participants (90%) attended re-assessment. There were no improvements with respect to the Stroop Stepping Test (primary outcome) in the intervention group. Compared to the CG, the IG improved significantly in measures of processing speed, visuo-spatial ability and concern about falling. Significant interactions were observed for measures of EF and divided attention, indicating group differences varied for different levels of the covariate with larger improvements in IG participants with poorer baseline performance. The interaction for depression showed no change for the IG but an increase in the CG for those with low depressive symptoms at baseline. Additionally, low and high-adherer groups differed in their baseline performance and responded differently to the intervention. Compared to high adherers, low adherers improved more in processing speed and visual scanning while high-adherers improved more in tasks related to EF. Conclusions This study shows that unsupervised stepping ICMT led to improvements in specific cognitive functions associated with falls in older people. Low adherers improved in less complex functions while high-adherers improved in EF. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12613000671763
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Affiliation(s)
- Daniel Schoene
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
- Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany
| | - Trinidad Valenzuela
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine Universidad Finis Terrae, Santiago, Chile
| | - Barbara Toson
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Connie Severino
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Jaime Garcia
- mHealth Laboratory, iNEXT, University of Technology Sydney, Sydney, Australia
| | - Thomas A. Davies
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Frances Russell
- RSL LifeCare Chair of Ageing, Australian Catholic University, Sydney, Australia
| | - Stuart T. Smith
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
- Faculty of Arts and Business, University of the Sunshine Coast, Sippy Downs, Australia
| | - Stephen R. Lord
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
- * E-mail:
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95
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Gschwind YJ, Eichberg S, Ejupi A, de Rosario H, Kroll M, Marston HR, Drobics M, Annegarn J, Wieching R, Lord SR, Aal K, Vaziri D, Woodbury A, Fink D, Delbaere K. ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial. Eur Rev Aging Phys Act 2015; 12:10. [PMID: 26865874 PMCID: PMC4748323 DOI: 10.1186/s11556-015-0155-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 10/30/2015] [Indexed: 12/20/2022] Open
Abstract
Background Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people’s homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors. Methods A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes. Results The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052). Conclusions The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function. Trial registration Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651 International Standard Randomised Controlled Trial Number: ISRCTN15932647
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Affiliation(s)
- Yves J Gschwind
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, Sydney, New South Wales 2031 Australia
| | - Sabine Eichberg
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Andreas Ejupi
- Assistive Healthcare Information Technology Group, Austrian Institute of Technology, Donau-City-Strasse 1, 1220 Vienna, Austria
| | - Helios de Rosario
- Institute of Biomechanics of Valencia, University Polytechnic of Valencia, Edificio 9C Camino de Vera s/n, 46022 Valencia, Spain ; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Healthcare Technology Group, Valencia, Spain
| | - Michael Kroll
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Hannah R Marston
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Mario Drobics
- Assistive Healthcare Information Technology Group, Austrian Institute of Technology, Donau-City-Strasse 1, 1220 Vienna, Austria
| | - Janneke Annegarn
- Personal Health Department, Philips Research Europe, High Tech Campus 34, 5656AE Eindhoven, The Netherlands
| | - Rainer Wieching
- Institute for Information Systems, University of Siegen, Hölderlinstrasse 3, 57076 Siegen, Germany
| | - Stephen R Lord
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, Sydney, New South Wales 2031 Australia
| | - Konstantin Aal
- Institute for Information Systems, University of Siegen, Hölderlinstrasse 3, 57076 Siegen, Germany
| | - Daryoush Vaziri
- Institute for Information Systems, University of Siegen, Hölderlinstrasse 3, 57076 Siegen, Germany
| | - Ashley Woodbury
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, Sydney, New South Wales 2031 Australia
| | - Dennis Fink
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Kim Delbaere
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, Sydney, New South Wales 2031 Australia
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96
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Salazar-González BC, Cruz-Quevedo JE, Gallegos-Cabriales EC, Villarreal-Reyna MDLA, Ceballos-Gurrola O, Hernández-Cortés PL, Garza-Elizondo ME, Gómez-Meza MV, Enriquez-Reyna MC. A Physical-Cognitive Intervention to Enhance Gait Speed in Older Mexican Adults. Am J Health Promot 2015; 30:77-84. [DOI: 10.4278/ajhp.130625-quan-329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To test the effects of a physical-cognitive exercise intervention on gait parameters under dual-task conditions in community-dwelling older adults. Design. A repeated-measures quasi-experimental design, with control and exercise groups, was used. Setting. Study participants consist of a convenience sample recruited from senior citizens' centers in Monterrey, Mexico. Subjects. A total of 143 sedentary participants ages 65 to 92 years per group participated. Intervention. A combined 45- to 60-minute program of physical and cognitive exercises was conducted in three weekly sessions during 12 weeks for the exercise group. Measures. The spatial gait parameters of speed (cm/s), step width, and stride length (cm); and the temporal parameters of single and double support time, cadence (steps per minute), and swing time(s) were measured using the GaitRite. Counting backwards or naming animals represented cognitive performance. Analysis. Two (groups: exercise group vs. control group) by three (time: baseline, week 6, and week 12) repeated-measures multivariate analysis of variance (MANOVA) was applied. Results. Repeated-measures multivariate analysis of variance revealed a significant group effect (Wilks lambda F4,279 = 6.78, p < .001); univariate analysis showed significant differences for gait speed (m/s), stride length, cadence, step width, and double support time. Time-by-group interaction showed significance in gait speed and stride length. Conclusion. The exercise group participants showed increased gait speed, cadence, and stride length, and reduced their step width and time spent with both feet on the ground. Walking while simultaneously performing a cognitive task might prepare older adults for competing/interfering demands from their environments. The protective health benefits of this intervention remain to be investigated.
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97
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Skjæret N, Nawaz A, Morat T, Schoene D, Helbostad JL, Vereijken B. Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy. Int J Med Inform 2015; 85:1-16. [PMID: 26559887 DOI: 10.1016/j.ijmedinf.2015.10.008] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description and discussion of different game technologies, physical functions targeted, and safety issues related to older adults playing exergames. OBJECTIVES This integrative review provides an overview of the technologies and games used, progression, safety measurements and associated adverse events, adherence to exergaming, outcome measures used, and their effect on physical function. METHODS We undertook systematic searches of SCOPUS and PubMed databases. Key search terms included "game", "exercise", and "aged", and were adapted to each database. To be included, studies had to involve older adults aged 65 years or above, have a pre-post training or intervention design, include ICT-implemented games with weight-bearing exercises, and have outcome measures that included physical activity variables and/or clinical tests of physical function. RESULTS Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and intervention designs and mostly focused on community-dwelling healthy older adults. The majority of the studies used commercially available gaming technologies that targeted a number of different physical functions. Most studies reported that they had used some form of safety measure during intervention. None of the studies reported serious adverse events. However, only 21 studies (35%) reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical measures of balance were the most frequently used outcome measures. PEDro scores indicated that most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out of 10. Several studies found positive effects of exergaming on balance and gait, while none reported negative effects. CONCLUSION Exergames show promise as an intervention to improve physical function in older adults, with few reported adverse events. As there is large variability between studies in terms of intervention protocols and outcome measures, as well as several methodological limitations, recommendations for both practice and further research are provided in order to successfully establish exergames as an exercise and rehabilitation tool for older adults.
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Affiliation(s)
- Nina Skjæret
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway.
| | - Ather Nawaz
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway.
| | - Tobias Morat
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Daniel Schoene
- Institute for Biomedicine of Aging, Friedrich-Alexander-University Erlangen-Nuremberg, Koberger Str. 60, 90408 Nuremberg, Germany.
| | - Jorunn Lægdheim Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway; Department of Clinical Services, St. Olav University Hospital, PO Box 3250 Sluppen, 7006 Trondheim, Norway.
| | - Beatrix Vereijken
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway.
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Eggenberger P, Theill N, Holenstein S, Schumacher V, de Bruin ED. Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up. Clin Interv Aging 2015; 10:1711-32. [PMID: 26604719 PMCID: PMC4631411 DOI: 10.2147/cia.s91997] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive-physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. METHODS Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. RESULTS Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (-77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or trend). CONCLUSION Long-term multicomponent cognitive-physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning.
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Affiliation(s)
- Patrick Eggenberger
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Switzerland
| | - Nathan Theill
- Division of Psychiatry Research, University of Zurich, Zurich, Switzerland ; Center for Gerontology, University of Zurich, Zurich, Switzerland
| | - Stefan Holenstein
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Switzerland
| | - Vera Schumacher
- Department of Gerontopsychology and Gerontology, University of Zurich, Zurich, Switzerland ; University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Switzerland ; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands ; Centre for Evidence Based Physiotherapy, Maastricht University, Maastricht, the Netherlands
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99
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Shams TA, Foussias G, Zawadzki JA, Marshe VS, Siddiqui I, Müller DJ, Wong AHC. The Effects of Video Games on Cognition and Brain Structure: Potential Implications for Neuropsychiatric Disorders. Curr Psychiatry Rep 2015. [PMID: 26216589 DOI: 10.1007/s11920-015-0609-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Video games are now a ubiquitous form of entertainment that has occasionally attracted negative attention. Video games have also been used to test cognitive function, as therapeutic interventions for neuropsychiatric disorders, and to explore mechanisms of experience-dependent structural brain changes. Here, we review current research on video games published from January 2011 to April 2014 with a focus on studies relating to mental health, cognition, and brain imaging. Overall, there is evidence that specific types of video games can alter brain structure or improve certain aspects of cognitive functioning. Video games can also be useful as neuropsychological assessment tools. While research in this area is still at a very early stage, there are interesting results that encourage further work in this field, and hold promise for utilizing this technology as a powerful therapeutic and experimental tool.
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Affiliation(s)
- Tahireh A Shams
- Pharmacogenetics Research Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
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100
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Eggenberger P, Schumacher V, Angst M, Theill N, de Bruin ED. Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up. Clin Interv Aging 2015; 10:1335-49. [PMID: 26316729 PMCID: PMC4544626 DOI: 10.2147/cia.s87732] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training. Methods Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Results Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R2=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Conclusion Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs may counteract widespread cognitive impairments in the elderly.
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Affiliation(s)
- Patrick Eggenberger
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Vera Schumacher
- Department of Gerontopsychology and Gerontology, University of Zurich, Zurich, Switzerland ; University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Marius Angst
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Nathan Theill
- Division of Psychiatry Research, University of Zurich, Schlieren, Switzerland ; Center for Gerontology, University of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Switzerland ; CAPHRI School for Public Health and Primary Care, Department of Epidemiology, Maastricht University, Maastricht, the Netherlands ; Centre for Evidence Based Physiotherapy, Maastricht University, Maastricht, the Netherlands
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