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Šlosar L, Voelcker-Rehage C, Paravlić AH, Abazovic E, de Bruin ED, Marusic U. Combining physical and virtual worlds for motor-cognitive training interventions: Position paper with guidelines on technology classification in movement-related research. Front Psychol 2022; 13:1009052. [PMID: 36591050 PMCID: PMC9797127 DOI: 10.3389/fpsyg.2022.1009052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
Efficient movements require intact motor and cognitive function. There is a growing literature on motor-cognitive interventions to improve the overall quality of life of healthy or diseased older people. For such interventions, novel technological advances are crucial not only in terms of motivation but also to improve the user experience in a multi-stimuli world, usually offered as a mixture of real and virtual environments. This article provides a classification system for movement-related research dealing with motor-cognitive interventions performed in different extents of a virtual environment. The classification is divided into three categories: (a) type of digital device with the associated degree of immersiveness provided; (b) presence or absence of a human-computer interaction; and (c) activity engagement during training, defined by activity >1.5 Metabolic Equivalent of task. Since virtual reality (VR) often categorizes different technologies under the same term, we propose a taxonomy of digital devices ranging from computer monitors and projectors to head-mounted VR technology. All immersive technologies that have developed rapidly in recent years are grouped under the umbrella term Extended Reality (XR). These include augmented reality (AR), mixed reality (MR), and VR, as well as all technologies that have yet to be developed. This technology has potential not only for gaming and entertainment, but also for research, motor-cognitive training programs, rehabilitation, telemedicine, etc. This position paper provides definitions, recommendations, and guidelines for future movement-related interventions based on digital devices, human-computer interactions, and physical engagement to use terms more consistently and contribute to a clearer understanding of their implications.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia,Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
| | - Claudia Voelcker-Rehage
- Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Armin H. Paravlić
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia,Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia,Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Ensar Abazovic
- Faculty of Sport and Physical Education, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Eling D. de Bruin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden,Department of Health, OST – Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia,Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia,*Correspondence: Uros Marusic,
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Torre MM, Temprado JJ. Effects of Exergames on Brain and Cognition in Older Adults: A Review Based on a New Categorization of Combined Training Intervention. Front Aging Neurosci 2022; 14:859715. [PMID: 35431905 PMCID: PMC9009337 DOI: 10.3389/fnagi.2022.859715] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
The literature on exergames has reported inconsistent benefits on brain and cognitive functions. Moreover, it is still unknown whether they yield to equal or superior benefits as compared to other forms of physical exercise. However, until now, a review of exergaming literature was lacking, that would reverse the “product first” approach to replacing it with a “training first” approach that is, an analysis of the different studies based on a detailed description of the type of combined training interventions that was supported by the utilized exergames. In the present review, thanks to a structured framework build around seven interacting constructs (stimuli, settings, targets, markers, outcomes, moderators, and mechanisms), which collectively afford a global picture of the determining factors of exergames training, we aimed to determine whether and under which conditions exergames could be more effective than conventional training. Twenty three studies were finally selected for review and analyzed. We concluded that, in spite of their potential to improve brain and cognition, beneficial factors contributing to exergaming efficacy as well as its underlying mechanisms need to be investigated more systematically thanks to common experimental designs based on gold standards. We proposed some directions in this respect.
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Alhuwail D, Abd-Alrazaq A, Al-Jafar E, Househ M. Telehealth for the geriatric population: uses, opportunities, and challenges. SMART HOME TECHNOLOGIES AND SERVICES FOR GERIATRIC REHABILITATION 2022:107-122. [DOI: 10.1016/b978-0-323-85173-2.00008-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Bovim LPV, Valved L, Bleikli B, Geitung AB, Soleim H, Bogen B. Theoretical Rationale for Design of Tasks in a Virtual Reality-Based Exergame for Rehabilitation Purposes. Front Aging Neurosci 2021; 13:734223. [PMID: 34795575 PMCID: PMC8593199 DOI: 10.3389/fnagi.2021.734223] [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: 06/30/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Virtual reality games are playing a greater role in rehabilitation settings. Previously, commercial games have dominated, but increasingly, bespoke games for specific rehabilitation contexts are emerging. Choice and design of tasks for VR-games are still not always clear, however; some games are designed to motivate and engage players, not necessarily with the facilitation of specific movements as a goal. Other games are designed specifically for the facilitation of specific movements. A theoretical background for the choice of tasks seems warranted. As an example, we use a game that was designed in our lab: VR Walk. Here, the player walks on a treadmill while wearing a head-mounted display showing a custom-made virtual environment. Tasks include walking on a glass bridge across a drop, obstacle avoidance, narrowing path, walking in virtual footsteps, memory, and selection tasks, and throwing and catching objects. Each task is designed according to research and theory from movement science, exercise science, and cognitive science. In this article, we discuss how for example walking across a glass bridge gives perceptual challenges that may be suitable for certain medical conditions, such as hearing loss, when perceptual abilities are strained to compensate for the hearing loss. In another example, walking in virtual footsteps may be seen as a motor and biomechanical constraint, where the double support phase and base of support can be manipulated, making the task beneficial for falls prevention. In a third example, memory and selection tasks may challenge individuals that have cognitive impairments. We posit that these theoretical considerations may be helpful for the choice of tasks and for the design of virtual reality games.
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Affiliation(s)
- Lars Peder Vatshelle Bovim
- SimArena Rehabilitation Lab, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.,The Vitality Centre for Children and Youth, Haukeland University Hospital, Bergen, Norway
| | - Lauritz Valved
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Bendik Bleikli
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Atle Birger Geitung
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Harald Soleim
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Bård Bogen
- SimArena Rehabilitation Lab, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Baschung Pfister P, Tobler-Ammann B, Knols RH, de Bruin ED, de Bie RA. Usability and Acceptance of an Interactive Tablet-Based Exercise Application: A Mixed Methods Study. Front Digit Health 2021; 2:578281. [PMID: 34713051 PMCID: PMC8521963 DOI: 10.3389/fdgth.2020.578281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose: To investigate usability and acceptance of a newly developed interactive, tablet-based exercise application (app) and to explore personal opinions of therapists when using this app in the clinical setting. Methods: Twenty participants (10 therapists and 10 inactive healthy adults) tested usability of this app performing different test tasks, using the think aloud method, and rated overall satisfaction with the System Usability Scale and acceptance with a modified Technology Acceptance Model Questionnaire. For a secondary objective, personal opinions of therapists were evaluated with two focus groups, one for team leaders and one for team members. Results: Overall, the app was judged to be usable. Effectiveness varied between 73 and 90%, overall satisfaction between 70.5 and 85.5/100 points and acceptance between 74 and 80%. Team leader and team member focus groups considered the app as providing a great opportunity for therapy extension, especially because of its blended character. Barriers to its implementation were seen in the existing clinical working processes, personal attitudes of therapists and uncertainty of who would cover expenses for this new form of therapy. Some improvements such as using videos instead of photos, the integration of more interactive tools and the possibility to add additional exercises were suggested in both settings. Conclusion: The app showed high acceptance and usability in trainees and therapists, although some ideas for upgrading functions were formulated. Before this app can be used in clinical practice, feasibility of this blended approach should be evaluated in a clinical setting.
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Affiliation(s)
- Pierrette Baschung Pfister
- Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Nursing and Allied Health Profession Office, Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland.,Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Bernadette Tobler-Ammann
- University Clinic of Hand- and Plastic Surgery, Department of Hand and Occupational Therapy Research, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Ruud H Knols
- Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Nursing and Allied Health Profession Office, Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland.,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Rob A de Bie
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Šlosar L, de Bruin ED, Fontes EB, Plevnik M, Pisot R, Simunic B, Marusic U. Additional Exergames to Regular Tennis Training Improves Cognitive-Motor Functions of Children but May Temporarily Affect Tennis Technique: A Single-Blind Randomized Controlled Trial. Front Psychol 2021; 12:611382. [PMID: 33790833 PMCID: PMC8005621 DOI: 10.3389/fpsyg.2021.611382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/23/2021] [Indexed: 12/23/2022] Open
Abstract
This study evaluated the effects of an exergame program (TennisVirtua-4, Playstation Kinect) combined with traditional tennis training on autonomic regulation, tennis technique, gross motor skills, clinical reaction time, and cognitive inhibitory control in children. Sixty-three children were randomized into four groups (1st - two exergame and two regular trainings sessions/week, 2nd - one exergame and one regular training sessions/week, 3rd - two regular trainings sessions/week, and 4th - one regular training session/week) and compared at baseline, 6-month immediately post intervention and at 1-year follow-up post intervention. At 6-month post intervention the combined exergame and regular training sessions revealed: higher breathing frequency, heart rate (all ps ≤ 0.001) and lower skin conductance levels (p = 0.001) during exergaming; additional benefits in the point of contact and kinetic chain elements of the tennis forehand and backhand technique (all ps ≤ 0.001); negative impact on the shot preparation and the follow-through elements (all ps ≤ 0.017); higher ball skills (as part of the gross motor skills) (p < 0.001); higher percentages of clinical reaction time improvement (1st -9.7% vs 3rd group -7.4% and 2nd -6.6% vs 4th group -4.4%, all ps ≤ 0.003) and cognitive inhibitory control improvement in both congruent (1st -20.5% vs 3rd group -18.4% and 2nd -11.5% vs 4th group -9.6%, all ps ≤ 0.05) and incongruent (1st group -19.1% vs 3rd group -12.5% and 2nd group -11.4% vs 4th group -6.5%, all ps ≤ 0.001) trials. The 1-year follow-up test showed no differences in the tennis technique, clinical reaction time and cognitive inhibitory control improvement between groups with the same number of trainings per week. The findings support exergaming as an additional training tool, aimed to improve important cognitive-motor tennis skills by adding dynamics to the standardized training process. Caution should be placed to planning this training, e.g., in a mesocycle, since exergaming might decrease the improvement of specific tennis technique parts of the trainees. (ClinicalTrials.gov; ID: NCT03946436).
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Affiliation(s)
- Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Eduardo Bodnariuc Fontes
- Research Group in Physical Activity, Cognition and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Matej Plevnik
- Department of Kinesiology, Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Bostjan Simunic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
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7
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de Bruin ED, Baur H, Brülhart Y, Luijckx E, Hinrichs T, Rogan S. Combining Stochastic Resonance Vibration With Exergaming for Motor-Cognitive Training in Long-Term Care; A Sham-Control Randomized Controlled Pilot Trial. Front Med (Lausanne) 2020; 7:507155. [PMID: 33330519 PMCID: PMC7734185 DOI: 10.3389/fmed.2020.507155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/09/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose: Physical and mental functions allow classifying older adults as “Go-Go” (independent functioning); “Slow-Go” (in need of care with a slight handicap); and “No-Go” (in need of care with severe functional limitation). The latter group exhibits reduced exercise tolerance. More recently technology-based motor-cognitive types of training services emerged as a possible training service. This study examined the use of technology including stochastic resonance whole-body vibration and Exergame-dance training for motor-cognitive training in care home dwelling adults. Methods: Seventeen older adults (10 women, 7 men, age range: 79–98) were randomly assigned to the intervention (IG, n = 9) or the sham group (SG, n = 8). IG performed five sets of 1-min whole-body vibration with 1-min rest in between, three times a week for the first 4 weeks of the training period with varying frequency. From weeks five to eight the Exergame-dance training was conducted after the vibration sessions. SG performed a stochastic resonance whole-body vibration training with the same terms applied, however, with a fixed frequency of 1 Hz, Noise 1. From weeks five to eight a passive trampoline-programme of 5 min was applied following the vibration sessions. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes were the Trail Making Test A and B (TMT A & B) and the Falls Efficacy Scale–International (FES-I). Outcomes were measured at baseline, after 4 and 8 weeks of intervention and at follow-up (4 weeks after the intervention). The non-parametric Puri and Sen rank-order test was applied, followed by an ANOVA for repeated measures to analyse main and interaction effects. Mann–Whitney U-Test was used to determine differences between the groups. Results: The post-hoc analysis showed significant effects on the SPPB total score with large effect sizes from baseline to 8 weeks (+72%, p = 0.005, η2 = 0.423). The TMT part B displayed significant improvements with large effect sizes from baseline to 8 weeks (+17.5%, p = 0.002, η2 = 0.779) and to follow-up (+21%, p = 0.001, η2 = 0.827). Conclusion: The technology based 8-week training programme consisting of a combination of stochastic resonance whole-body vibration and Exergame-dance training showed beneficial effects on both physical and cognitive performance in older care home dwelling adults.
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Affiliation(s)
- Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Heiner Baur
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Yvonne Brülhart
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Eefje Luijckx
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Slavko Rogan
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Swanenburg J, Büchi F, Straumann D, Weber KP, de Bruin ED. Exergaming With Integrated Head Turn Tasks Improves Compensatory Saccade Pattern in Some Patients With Chronic Peripheral Unilateral Vestibular Hypofunction. Front Neurol 2020; 11:601. [PMID: 32714269 PMCID: PMC7344241 DOI: 10.3389/fneur.2020.00601] [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: 03/17/2020] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to determine whether vestibular rehabilitation using active video games (Exergames), including promoted head turns and unsupported locomotion, may facilitate vestibular compensation and gait in subjects with one-sided chronic peripheral vestibular hypofunction (cPVH). Methods: 12 patients with cPVH (mean age of 65 ± 12 years, 8 male) were recruited for this study. The study consisted of a four-week baseline control period T1-T2 followed by a four-week intervention period T2-T3. The intervention included exergames that required physical tasks such as steps, weight shifts or balance control to cognitive challenges, in a virtual environment to play the game. The subjects participated in a total of 176 min of exergaming in eight sessions. Because of the changing projection direction of the game to the wall, the subjects had to turn their heads constantly while playing the game. Dynamic visual acuity (DVA) was assessed. Vestibulo-Ocular reflex (VOR) gain deficit and cumulative overt saccade amplitude (COSA) were measured with the video head-impulse test. Additionally, the functional gait assessment (FGA), Extended Timed Get-Up-and-Go (ETGUG), and the Dizziness handicap inventory (DHI), were assessed. Results: DVA showed no significant group level change (p = 0.475, z = -0.714, d = 0.295) with a small effect size and improvements in five out of 12 subjects. Ipsilesional VOR gain did not improve (p = 0.157, z = -1.414, d = 0.481) on group level while there was an intermediate effect size and improvements in six out of 12 subjects. COSA got significant smaller (p = 0.006, z = -2.746, d = 1.354) with improvements in seven out of 12 subjects. The contralesional sides did not change. The FGA for the group significantly improved with an intermediate effect size (p < 0.001, z = -3.08, d = 1.617) and five individuals showed clinically relevant improvements. The ETGUG group value improved significantly with a strong effect size (p < 0.001, z = -2.67, d = 1.030), with seven individuals contributing to this change. The DHI showed no change (p = 0.172, z = -1.381, d = 0.592) neither on the group nor on the individuals' level. The game scores of the subjects improved during the intervention period of the intervention for every game. Conclusion: The results of this study demonstrate that exergaming with promoted head turns facilitates vestibular compensation in some subjects with cPVH. This is the first study that shows an improvement in cumulative overt saccade amplitude after exergaming in chronic vestibular subjects.
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Affiliation(s)
- Jaap Swanenburg
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Zurich, Switzerland
| | - Fabienne Büchi
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik Straumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Konrad P Weber
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Gennaro F, Maino P, Kaelin-Lang A, De Bock K, de Bruin ED. Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study. J Clin Med 2020; 9:E720. [PMID: 32155951 PMCID: PMC7141202 DOI: 10.3390/jcm9030720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia is a muscle disease listed within the ICD-10 classification. Several operational definitions have been created for sarcopenia screening; however, an international consensus is lacking. The Centers for Disease Control and Prevention have recently recognized that sarcopenia detection requires improved diagnosis and screening measures. Mounting evidence hints towards changes in the corticospinal communication system where corticomuscular coherence (CMC) reflects an effective mechanism of corticospinal interaction. CMC can be assessed during locomotion by means of simultaneously measuring Electroencephalography (EEG) and Electromyography (EMG). The aim of this study was to perform sarcopenia screening in community-dwelling older adults and explore the possibility of using CMC assessed during gait to discriminate between sarcopenic and non-sarcopenic older adults. Receiver Operating Characteristic (ROC) curves showed high sensitivity, precision and accuracy of CMC assessed from EEG Cz sensor and EMG sensors located over Musculus Vastus Medialis [Cz-VM; AUC (95.0%CI): 0.98 (0.92-1.04), sensitivity: 1.00, 1-specificity: 0.89, p < 0.001] and with Musculus Biceps Femoris [Cz-BF; AUC (95.0%CI): 0.86 (0.68-1.03), sensitivity: 1.00, 1-specificity: 0.70, p < 0.001]. These muscles showed significant differences with large magnitude of effect between sarcopenic and non-sarcopenic older adults [Hedge's g (95.0%CI): 2.2 (1.3-3.1), p = 0.005 and Hedge's g (95.0%CI): 1.5 (0.7-2.2), p = 0.010; respectively]. The novelty of this exploratory investigation is the hint toward a novel possible determinant of age-related sarcopenia, derived from corticospinal control of locomotion and shown by the observed large differences in CMC when sarcopenic and non-sarcopenic older adults are compared. This, in turn, might represent in future a potential treatment target to counteract sarcopenia as well as a parameter to monitor the progression of the disease and/or the potential recovery following other treatment interventions.
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Affiliation(s)
- Federico Gennaro
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, 8093 Zurich, Switzerland; (K.D.B.); (E.D.d.B.)
| | - Paolo Maino
- Pain Management Center, Neurocenter of Southern Switzerland, Regional Hospital of Lugano, 6962 Lugano, Switzerland;
| | - Alain Kaelin-Lang
- Neurocenter of Southern Switzerland, Regional Hospital of Lugano, 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Medical faculty, University of Bern, 3008 Bern, Switzerland
| | - Katrien De Bock
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, 8093 Zurich, Switzerland; (K.D.B.); (E.D.d.B.)
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, 8093 Zurich, Switzerland; (K.D.B.); (E.D.d.B.)
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
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10
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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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11
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Rebsamen S, Knols RH, Pfister PB, de Bruin ED. Exergame-Driven High-Intensity Interval Training in Untrained Community Dwelling Older Adults: A Formative One Group Quasi- Experimental Feasibility Trial. Front Physiol 2019; 10:1019. [PMID: 31440168 PMCID: PMC6693477 DOI: 10.3389/fphys.2019.01019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/24/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose To investigate the feasibility of an exergame-driven high-intensity interval training (HIIT) and its effects on cardiovascular fitness in untrained community dwelling older adults. Methods Twelve older participants [10 women, age 72.3 (SD: 4.44) years] performed a high-intensity interval exergame intervention three times a week for 4 weeks. Data was acquired during two baseline and one final measurement. Feasibility outcomes included attrition, adherence, acceptability [Technology Acceptance Model Questionnaire (TAM)], usability [System Usability Scale (SUS)], and enjoyment of exergaming. Furthermore, participants' physical activity levels pre and post intervention were compared to physical activity levels for similar types of training. The secondary outcome was exercise capacity [heart rate at rest (HRrest), heart rate variability (HRV), maximum heart rate (HRmax), and maximum workload (W, in watt)] evaluated through maximal exercise testing. Results Eleven participants completed the study (8% attrition), without any adverse events. Adherence to the HIIT intervention was 91% and participants showed high acceptance of the intervention with TAM scores between 5.8 and 6.7 points. User satisfaction was rated as excellent (SUS total score: 93.5 of 100) and the overall enjoyment of exergaming scored 4.5 of 5 possible points. Total exercise time ranged from 19 to 35 min with a mean of 30.8 (SD: 3.6) min. Actual high-intensity exercise time showed consistency with the target exercise time in 98% percent of trainings. Eighty-six percent of high-intensity intervals met the targeted intensity range (>70-90% of HRmax). Thirty-six percent of the recovery periods were completed with a heart rate above the target range of 50-70% of HRmax. Maximum workload (W) during the incremental exercise test post-training increased significantly compared to the baseline measurements one and two (p = 0.032, effect size r = 0.77 and p = 0.012, r = 0.87). Conclusion High-intensity interval training through exergaming is feasible, safe, and shows high usability and acceptance in community dwelling older people. Exergame-driven HIIT had a significant effect on maximum power output on an incremental exercise test. A more extensive exergame intervention period, higher work to recovery ratios as well as a higher-intensity activity should be considered in future projects.
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Affiliation(s)
- Stefanie Rebsamen
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.,Institute of Physiotherapy, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Ruud H Knols
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Pierrette Baschung Pfister
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences 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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