1
|
Huang WY, Chang ST, Lee CH, Liou IH, Cherng RJ. Effects of virtual reality on the balance performance of older adults: a systematic review and meta-analysis. J Phys Ther Sci 2024; 36:457-470. [PMID: 39092409 PMCID: PMC11290862 DOI: 10.1589/jpts.36.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/04/2024] [Indexed: 08/04/2024] Open
Abstract
[Purpose] Virtual reality has been increasingly used to improve the balance performance of older adults; however, the effect remains inconclusive. This study aimed to examine the effects of virtual reality on the balance performance of older adults through a systematic review and meta-analysis. [Methods] The PubMed, MEDLINE, CINAHL, Cochrane Library, and PEDro electronic databases were searched. Only randomized clinical trials published in English from January 1st, 1980, to September 30, 2022, were included and reviewed. Outcome measures included the Berg Balance Scale, Timed Up and Go Test and Activity-specific Balance Confidence scale. [Results] The results showed that virtual reality training for older adults led to significant improvements in Berg Balance Scale scores and Timed Up and Go Test times compared with non-virtual reality training. However, such an outcome was not observed with regard to the Activity-specific Balance Confidence scale. [Conclusion] Virtual reality training is effective in improving both static and dynamic balance among older adults. However, its effect on their self-confidence regarding balance is not significant.
Collapse
Affiliation(s)
- Wan-Yun Huang
- Institute of Allied Health Sciences, College of Medicine,
National Cheng Kung University: No. 16, Ln. 243, Rongzong Rd., Zuoying Dist., Kaohsiung
City 813022, Taiwan (R.O.C.)
- Department of Physical Medicine and Rehabilitation,
Kaohsiung Veterans General Hospital, Taiwan (R.O.C.)
| | - Shin-Tsu Chang
- Department of Physical Medicine and Rehabilitation,
Kaohsiung Veterans General Hospital, Taiwan (R.O.C.)
- Department of Physical Medicine and Rehabilitation,
Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taiwan
(R.O.C)
| | - Chao-Hsien Lee
- Department of Health Business Administration, Meiho
University, Taiwan (R.O.C)
| | - I-Hsiu Liou
- Department of Physical Medicine and Rehabilitation,
Kaohsiung Veterans General Hospital, Taiwan (R.O.C.)
| | - Rong-Ju Cherng
- Institute of Allied Health Sciences, College of Medicine,
National Cheng Kung University: No. 16, Ln. 243, Rongzong Rd., Zuoying Dist., Kaohsiung
City 813022, Taiwan (R.O.C.)
- Department of Physical Therapy, College of Medicine,
National Cheng Kung University, Taiwan (R.O.C)
| |
Collapse
|
2
|
Liang SGS, Fan ESL, Lam PK, Kwok WT, Ma CZH, Lam FMH. The effect of adding real-time postural feedback in balance and mobility training in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 123:105439. [PMID: 38643641 DOI: 10.1016/j.archger.2024.105439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES This study aimed to systematically review the additional value of providing real-time postural feedback during balance and mobility training in older people. METHODS PubMed, Embase, CINAHL, and Web-of-Science were searched from inception to August 2023. Studies comparing the effectiveness of feedback-based versus non-feedback-based postural balance or mobility training on balance or mobility outcomes were selected. Similar outcomes were pooled in meta-analyses using a random-effect model. The quality of evidence for available outcomes was rated by Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Eight studies were identified with 203 subjects. Two studies showed that providing postural feedback immediately improved stability in static balance and gait. For the post-training effect, however, no significant change was found in trunk movement during single-leg standing (i.e., pitch angle, MD=0.65, 95 %CI=-0.77 to 2.07, low-quality; roll angle, MD=0.96, 95 %CI=-0.87 to 2.80, moderate-quality), in the Mini-BESTest (MD=1.88, 95 %CI=-0.05 to 3.80, moderate-quality), and in balance confidence (MD=0.29, 95 %CI=-3.43 to 4.2, moderate-quality). A worsened functional reach distance was associated with providing feedback during balance training (MD=-3.26, 95 %CI=-6.31 to -0.21, high-quality). Meta-analyses on mobility outcomes were mostly insignificant, except for the trunk-roll angle of walking (MD=0.87, 95 %CI=0.05 to 1.70, low-quality) and trunk-pitch angle of walking with head-turning (MD=1.87, 95 %CI=0.95 to 2.79, moderate-quality). CONCLUSION Adding real-time postural feedback to balance and mobility training might immediately improve stability in balance and mobility in older people. However, mixed results were reported for its post-training effect.
Collapse
Affiliation(s)
- Sam Guo-Shi Liang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Eva Si-Long Fan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Pik Kwan Lam
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Wing Tung Kwok
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Freddy Man-Hin Lam
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
| |
Collapse
|
3
|
Pinto-Fernandez D, Gomez M, Rodrigues C, Rojo A, Raya R, Rocon E, Moreno JC, Torricelli D. Augmented Reality Feedback for Exoskeleton-Assisted Walking. A Feasibility Study. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941171 DOI: 10.1109/icorr58425.2023.10304606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Powered lower limb exoskeletons have been used in recent decades to support and improve conventional gait rehabilitation programs. In this context, visual feedback is considered a valuable tool to facilitate patient learning and engagement. Treadmill-based lower limb robotic exoskeletons are commonly incorporated with traditional screens or virtual reality (VR) devices. However, these modalities are incompatible with over-ground robotic exoskeletons, in which users should pay attention to multiple elements of the open environment and more complex tasks. Recent advances in augmented reality (AR) technology have unlocked a new way of displaying 3D graphics in untethered wearable devices like Microsoft's Hololens 2 without occluding the rest of the user's field of view. These advances can be crucial in certain situations and position AR as an excellent candidate to improve visual feedback when using robotic exoskeletons. In this work, we present the development of an AR-based audio-visual feedback system that tracks the trunk rotation from an Inertial Measurement Unit (IMU) to aid in walking tasks assisted by a lower limb robotic exoskeleton. A preliminary study was done integrating the H3 robotic exoskeleton with Hololens 2. We observed that displaying posture information is feasible and could help mitigate the unnatural posture often imposed by a robotic exoskeleton.
Collapse
|
4
|
Shin S, Wuensche B. What type of exercises should older adults engage in to improve fall efficacy and physical fitness related to falling? J Exerc Rehabil 2023; 19:198-207. [PMID: 37662531 PMCID: PMC10468295 DOI: 10.12965/jer.2346276.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/18/2023] [Indexed: 09/05/2023] Open
Abstract
This study aimed to examine the effects of exercise interventions developed over the past 10 years to prevent falls among older adults. Cochrane, PubMed, and Embase databases were systematically searched on November 3, 2022, using the following keywords: "elderly" or "aged" and "fall prevention exercise" and "randomized controlled trial." A total of 918 articles were retrieved, and finally, 18 studies were included in the meta-analysis. main conclusions were as follows: fall prevention exercises showed moderately positive effects on balance, gait, mobility, physical function, lower limb power, and strength, but low effects on proprioception, vision, and reaction speed. The effect sizes were highest when the intervention period was 1-24 weeks, time was 31-60 min, and frequency was thrice per week. Place of intervention (home, community, laboratory) and age (>75 years, <75 years) showed similarly moderate effect sizes. A combined program that includes balance, co-ordination, and resistance exercises is appropriate to improve fall-related fitness and fall efficacy in community-dwelling older individuals.
Collapse
Affiliation(s)
- Sohee Shin
- School of Exercise and Sport Science, University of Ulsan, Ulsan,
Korea
| | - Burkhard Wuensche
- Department of Computer Science, University of Auckland, Auckland,
New Zealand
| |
Collapse
|
5
|
Gerards M, Marcellis R, Senden R, Poeze M, de Bie R, Meijer K, Lenssen A. The effect of perturbation-based balance training on balance control and fear of falling in older adults: a single-blind randomised controlled trial. BMC Geriatr 2023; 23:305. [PMID: 37198543 DOI: 10.1186/s12877-023-03988-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/22/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Perturbation-based balance training (PBT) is an emerging intervention shown to improve balance recovery responses and reduce falls in everyday life in older adults. However, perturbation interventions were heterogeneous in nature and need improvement. This study aims to investigate the effects of a PBT protocol that was designed to address previously identified challenges of PBT, in addition to usual care, on balance control and fear of falling in older adults at increased risk of falling. METHODS Community-dwelling older adults (age ≥ 65 years) who visited the hospital outpatient clinic due to a fall incident were included. Participants received PBT in addition to usual care (referral to a physiotherapist) versus usual care alone. PBT consisted of three 30-minute sessions in three weeks. Unilateral treadmill belt accelerations and decelerations and platform perturbations (shifts and tilts) were applied during standing and walking on the Computer Assisted Rehabilitation Environment (CAREN, Motek Medical BV). This dual-belt treadmill embedded in a motion platform with 6 degrees of freedom is surrounded by a 180° screen on which virtual reality environments are projected. Duration and contents of the training were standardised, while training progression was individualised. Fear of falling (FES-I) and balance control (Mini-BESTest) were assessed at baseline and one week post-intervention. Primary analysis compared changes in outcome measures between groups using Mann-Whitney U tests. RESULTS Eighty-two participants were included (PBT group n = 39), with a median age of 73 years (IQR 8 years). Median Mini-BESTest scores did not clinically relevantly improve and were not significantly different between groups post-intervention (p = 0.87). FES-I scores did not change in either group. CONCLUSIONS Participation in a PBT program including multiple perturbation types and directions did not lead to different effects than usual care on clinical measures of balance control or fear of falling in community-dwelling older adults with a recent history of falls. More research is needed to explore how to modulate PBT training dose, and which clinical outcomes are most suitable to measure training effects on balance control. TRIAL REGISTRATION Nederlands Trial Register NL7680. Registered 17-04-2019 - retrospectively registered. https://www.trialregister.nl/trial/7680 .
Collapse
Affiliation(s)
- Marissa Gerards
- Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
- Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
| | - Rik Marcellis
- Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Rachel Senden
- Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Martijn Poeze
- Department of Surgery, division of Trauma Surgery, MUMC+, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Rob de Bie
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Antoine Lenssen
- Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| |
Collapse
|
6
|
Mak TCT, Wong TWL, Ng SSM. Visual-related training to improve balance and walking ability in older adults: A systematic review. Exp Gerontol 2021; 156:111612. [PMID: 34718089 DOI: 10.1016/j.exger.2021.111612] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 10/20/2022]
Abstract
Evidence has emerged about the use of visual-related training as an intervention to improve mobility that could implicate fall prevention in the older population. The objective of this systematic review was to investigate whether visual-related interventions are effective in improving balance and walking ability in healthy older adults. An electronic database search was conducted using Pubmed, Embase, CINAHL Plus, Web of Science, PsycINFO, and SportDiscus. Seventeen studies out of a total of 3297 studies were identified in this review that met the inclusion criteria of (1) adopting a longitudinal design with at least one control comparison group, (2) targeting healthy older adults (age 60 or above), (3) primary focus targeting visual element, and (4) the primary outcome(s) were measures indicating walking and/or balance ability. Our results indicated that visual-related training generally led to improvements in balance and walking ability in healthy older adults. It seems necessary that visual-related training should at least involve mobility-related movement component(s), or form a part of a multi-component training to achieve a beneficial effect on balance and walking. The effectiveness and feasibility of these visual-related training in clinical practice for rehabilitation has been discussed and needs to be investigated in future studies. (197/200).
Collapse
Affiliation(s)
- Toby C T Mak
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region.
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| |
Collapse
|
7
|
Nishchyk A, Chen W, Pripp AH, Bergland A. The Effect of Mixed Reality Technologies for Falls Prevention Among Older Adults: Systematic Review and Meta-analysis. JMIR Aging 2021; 4:e27972. [PMID: 34255643 PMCID: PMC8280833 DOI: 10.2196/27972] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Falling is one of the most common and serious age-related issues, and falls can significantly impair the quality of life of older adults. Approximately one-third of people over 65 experience a fall annually. Previous research has shown that physical exercise could help reduce falls among older adults and improve their health. However, older adults often find it challenging to follow and adhere to physical exercise programs. Interventions using mixed reality (MR) technology could help address these issues. MR combines artificial augmented computer-generated elements with the real world. It has frequently been used for training and rehabilitation purposes. OBJECTIVE The aim of this systematic literature review and meta-analysis was to investigate the use of the full spectrum of MR technologies for fall prevention intervention and summarize evidence of the effectiveness of this approach. METHODS In our qualitative synthesis, we analyzed a number of features of the selected studies, including aim, type of exercise, technology used for intervention, study sample size, participant demographics and history of falls, study design, involvement of health professionals or caregivers, duration and frequency of the intervention, study outcome measures, and results of the study. To systematically assess the results of the selected studies and identify the common effect of MR interventions, a meta-analysis was performed. RESULTS Seven databases were searched, and the initial search yielded 5838 results. With the considered inclusion and exclusion criteria, 21 studies were included in the qualitative synthesis and 12 were included in meta-analysis. The majority of studies demonstrated a positive effect of an MR intervention on fall risk factors among older participants. The meta-analysis demonstrated a statistically significant difference in Berg Balance Scale score between the intervention and control groups (ES: 0.564; 95% CI 0.246-0.882; P<.001) with heterogeneity statistics of I2=54.9% and Q=17.74 (P=.02), and a statistical difference in Timed Up and Go test scores between the intervention and control groups (ES: 0.318; 95% CI 0.025-0.662; P<.001) with heterogeneity statistics of I2=77.6% and Q=44.63 (P<.001). The corresponding funnel plot and the Egger test for small-study effects (P=.76 and P=.11 for Berg Balance Scale and Timed Up and Go, respectively) indicate that a minor publication bias in the studies might be present in the Berg Balance Scale results. CONCLUSIONS The literature review and meta-analysis demonstrate that the use of MR interventions can have a positive effect on physical functions in the elderly. MR has the potential to help older users perform physical exercises that could improve their health conditions. However, more research on the effect of MR fall prevention interventions should be conducted with special focus given to MR usability issues.
Collapse
Affiliation(s)
- Anna Nishchyk
- Department of Computer Science, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
| | - Weiqin Chen
- Department of Computer Science, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
| | - Are Hugo Pripp
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
8
|
Shideler BL, Martelli D, Prado A, Agrawal SK. Overground gait training using virtual reality aimed at gait symmetry. Hum Mov Sci 2021; 76:102770. [PMID: 33636570 DOI: 10.1016/j.humov.2021.102770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/27/2020] [Accepted: 02/01/2021] [Indexed: 01/30/2023]
Abstract
This study investigated if training in a virtual reality (VR) environment that provides visual and audio biofeedback on foot placement can induce changes to spatial and temporal parameters of gait during overground walking. Eighteen healthy young adults walked for 23 min back and forth on an instrumented walkway in three different conditions: (i) real environment (RE), (ii) virtual environment (VE) with no biofeedback, and (iii) VE with biofeedback. Visual and audio biofeedback while stepping on virtual footprint targets appearing along a straight path encouraged participants to walk with an asymmetrical step length (SL). A repeated-measures, one-way ANOVA, followed by a pairwise comparison post-hoc analysis with Bonferroni's correction, was performed to compare the step length difference (SLD), stance phase percentage difference (SPPD), and double-support percentage difference (DSPD) between early and late phases of all walking conditions. The results demonstrate the efficacy of the VE biofeedback system for training asymmetrical gait patterns. Participants temporarily adapted an asymmetrical gait pattern immediately post-training in the VE. Induced asymmetries persisted significantly while later walking in the RE. Asymmetry was significant in the spatial parameters of gait (SLD) but not in the temporal parameters (SPPD and DSPD). This paper demonstrates a method to induce unilateral changes in spatial parameters of gait using a novel VR tool. This study provides a proof-of-concept validation that VR biofeedback training can be conducted directly overground and could potentially provide a new method for treatment of hemiplegic gait or asymmetrical walking.
Collapse
Affiliation(s)
- Blynn L Shideler
- Robotics and Rehabilitation (ROAR) Laboratory, Department of Mechanical Engineering, Columbia University, New York, United States; Department of Biomedical Engineering, Columbia University, New York, United States
| | - Dario Martelli
- Department of Mechanical Engineering, The University of Alabama, Tuscaloosa, United States
| | - Antonio Prado
- Robotics and Rehabilitation (ROAR) Laboratory, Department of Mechanical Engineering, Columbia University, New York, United States
| | - Sunil K Agrawal
- Robotics and Rehabilitation (ROAR) Laboratory, Department of Mechanical Engineering, Columbia University, New York, United States; Department of Rehabilitation and Regenerative Medicine, Columbia University Valegos College of Physicians and Surgeons, New York, United States.
| |
Collapse
|
9
|
Gerards MHG, Marcellis RGJ, Poeze M, Lenssen AF, Meijer K, de Bie RA. Perturbation-based balance training to improve balance control and reduce falls in older adults - study protocol for a randomized controlled trial. BMC Geriatr 2021; 21:9. [PMID: 33407204 PMCID: PMC7788687 DOI: 10.1186/s12877-020-01944-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/02/2020] [Indexed: 12/27/2022] Open
Abstract
Background Falls are a common cause of injuries and hospitalization among older adults. While conventional balance training appears effective in preventing falls, a relatively large number of training sessions are needed and retention of the effects after the training period is hard to accomplish. This may be because these interventions are not sufficiently task-specific for the mechanism of falls. Many falls in older adults occur due to unexpected external perturbations during gait, such as trips. Therefore, there is increasing interest in perturbation-based balance training (PBT), which is a more task-specific intervention to improve reactive balance control after unexpected perturbations. The literature suggests that PBT may be more effective and require fewer training sessions to reduce falls incidence in older adults, than conventional balance training. We aim to evaluate the effect of a three-session PBT protocol on balance control, daily life falls and fear of falling. Secondly, we will evaluate the acceptability of the PBT protocol. Methods This is a mixed-methods study combining a single-blind (outcome assessor) randomized controlled trial (RCT) using a parallel-group design, and qualitative research evaluating the acceptability of the intervention. The study sample consists of community-dwelling older adults aged 65 years and older who have recently fallen and visited the MUMC+ outpatient clinic. Subjects are randomized into two groups. The control group (n = 40) receives usual care, meaning referral to a physical therapist. The intervention group (n = 40) receives usual care plus three 30-min sessions of PBT in the Computer Assisted Rehabilitation Environment. Subjects’ balance control (Mini-BESTest) and fear of falling (FES-I) will be assessed at baseline, and 4 weeks and 3 months post-baseline. Daily life falls will be recorded with falls calendars until 6 months after the first follow-up measurement, long-term injurious falls will be recorded at 2-years’ follow-up via the electronic patient record. Acceptability of the PBT protocol will be evaluated with semi-structured interviews in a subsample from the intervention group. Discussion This study will contribute to the evidence for the effectiveness of PBT using a training protocol based on the available literature, and also give much needed insights into the acceptability of PBT for older adults. Trial registration Nederlands Trial Register NL7680. Registered 17-04-2019 – retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-020-01944-7.
Collapse
Affiliation(s)
- Marissa H G Gerards
- Department of Physical therapy, Maastricht University Medical Center+ (MUMC+), Peter Debyelaan 25, 6229 HX, Maastricht, the Netherlands. .,Department of Epidemiology, Maastricht University, Peter Debyeplein 1, 6200 MD, Maastricht, the Netherlands. .,Care and Public Health Research Institute CAPHRI, Maastricht, The Netherlands.
| | - Rik G J Marcellis
- Department of Physical therapy, Maastricht University Medical Center+ (MUMC+), Peter Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - Martijn Poeze
- Department of Surgery, division of Trauma surgery, MUMC+, Peter Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,School of Nutrition and Translational Research in Metabolism NUTRIM, Maastricht, The Netherlands
| | - Antoine F Lenssen
- Department of Physical therapy, Maastricht University Medical Center+ (MUMC+), Peter Debyelaan 25, 6229 HX, Maastricht, the Netherlands.,Department of Epidemiology, Maastricht University, Peter Debyeplein 1, 6200 MD, Maastricht, the Netherlands.,Care and Public Health Research Institute CAPHRI, Maastricht, The Netherlands
| | - Kenneth Meijer
- School of Nutrition and Translational Research in Metabolism NUTRIM, Maastricht, The Netherlands.,Department of Movement Sciences, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
| | - Rob A de Bie
- Department of Epidemiology, Maastricht University, Peter Debyeplein 1, 6200 MD, Maastricht, the Netherlands.,Care and Public Health Research Institute CAPHRI, Maastricht, The Netherlands
| |
Collapse
|
10
|
Motor adaptation to real-life external environments using immersive virtual reality: A pilot study. J Bodyw Mov Ther 2020; 24:152-158. [PMID: 33218504 DOI: 10.1016/j.jbmt.2020.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 02/25/2020] [Accepted: 06/07/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Virtual reality (VR) has been described as an emerging therapeutic strategy to promote motor adaptation in different populations. The aim of this study was to investigate the effect of virtual environment demands, provided by an immersive VR system, on kinematic and spatio-temporal gait parameters in healthy young participants. METHODS Fifteen healthy young participants participated in this experimental study performing, in sequence, a baseline natural walking (NW) block, two different virtual environment walking blocks (snowy and crowded conditions), and a mixed walking block (including NW, snowy, and crowded conditions). Participants' Center-of-Mass (COM) excursion angle, medio-lateral (ML) COM excursion, step length, and walking speed were analyzed for each trial. RESULTS COM excursion angle and ML-COM excursion increased significantly during the first snowy and crowded VR trials compared to NW trials, while walking speed and step length decreased only for the snowy conditions. COM excursion angle and ML-COM excursion increased significantly from the first to the fourth VR snowy trial and decreased from the first to the fourth VR crowded trial. Participants retained the acquired motor adaptations even after the mixed block. CONCLUSION This study showed that kinematic and spatio-temporal gait parameters of young participants changed according to the virtual environment demands provided for each virtual scenario. In addition, all participants showed a consistent gait adaptation process to each virtual environment across the VR trials. The present findings highlight the impact of VR for gait adaptation, suggesting that VR training could modify motor behavior and enhance the motor adaptation process in healthy young participants.
Collapse
|
11
|
Anson E, Thompson E, Karpen SC, Odle BL, Seier E, Jeka J, Panus PC. Visual biofeedback training reduces quantitative drugs index scores associated with fall risk. BMC Res Notes 2018; 11:750. [PMID: 30348198 PMCID: PMC6196457 DOI: 10.1186/s13104-018-3859-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Drugs increase fall risk and decrease performance on balance and mobility tests. Conversely, whether biofeedback training to reduce fall risk also decreases scores on a published drug-based fall risk index has not been documented. Forty-eight community-dwelling older adults underwent either treadmill gait training plus visual feedback (+VFB), or walked on a treadmill without feedback. The Quantitative Drug Index (QDI) was derived from each participant's drug list and is based upon all cause drug-associated fall risk. Analysis of covariance assessed changes in the QDI during the study, and data is presented as mean ± standard error of the mean. RESULTS The QDI scores decreased significantly (p = 0.031) for participants receiving treadmill gait training +VFB (- 0.259 ± 0.207), compared to participants who walked on the treadmill without VFB (0.463 ± 0.246). Changes in participants QDI scores were dependent in part upon their age, which was a significant covariate (p = 0.007). These preliminary results demonstrate that rehabilitation to reduce fall risk may also decrease use of drugs associated with falls. Determination of which drugs or drug classes that contribute to the reduction in QDI scores for participants receiving treadmill gait training +VFB, compared to treadmill walking only, will require a larger participant investigation. Trial Registration ISRNCT01690611, ClinicalTrials.gov #366151-1, initial 9/24/2012, completed 4/21/2016.
Collapse
Affiliation(s)
- Eric Anson
- Department of Otolaryngology, University of Rochester, 601 Elmwood Avenue, Box 629, Rochester, NY, 14642, USA
| | - Elizabeth Thompson
- Department of Physical Therapy, Temple University, 1800 N Broad St, Philadelphia, PA, 91222, USA
| | - Samuel C Karpen
- University of Georgia College of Veterinary Medicine, 501 D. W. Brooks Drive, Athens, GA, 30602, USA
| | - Brian L Odle
- Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Box 70594, Johnson City, TN, 37614, USA
| | - Edith Seier
- Mathematics and Statistics Department, College of Arts and Sciences, East Tennessee State University, Box 70663, Johnson City, TN, 37614, USA
| | - John Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, STAR Health Sciences Campus, 540 S College Ave, Newark, DE, 19713, USA
| | - Peter C Panus
- Pharmaceutical Sciences, Gatton College of Pharmacy, East Tennessee State University, Box 70657, Johnson City, TN, 37614, USA.
| |
Collapse
|