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Pavlou M, Flavell CA, Gourtani FM, Nikitas C, Kikidis D, Bibas A, Gatsios D, Tsakanikas V, Fotiadis DI, Koutsouris D, Steinicke F, Walz ID, Maurer C, Papadopoulou S, Tsoukatos M, Pardalis A, Bamiou DE. Feasibility and acceptability of the HOLObalance telerehabilitation system compared with standard care for older adults at risk of falls: the HOLOBalance assessor blinded pilot randomised controlled study. Age Ageing 2024; 53:afae214. [PMID: 39373575 PMCID: PMC11457341 DOI: 10.1093/ageing/afae214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Indexed: 10/08/2024] Open
Abstract
BACKGROUND Falls have high socioeconomic costs. Information and communication technologies may support provision and monitoring of multisensory (MSR) physiotherapy programmes. The HOLOBalance platform used augmented reality holograms to provide patient-centred, individualised MSR. OBJECTIVES To determine the platform's safety, acceptability and feasibility, investigate functional gait and dynamic balance benefits and provide data for a definitive trial. DESIGN AND SETTING Single-blinded pilot randomised controlled feasibility study. Interventions were conducted at clinical sites or participants' homes in three European countries. PARTICIPANTS Community-dwelling older adults (median age 73 years; 64.2% female) at risk of falls were enrolled (May 2020-August 2021). METHODS Participants were randomised to an 8-week clinic or home-based telerehabilitation MSR or OTAGO (control group) programme. Compliance, satisfaction, and adverse events determined feasibility. Clinical outcomes, assessed (blinded) within one-week prior to and post-intervention, included functional gait assessment (FGA), Mini BESTest and cognitive function. RESULTS Randomisation to completion rate was 76.15% with 109 participants recruited (n = 289 screened). Drop-out rate was similar between groups. Adverse events were reported (n = 3) in the control group. Sixty-nine percent would recommend the HOLOBalance intervention. Findings were similar for the home and clinic-based arms of each intervention; data was combined for analysis. FGA (95%CI [1.63, 4.19]) and Mini-BESTest (95%CI [1.46, 3.93]) showed greater improvement in the HOLOBalance group with a clinically meaningful change of 4/30 noted for the FGA. CONCLUSIONS HOLObalance was feasible to implement and acceptable to older adults at risk of falls, with FGA and Mini-BEST improvements exceeding those for the OTAGO programme. A definitive trial is warranted.
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Affiliation(s)
- Marousa Pavlou
- Centre for Human and Applied Physiological Sciences, King’s College London, London, UK
- Ear Institute, University College London, London, UK
- Department of Audiovestibular Medicine, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
| | - Carol Ann Flavell
- Centre for Human and Applied Physiological Sciences, King’s College London, London, UK
| | | | - Christos Nikitas
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Dimitris Kikidis
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Athanasios Bibas
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Dimitris Gatsios
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Vassilis Tsakanikas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Biomedical Research Institute, Ioannina, Greece
| | - Dimitrios Koutsouris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Frank Steinicke
- Human-Computer Interaction Group, Department of Informatics, Universität Hamburg, Hamburg, Germany
| | - Isabelle Daniela Walz
- Department of Neurology and Neuroscience, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Christoph Maurer
- Department of Neurology and Neuroscience, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Sofia Papadopoulou
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Michalis Tsoukatos
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Athanasios Pardalis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Doris-Eva Bamiou
- Ear Institute, University College London, London, UK
- Department of Audiovestibular Medicine, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
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Berglund A, Klompstra L, Orädd H, Fallström J, Strömberg A, Jaarsma T, Berglund E. The Rationale Behind the Design Decisions in an Augmented Reality Mobile eHealth Exergame to Increase Physical Activity for Inactive Older People With Heart Failure. JMIR Serious Games 2024; 12:e50066. [PMID: 39185820 PMCID: PMC11382433 DOI: 10.2196/50066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 04/29/2024] [Accepted: 06/11/2024] [Indexed: 08/27/2024] Open
Abstract
Unlabelled Physical activity is important for everyone to maintain and improve health, especially for people with chronic diseases. Mobile exergaming has the potential to increase physical activity and to specifically reach people with poor activity levels. However, commercial mobile exergames are not specially designed for older people with chronic illnesses such as heart failure. The primary aim of this viewpoint is to describe the underlying reasoning guiding the design choices made in developing a mobile exergame, Heart Farming, tailored specifically for sedentary older people diagnosed with heart failure. The goal of the exergame is to increase physical activity levels by increasing the daily walking duration of patients with heart failure by at least 10 minutes. The rationale guiding the design decisions of the mobile exergame is grounded in the thoughtful integration of gamification strategies tailored for application in cardiovascular care. This integration is achieved through applying gamification components, gamification elements, and gamification principles. The Heart Farming mobile exergame is about helping a farmer take care of and expand a virtual farm, with these activities taking place while the patient walks in the real world. The exergame can be adapted to individual preferences and physical condition regarding where, how, when, and how much to play and walk. The exergame is developed using augmented reality so it can be played both indoors and outdoors. Augmented reality technology is used to track the patients' movement in the real world and to interpret that movement into events in the exergame rather than to augment the mobile user interface.
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Affiliation(s)
- Aseel Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Helena Orädd
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Johan Fallström
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Erik Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
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Berglund A, Jaarsma T, Orädd H, Fallström J, Strömberg A, Klompstra L, Berglund E. The Application of a Serious Game Framework to Design and Develop an Exergame for Patients With Heart Failure. JMIR Form Res 2024; 8:e50063. [PMID: 39110976 PMCID: PMC11339584 DOI: 10.2196/50063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 12/29/2023] [Accepted: 06/26/2024] [Indexed: 08/25/2024] Open
Abstract
Reducing inactivity in patients with chronic disease is vital since it can decrease the risk of disease progression and mortality. Exergames are an innovative approach to becoming more physically active and positively affecting physical health outcomes. Serious games are designed for purposes beyond entertainment and exergames are serious games for physical activity. However, current commercial exergames might not optimally meet the needs of patients with special needs. Developing tailored exergames is challenging and requires an appropriate process. The primary goal of this viewpoint is to describe significant lessons learned from designing and developing an exergame for patients with chronic heart failure using the player-centered, iterative, interdisciplinary, and integrated (P-III) framework for serious games. Four of the framework's pillars were used in the design and development of a mobile exergame: player-centered design, iterative development of the game, interdisciplinary teamwork, and integration of play and serious content. The mobile exergame was developed iteratively in 7 iterations by an interdisciplinary team involving users and stakeholders in all iterations. Stakeholders played various roles during the development process, making the team stay focused on the needs of the patients and creating an exergame that catered to these needs. Evaluations were conducted during each iteration by both the team and users or patients according to the player-centered design pillar. Since the exergame was created for a smartphone, the assessments were conducted both on the development computer and on the intended platforms. This required continuous deployment of the exergame to the platforms and smartphones that support augmented reality. Our findings show that the serious game P-III framework needs to be modified in order to be used for the design and development of exergames. In this viewpoint, we propose an updated version of the P-III framework for exergame development including (1) a separate and thorough design of the physical activity and physical interaction, and (2) early and continuous deployment of the exergame on the intended platform to enable evaluations and everyday life testing.
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Affiliation(s)
- Aseel Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helena Orädd
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Johan Fallström
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Erik Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
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Rytterström P, Strömberg A, Jaarsma T, Klompstra L. Exergaming to Increase Physical Activity in Older Adults: Feasibility and Practical Implications. Curr Heart Fail Rep 2024; 21:439-459. [PMID: 39023808 PMCID: PMC11333506 DOI: 10.1007/s11897-024-00675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE OF REVIEW To evaluate the feasibility of exergaming among older adults, focusing on acceptability, demand, implementation, and practicality. Additionally, to offer practical implications based on the review's findings. RECENT FINDINGS Exergaming is a safe for older adults, potentially increasing physical activity, balance, cognition, and mood. Despite these possible benefits, barriers such as unfamiliarity with equipment, complex controls, and unclear instructions may challenge older adults in exergaming. Based on the experience of older adults, they found exergaming enjoyable, particularly the social interactions. Exergaming was perceived as physically and cognitively demanding, with technical and safety challenges. Introducing exergaming requires thorough familiarization, including written and video instructions, follow-up support, and home accessibility. To be able to follow improvements during exergaming as well as age-appropriate challenges are important for successful integration into daily life. Based on these findings, an ExerGameFlow model for older adults was developed which provides practical implications for future design of exergames and interventions.
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Affiliation(s)
- Patrik Rytterström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
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Shrestha AB, Taha AM, Siddiq A, Shrestha S, Thakur P, Chapagain S, Sharma S, Halder A, Rajak K, Shah V. Virtual and augmented reality in cardiovascular care in low and middle income country. Curr Probl Cardiol 2024; 49:102380. [PMID: 38191103 DOI: 10.1016/j.cpcardiol.2024.102380] [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: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
The global health sector has witnessed an escalating integration of Virtual Reality (VR) and Augmented Reality (AR) technologies, particularly in high-income countries. The application of these cutting-edge technologies is gradually extending to Low- and Middle-Income Countries (LMICs), notably in the domain of cardiovascular care. AR and VR technologies are revolutionizing cardiovascular care by offering solutions for diagnosis, medical training, and surgical planning. AR and VR provide detailed and immersive visualizations of cardiac structures, aiding in diagnosis and intervention planning. In cardiovascular care, VR reduces patient-reported pain, eases anxiety, and accelerates post-procedural recovery. AR and VR are also valuable for life support training, creating immersive and controlled learning environments. AR and VR have the potential to significantly impact healthcare in low- and middle-income countries with enhanced accessibility and affordability. This review outlines the existing spectrum of VR and AR adoption and its burgeoning utility in the cardiovascular domain within LMICs.
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Affiliation(s)
- Abhigan Babu Shrestha
- Department of Internal medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh.
| | | | | | | | - Prince Thakur
- Nepalgunj Medical College and Research Institute, Nepalgunj, Nepal
| | | | | | - Anupam Halder
- Department of Internal Medicine, UPMC Harrisburg, PA, United States
| | - Kripa Rajak
- Department of Internal Medicine, UPMC Harrisburg, PA, United States
| | - Vaibhav Shah
- Department of Internal Medicine, Icahn School of Medicine, Mount Sinai- Elmhurst Hospital Centre, New York, United States
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Ravani E, Ali F, Albuainain S, Flamarzi S, Dirar T, O’Brien M, Morris L. Exploring the barriers and facilitators experienced by patients with heart failure when using popular exergaming platforms for self-management-a systematic review. Digit Health 2024; 10:20552076241249823. [PMID: 39070896 PMCID: PMC11282532 DOI: 10.1177/20552076241249823] [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] [Accepted: 04/10/2024] [Indexed: 07/30/2024] Open
Abstract
Objective To systematically explore the barriers and facilitators experienced by patients with heart failure when using the most popular commercially-accessible digital exergaming platforms for self-management. Methods A systematic literature search was conducted in: Embase, SCOPUS, PubMed, and ProQuest. Qualitative/mixed methods studies published in English between 2000 and 2024, including adults >18 years with heart failure using digital gaming platforms for exercise as self-management (i.e. Microsoft Xbox/Kinect, Sony PlayStation®, Nintendo™ Wii) were considered. Risk of bias was assessed using the Critical Appraisal Skills Program. The grounded theory method was used to extract, analyze, and synthesize the data. Results Three articles which qualitatively reported on the experiences of the patients with heart failure when using Nintendo™ Wii for self-management were included. Seventy-nine participants (male and female, age 32-81 years) were included in the studies. The three included studies were of high quality. Extracted qualitative data were grouped into subthemes, which were grouped into main themes, namely, Engagement, Apathy, Convenience, Health-related benefits and Gaming Platforms. The main themes were categorized into Barriers and Facilitators. Patients reported that gaming platforms were simple, easy to use, interesting, and motivating (Facilitators). Boredom while playing specific games, preferring other activities and technical issues were reported as Barriers. Conclusion This review provides the first insights into the barriers and facilitators patients with heart failure experience when using popular digital exergaming platforms to participate in exercise programs in the self-management of their condition. However, few high-quality studies exist which limits the conclusions made and warrants further research in this area.
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Affiliation(s)
- Elham Ravani
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Fai Ali
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Sara Albuainain
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Sara Flamarzi
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Tuqa Dirar
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Michelle O’Brien
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
| | - Linzette Morris
- Department of Rehabilitation Sciences, College of Health Science, QU Health Sector, Qatar University, Doha, Qatar
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Vasodi E, Saatchian V, Dehghan Ghahfarokhi A. Virtual reality-based exercise interventions on quality of life, some balance factors and depression in older adults: A systematic review and meta-analysis of randomized controlled trials. Geriatr Nurs 2023; 53:227-239. [PMID: 37598426 DOI: 10.1016/j.gerinurse.2023.07.019] [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: 05/27/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the impact of virtual reality-based exercise on the quality of life, some balance variables, and depression among older adults aged 60 years or older. METHOD We systematically searched five electronic databases. RESULTS Twenty-seven articles met our inclusion criteria. Meta-analysis revealed that exercise using virtual reality had a significant positive effect on overall quality of life (p = 0.05), mental (p = 0.001) and physical component scores (p = 0.01), social relation (p = 0.0002), psychological health(p = 0.01), physical health(p = 0.04), and environmental health (p = 0.04). Additionally, depression significantly improved following virtual reality-based exercise (p = 0.01). However, there were significant improvements in the balance berg scale (p<0.00001) and ABC scale (p<0.00001) but not in timed-up-and-go(TUG) or 8-foot-up-and-go(8-FUG). DISCUSSION Virtual reality-based exercise has a positive impact on various aspects of quality of life, BBS and ABC scores, and depression. More studies with larger sample sizes and less heterogeneity in design and assessments are required.
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Affiliation(s)
- Elham Vasodi
- Department of Physical Education and Sport Sciences, Shahrood University of Technology, Shahrood, Iran
| | - Vahid Saatchian
- Department of Physical Education and Sport Sciences, Imam Reza international University, Mashhad, Iran.
| | - Amin Dehghan Ghahfarokhi
- Sport Management Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Moonaghi HK, Ahrari S, Mahdizadeh SM, Bakavoli AH, Riahi SM. Effective Strategies for Physical Activity Adherence in Heart Failure Patients: An Umbrella Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1832-1843. [PMID: 38033844 PMCID: PMC10682580 DOI: 10.18502/ijph.v52i9.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/15/2022] [Indexed: 12/02/2023]
Abstract
Background Despite the importance of physical activity in heart failure treatment, physical activity adherence in heart failure patients is low. The purpose of this umbrella review was to obtain the best strategies for enhancing physical activity adherence among HF patients. Methods Databases were investigated from 2010 to Jan 2022. The full text of the papers was investigated in terms of inclusion and exclusion criteria. Eventually, out of 74 relevant papers, 7-review study with 20977 patients were eligible and included in the study. Results Five key effective approaches were identified in two subsets for enhancing physical activity adherence as follows: 1) exercise-based approaches including 1.1) Exergames, whereby the extent of adherence to exergames was between 84 and 98%. 1.2) Tele-rehabilitation with 70%-100% adherence the intervention groups 1.3) Tai chi and Qigong practices (TQPs), whereby the exercise adherence in TQP groups was 67-100%, 2. Theoretical-behavioral approaches 2.1) approaches based on behavioral and psychological theories, which were a combination of an exercise program alongside a behavior modification intervention, 2.2) Self-efficacy. Conclusion Approaches that are based on exercise alongside behavioral and theoretical interventions could enhance physical activity adherence among HF patients. It is suggested to evaluate mix methods of exercise-based approaches and theoretical-behavioral approaches mentioned in this study in future clinical trial studies. Use of capacity of TR programs improve to physical activity adherence should receive more attention.
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Affiliation(s)
- Hossein Karimi Moonaghi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahnaz Ahrari
- Department of ParaMedicine, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mousa Mahdizadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari Bakavoli
- Department of Cardiology, School of Medicine, Ghaem Hospital Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Riahi
- Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
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Boureau A, Annweiler C, Belmin J, Bouleti C, Chacornac M, Chuzeville M, David J, Jourdain P, Krolak‐Salmon P, Lamblin N, Paccalin M, Sebbag L, Hanon O. Practical management of frailty in older patients with heart failure: Statement from a panel of multidisciplinary experts on behalf the Heart Failure Working Group of the French Society of Cardiology and on behalf French Society of Geriatrics and Gerontology. ESC Heart Fail 2022; 9:4053-4063. [PMID: 36039817 PMCID: PMC9773761 DOI: 10.1002/ehf2.14040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/02/2022] [Accepted: 06/09/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS The heart failure (HF) prognosis in older patients remains poor with a high 5-years mortality rate more frequently attributed to noncardiovascular causes. The complex interplay between frailty and heart failure contribute to poor health outcomes of older adults with HF independently of ejection fraction. The aim of this position paper is to propose a practical management of frailty in older patients with heart failure. METHODS A panel of multidisciplinary experts on behalf the Heart Failure Working Group of the French Society of Cardiology and on behalf French Society of Geriatrics and Gerontology conducted a systematic literature search on the interlink between frailty and HF, met to propose an early frailty screening by non-geriatricians and to propose ways to implement management plan of frailty. Statements were agreed by expert consensus. RESULTS Clinically relevant aspects of interlink between frailty and HF have been reported to identify the population eligible for screening and the most suitable screening test(s). The frailty screening program proposed focuses on frailty model defined by an accumulation of deficits including geriatric syndromes, comorbidities, for older patients with HF in different settings of care. The management plan of frailty includes optimization of HF pharmacological treatments and non-surgical device treatment as well as optimization of a global patient-centred biopsychosocial blended collaborative care pathway. CONCLUSION The current manuscript provides practical recommendations on how to screen and optimize frailty management in older patients with heart failure.
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Affiliation(s)
- Anne‐Sophie Boureau
- Department of Geriatrics, University Hospital, Nantes, France; Institut du ThoraxUniversity HospitalNantesFrance
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers; UPRES EA 4638, University of Angers; Gérontopôle Autonomie Longévité des Pays de la Loire; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and DentistryUniversity of Western OntarioLondonONCanada
| | - Joël Belmin
- Hôpital Charles Foix et Sorbonne UniversitéIvry‐sur‐SeineFrance
| | - Claire Bouleti
- Cardiology, University of Poitiers, Clinical Investigation Center (CIC) INSERM 1402Poitiers University HospitalPoitiersFrance
| | | | - Michel Chuzeville
- Geriatric Cardiology Department, Edouard Herriot HospitalHospices Civils de LyonLyonFrance
| | - Jean‐Philippe David
- INSERM‐ U955, IMRB, CEpiA team, Department of Geriatric Medicine, AP‐HP, Hôpitaux Henri‐MondorUniv Paris Est CreteilCreteilFrance
| | - Patrick Jourdain
- DMU COREVE, GHU Paris Saclay, APHP, Paris, France; INSERM UMR S 999IHU TORINO (thorax Innovation)TurinItaly
| | - Pierre Krolak‐Salmon
- Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Hospices Civils de Lyon, Villeurbanne, France; University of Lyon, Lyon, France; Neuroscience Research Centre of Lyon, INSERM 1048CNRSLyonFrance
| | - Nicolas Lamblin
- Institut Cœur Poumon, CHU de Lille, Inserm U1167, Institut Pasteur de LilleUniversité de LilleLilleFrance
| | - Marc Paccalin
- Department of GeriatricsCHU La Milétrie, CIC‐1402PoitiersFrance
| | - Laurent Sebbag
- Service Insuffisance Cardiaque et Transplantation Hospices Civils de Lyon Hôpital Louis PradelBronFrance
| | - Olivier Hanon
- Department of GeriatricsUniversité de Paris, EA 4468, APHP, Hôpital BrocaParisFrance
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Blasco-Peris C, Fuertes-Kenneally L, Vetrovsky T, Sarabia JM, Climent-Paya V, Manresa-Rocamora A. Effects of Exergaming in Patients with Cardiovascular Disease Compared to Conventional Cardiac Rehabilitation: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3492. [PMID: 35329177 PMCID: PMC8950475 DOI: 10.3390/ijerph19063492] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 02/04/2023]
Abstract
Background: Exercise-based cardiac rehabilitation (CR) programs are used for improving prognosis and quality of life in patients with cardiovascular disease (CVD). Nonetheless, adherence to these programs is low, and exercise-based CR programs based on virtual reality (i.e., exergaming) have been proposed as an alternative to conventional CR programs. However, whether exergaming programs are superior to conventional CR programs in patients with CVD is not known. Objective: This systematic review with meta-analysis was conducted to explore whether exergaming enhances exercise capacity, quality of life, mental health, motivation, and exercise adherence to a greater extent than conventional CR programs in patients with CVD. Method: Electronic searches were carried out in PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases up to June 2021. Meta-analyses were performed using robust variance estimation with small-sample corrections. The effect sizes were calculated as the mean differences (MD) or standardized mean differences (SMD) as appropriate. The SMD magnitude was classified as trivial (<0.20), small (0.20−0.49), medium (0.50−0.79), or large (≥0.80). Heterogeneity was interpreted based on the I2 statistics as low (25%), moderate (50%), or high (75%). Results: Pooled analyses showed no differences between exergaming and conventional CR programs for enhancing exercise capacity (i.e., distance covered in the six-minute walk test) (MD+ = 14.07 m (95% confidence interval (CI) −38.18 to 66.32 m); p = 0.426) and mental health (SMD+ = 0.17 (95% CI −0.36 to 0.70); p = 0.358). The results showed a small, statistically nonsignificant improvement in quality of life in favor of exergaming (SMD+ = 0.22 (95% CI = −0.37 to 0.81); p = 0.294). Moderate heterogeneity was found for exercise capacity (I2 = 53.7%), while no heterogeneity was found for quality of life (I2 = 3.3%) and mental health (I2 = 0.0%). Conclusions: Exergaming seems not to be superior to conventional CR programs for improving exercise capacity, quality of life, or mental health in patients with CVD.
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Affiliation(s)
- Carles Blasco-Peris
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain; (C.B.-P.); (L.F.-K.); (J.M.S.); (A.M.-R.)
- Department of Physical Education and Sport, University of Valencia, 46010 Valencia, Spain
| | - Laura Fuertes-Kenneally
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain; (C.B.-P.); (L.F.-K.); (J.M.S.); (A.M.-R.)
- Cardiology Department, Alicante General University Hospital (HGUA), 03010 Alicante, Spain
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic;
| | - José Manuel Sarabia
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain; (C.B.-P.); (L.F.-K.); (J.M.S.); (A.M.-R.)
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Vicente Climent-Paya
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain; (C.B.-P.); (L.F.-K.); (J.M.S.); (A.M.-R.)
- Cardiology Department, Alicante General University Hospital (HGUA), 03010 Alicante, Spain
| | - Agustín Manresa-Rocamora
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain; (C.B.-P.); (L.F.-K.); (J.M.S.); (A.M.-R.)
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
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11
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Chu CH, Quan AML, Souter A, Krisnagopal A, Biss RK. Effects of Exergaming on Physical and Cognitive Outcomes of Older Adults Living in Long-Term Care Homes: A Systematic Review. Gerontology 2022; 68:1044-1060. [PMID: 35290983 PMCID: PMC9501726 DOI: 10.1159/000521832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Aging is often associated with increasing functional decline as measured by deterioration in mobility and activities of daily living. Older adults (OAs) living in residential long-term care (LTC) homes in particular may not engage in regular physical exercise, significantly increasing their risk of further cognitive and functional decline. Exergaming may hold promise for OAs by combining exercise and technology-based gaming systems, but evidence for its use in LTC is unknown. METHODS A systematic review was conducted to summarize the effects of exergaming interventions on physical, cognitive, and quality of life (QoL) outcomes for OAs (>65 years of age) living in LTC. RESULTS Twenty-one studies involving 657 OAs living in LTC met the inclusion criteria. Most studies were associated with a high risk of bias and many used uncontrolled designs and small samples. Across studies, exergame interventions were associated with preliminary benefits relative to control conditions on standardized measures of physical outcomes (e.g., Timed Up & Go, 5-meter gait speed). No consistent effects were found for cognitive and QoL outcomes. CONCLUSIONS Exergames might be a promising intervention to benefit the physical health of OAs (>65 years) living in LTC, but more research is required to determine the effects of exergaming on physical health, as well as cognitive and QoL outcomes. More specifically, larger and more methodologically robust evaluations are needed.
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Affiliation(s)
- Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Amanda My Linh Quan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Allison Souter
- Faculty of Arts and Science, Queens University, Kingston, Ontario, Canada
| | | | - Renée K Biss
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
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12
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Hayden L, Passarelli C, Shepley SE, Tigno W. A scoping review: Sensory interventions for older adults living with dementia. DEMENTIA 2022; 21:1416-1448. [PMID: 35230906 DOI: 10.1177/14713012211067027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This scoping review focused on the existing scholarly literature exploring sensory interventions and immersive environments developed for, and used by, older adults living with dementia. The purpose of the scoping review is 1) to understand the various sensory interventions that have been developed, used, and have provided data to show how such interventions are expected to impact the lives of individuals living with dementia; and 2) to understand how the field is moving forward. We chose to map the literature to understand the types of interventions, the types of outcomes measured, and the contexts of their implementation. Our search was constrained to references from 1990 to 1 June 2019 in the following databases: Academic Search Complete, CINAHL Complete, MEDLINE, PsycINFO databases, and Summon Search discovery layer. We screened 2305 articles based on their titles and abstracts, and 465 were sent to full text review, of which 170 were included in our full text extraction. Once the data were extracted, we created emic categories, which emerged from the data, for data that were amenable to categorization (e.g., study setting, intervention type, and outcome type). We developed ten different categories of interventions: art, aromatics, light, multi-component interventions, multisensory rooms, multisensory, music, nature, touch, and taste. Sensory interventions are a standard psychosocial approach to managing the personal expressions commonly experienced by people living with dementia. Our findings can help providers, caregivers, and researchers better design interventions for those living with dementia, to help them selectively choose interventions for particular outcomes and settings. Two areas emerging in the field are nature interventions (replacing traditional "multisensory rooms" with natural environments that are inherently multisensory and engaging) and multi-component interventions (where cognitive training programs are enhanced by adding sensory components).
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13
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Kim JH. Regular physical exercise and its association with depression: A population-based study short title: Exercise and depression. Psychiatry Res 2022; 309:114406. [PMID: 35074644 DOI: 10.1016/j.psychres.2022.114406] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 01/01/2023]
Abstract
This study is to estimate the relation between regular physical exercise and the risk of depressive disorder and depressive symptoms. Data from the Korean Longitudinal Study of Aging (KLoSA) from 2008 to 2018 were used, and 3,070 research samples were included at baseline at 2008. To analyze the relation between physical exercise and risk of depression, a generalized estimating equation (GEE) model and chi-square test were used. The estimate of Center for Epidemiologic Studies Depression (CESD) in those with "< 3 h" of exercise per week was 0.033 higher (95% Confidence Interval [CI]: 0.001 - 0.065 p-value: 0.046) compared to those with "5 h or more" of exercise per week. In terms of exercise duration, the estimates for CESD was 0.153 higher (95% CI: 0.111 - 0.195 p-value: <0.0001) in "< 1 year" and 0.143 higher (95% CI: 0.109-0.178 p-value: <0.0001) in "1-2 year", compared to "5 years or more" of exercise duration. This study showed a negative relationship between regular exercise and depressive symptoms in community-dwelling adults aged 45 years and above. To develop the habit of regular physical exercise and to reinforce self-esteem, simple and practical strategies of effective exercise may become important but effective exercise interventions.
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Affiliation(s)
- Jae-Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 330-714 Cheonan, Republic of Korea; Institute of Health Promotion and Policy, Dankook University, Cheonan, Republic of Korea.
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14
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Vaccaro JA, Gaillard TR, Marsilli RL. Review and Implications of Intergenerational Communication and Social Support in Chronic Disease Care and Participation in Health Research of Low-Income, Minority Older Adults in the United States. Front Public Health 2021; 9:769731. [PMID: 35004581 PMCID: PMC8728749 DOI: 10.3389/fpubh.2021.769731] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Health disparities disproportionally affect Black and Hispanic older US adults. Health research is needed to understand and eliminate these disparities; however, older adults, and particularly Black and Hispanic/Latino older adults are underrepresented in health research. Adult children have influenced health behavior and health outcomes of their older parents in several demographics in the US. Analysis of these studies can lead to a model for the development of interventions aimed at improving health and healthcare participation of older Black and Hispanic US adults. Objectives: To review the role of intergenerational communication and social support in health behavior, health research, and health outcomes for older adults and to apply these findings toward a model for health interventions for Black and Hispanic US older adults. Methods: An analytical narrative review and application toward an intervention model. Results: Key topic areas were reviewed and analyzed by examining studies that applied forms of intergenerational communication and/or intergenerational social support with the goal of either improving health, disease management and/or participation in health research in populations world-wide. Next, a model for providing health interventions in older Black and Hispanic US adults was developed using strategies gleaned from the findings. Conclusion: A model for health intervention for Black and Hispanic/Latino US older adults was presented based on an analytical review and intergenerational communication and/or social support. Qualitative data are necessary to understand the enablers and barriers of intergenerational communication and social support to improve health outcomes in these populations.
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Affiliation(s)
- Joan A. Vaccaro
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Trudy R. Gaillard
- Nichole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, United States,*Correspondence: Trudy R. Gaillard
| | - Ramces L. Marsilli
- Information and Research Service, Library Operations, Florida International University, Miami, FL, United States
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15
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Wii or Kinect? A Pilot Study of the Exergame Effects on Older Adults' Physical Fitness and Psychological Perception. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412939. [PMID: 34948547 PMCID: PMC8701390 DOI: 10.3390/ijerph182412939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Exergames are now often implemented among older adults for health purposes. This study aimed to investigate whether playing Kinect and Wii exergames has effects on older adults’ physical fitness and psychological perceptions towards exergames. A total of 23 older participants aged above 60 years were recruited and randomly assigned into two groups, in which they played either Kinect or Wii Bowling exergames for three sessions in one week. Physiological and psychological measures were collected including heart rate, blood pressure, shoulder flexibility, as well as perceived benefits and intentions for future use. Findings indicated that exergames are equivalent to light-intensity exercises, and hence pose no or minimal risk to older adults. Older adults had a positive attitude towards exergames and have a strong willingness to engage in exergaming on a regular basis. Although no significant platform difference was identified, observation and qualitative findings suggested that Wii might provide a more intense physical activity than Kinect, while Kinect might obtain a higher perception among older adults than Wii. The study has several practical implications for both health professionals and exergame designers targeting the ageing population.
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16
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Jaarsma T, Klompstra L, Strömberg A, Ben Gal T, Mårtensson J, van der Wal MH. Exploring factors related to non-adherence to exergaming in patients with chronic heart failure. ESC Heart Fail 2021; 8:4644-4651. [PMID: 35167729 PMCID: PMC8712787 DOI: 10.1002/ehf2.13616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/23/2021] [Accepted: 09/04/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS This study aimed to explore factors related to non-adherence to exergaming in patients with heart failure. METHODS AND RESULTS Data from patients in the exergame group in the HF-Wii trial were used. Adherence to exergaming was defined as playing 80% or more of the recommended time. Data on adherence and reasons for not exergaming at all were collected during phone calls after 2, 4, 8, and 12 weeks. Logistic regression was performed between patients who were adherent and patients who were non-adherent. Secondly, a logistic regression was performed between patients who not exergamed at all and patients who were adherent to exergaming. Finally, we analysed the reasons for not exergaming at all with manifest content analysis. Almost half of the patients were adherent to exergaming. Patients who were adherent had lower social motivation [odds ratio (OR) 0.072; 95% confidence interval (CI) 0.054-0.095], fewer sleeping problems (OR 0.84; 95% CI 0.76-0.092), and higher exercise capacity (OR 1.003; 95% CI 1.001-1.005) compared with patients who were non-adherent. Patients who not exergamed at all had lower cognition (OR 1.18; 95% CI 1.06-1.31) and more often suffered from peripheral vascular disease (OR 3.74; 95% CI 1.01-13.83) compared with patients who were adherent to exergaming. Patients most often cited disease-specific barriers as a reason for not exergaming at all. CONCLUSIONS A thorough baseline assessment of physical function and cognition is needed before beginning an exergame intervention. It is important to offer the possibility to exergame with others, to be able to adapt the intensity of physical activity.
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Affiliation(s)
- Tiny Jaarsma
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
| | - Leonie Klompstra
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
| | - Anna Strömberg
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
- Department of CardiologyLinkoping UniversityLinkopingSweden
| | - Tuvia Ben Gal
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Jan Mårtensson
- Department of Nursing, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Martje H.L. van der Wal
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Cardiology, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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17
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Ismail NA, Hashim HA, Ahmad Yusof H. Physical Activity and Exergames Among Older Adults: A Scoping Review. Games Health J 2021; 11:1-17. [PMID: 34851732 DOI: 10.1089/g4h.2021.0104] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Recently, exergames have been widely applied as exercise platforms among older adults. However, studies on the influence of exergames on older adults' physical activity remain scarce. The review article highlights the potential benefit of exergames as a physical activity tool for older adults. The literature search followed the PRISMA guidelines on databases PubMed (Public/Publisher MEDLINE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, and Scopus. The literature included studies that evaluated the influence of exergames on older adults' physical activity. Articles were excluded if the mixed intervention was used, emphasizing specific limbs, improving specific tasks, or not mentioning intervention. The review article identified 25 studies that reported on 855 older adults 55 years of age and older. In addition, the common exergaming technology platforms examined were Microsoft Kinect™, Nintendo® Wii™, cybercycling, and interactive video dance games. Meanwhile, 11 studies used a pretest/post-test design and randomized controlled trial design in 14 studies. The review found that exergames significantly impacted the older adults' physical activity level as participants experienced improved balance and cognitive function, and enjoyed playing exergame, thus prolonging their game engagement. Although research on exergames is still new, current evidence showed a significant potential benefit of exergames as a physical activity tool for older adults. To overcome the limitation on various parameters that showed different effects and outcomes of exergames, the study recommends implementing randomized controlled trials with long-term observation using a mixed-method approach. Moreover, a multidisciplinary method involving exercise and neuromotor control experts could determine potential mechanisms of action that benefited from the exercises.
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Affiliation(s)
- Noor Azila Ismail
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Hairul Anuar Hashim
- Exercise & Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Hazwani Ahmad Yusof
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia
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18
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Kamnardsiri T, Phirom K, Boripuntakul S, Sungkarat S. An Interactive Physical-Cognitive Game-Based Training System Using Kinect for Older Adults: Development and Usability Study. JMIR Serious Games 2021; 9:e27848. [PMID: 34704953 PMCID: PMC8581754 DOI: 10.2196/27848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/08/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Declines in physical and cognitive functions are recognized as important risk factors for falls in older adults. Promising evidence suggests that interactive game-based systems that allow simultaneous physical and cognitive exercise are a potential approach to enhance exercise adherence and reduce fall risk in older adults. However, a limited number of studies have reported the development of a combined physical-cognitive game-based training system for fall risk reduction in older adults. OBJECTIVE The aim of this study is to develop and evaluate the usability of an interactive physical-cognitive game-based training system (game-based exercise) for older adults. METHODS In the development phase (Part I), a game-based exercise prototype was created by integrating knowledge and a literature review as well as brainstorming with experts on effective fall prevention exercise for older adults. The output was a game-based exercise prototype that covers crucial physical and cognitive components related to falls. In the usability testing (Part II), 5 games (ie, Fruits Hunter, Where Am I?, Whack a Mole, Sky Falls, and Crossing Poison River) with three difficulty levels (ie, beginner, intermediate, and advanced levels) were tested in 5 older adults (mean age 70.40 years, SD 5.41 years). After completing the games, participants rated their enjoyment level while engaging with the games using the Physical Activity Enjoyment Scale (PACES) and commented on the games. Descriptive statistics were used to describe the participants' characteristics and PACES scores. RESULTS The results showed that the average PACES score was 123 out of 126 points overall and between 6.66 and 7.00 for each item, indicating a high level of enjoyment. Positive feedback, such as praise for the well-designed interactions and user-friendly interfaces, was also provided. CONCLUSIONS These findings suggest that it is promising to implement an interactive, physical-cognitive game-based exercise in older adults. The effectiveness of a game-based exercise program for fall risk reduction has yet to be determined.
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Affiliation(s)
- Teerawat Kamnardsiri
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, Thailand
- Department of Digital Game, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Kochaphan Phirom
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sirinun Boripuntakul
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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19
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Rodacki ALF, Pitta A, Lara JP, Pophal da Silva L, Villarejo Mayor JJ, Moreira NB. Exergames Training Effects on Gait During Single and Dual Tasks in Sexagenarian Women. Games Health J 2021; 10:321-329. [PMID: 34449273 DOI: 10.1089/g4h.2021.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: This study was designed to analyze the effects of an exergames training program on gait parameters while holding a cellphone conversation at self-selected walking speed (SSWS) and fast walking speed (FWS). Materials and Methods: Twenty-one older women (66.3 ± 4.0 years) practiced exergames for 12 weeks and were assessed for spatiotemporal gait parameters at SSWS and FWS under single task and dual task. The strength of the lower limbs was measured by an isokinetic dynamometer (Byodex System 3). The cognitive function was assessed with the Montreal Cognitive Assessment (MoCA). The tests were assessed 4 weeks before the start of the exergames training (baseline, T0), immediately before (pretraining, T1), and at the end of 12 weeks of the exergame training (post-training, T2), except for the MoCA test that was assessed at T0 and T2. Results: The spatiotemporal gait parameters at SSWS and FWS showed extensive changes when a cellphone conversation was sustained (e.g., 6.5% and 5.8% reduction in walking speed, respectively). Exergames training was not effective in minimizing these changes or improving muscle strength after 12 weeks (<3.0%). Minor cognitive improvements (0.5 points) were observed in response to training. Conclusion: Holding a cellphone conversation while walking changed several gait parameters, irrespective of the walking speed. The spatiotemporal gait parameters and lower limb muscle strength in sexagenarian women remained unchanged after the exergames training program.
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Affiliation(s)
- André Luiz Felix Rodacki
- Centro de Estudos do Comportamento Motor (CECOM), Universidade Federal do Paraná, Coronel Heráclito dos Santos Av., 100 Curitiba, Brazil
| | - Arthur Pitta
- Centro de Estudos do Comportamento Motor (CECOM), Universidade Federal do Paraná, Coronel Heráclito dos Santos Av., 100 Curitiba, Brazil
| | - Jerusa Petróvna Lara
- Centro de Estudos do Comportamento Motor (CECOM), Universidade Federal do Paraná, Coronel Heráclito dos Santos Av., 100 Curitiba, Brazil
| | - Letícia Pophal da Silva
- Centro de Estudos do Comportamento Motor (CECOM), Universidade Federal do Paraná, Coronel Heráclito dos Santos Av., 100 Curitiba, Brazil
| | - John Jairo Villarejo Mayor
- Centro de Estudos do Comportamento Motor (CECOM), Universidade Federal do Paraná, Coronel Heráclito dos Santos Av., 100 Curitiba, Brazil
| | - Natália Boneti Moreira
- Centro de Estudos do Comportamento Motor (CECOM), Universidade Federal do Paraná, Coronel Heráclito dos Santos Av., 100 Curitiba, Brazil
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Abstract
BACKGROUND Few investigators have explored challenges and facilitators to exergaming, essential factors to exergaming adherence, among patients with heart failure. OBJECTIVES In this qualitative study, we explored facilitators and challenges using a home-based exergame platform, the Nintendo Wii Sports, in patients with heart failure. METHODS Semistructured face-to-face interviews were conducted in 13 participants given a diagnosis of heart failure (age range, 34-69 years). Participants were asked about their experiences with exergaming. Transcribed interviews were analyzed with content analysis. RESULTS The following 4 facilitators were identified: (1) enjoyment and competition motivated gaming, (2) accessibility at home gave freedom and lowered participants' barriers to exercise, (3) physical benefits when decreasing sedentary lifestyle, and (4) psychosocial benefits on stress, mood, and family interactions. Challenges included (1) diminished engagement over time due to boredom playing similar games and (2) frustrations due to game difficulty and lack of improvement. CONCLUSION Exergaming can increase individuals' physical activity because of easy accessibility and the fun and motivating factors the games offer. Participants initially found exergaming enjoyable and challenging. However, engagement diminished over time because of boredom from playing the same games for a period of time. Participants' preferences and capacities, participants' past experiences, and social support must be considered to avoid boredom and frustrations. Future studies are warranted to determine adherence to exergaming among patients with heart failure and, ultimately, increased overall well-being and healthcare delivery in this patient population.
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21
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A Feasibility Study of a Multifaceted Walking Intervention to Maintain the Functional Mobility, Activities of Daily Living, and Quality of Life of Nursing Home Residents With Dementia. Rehabil Nurs 2021; 45:204-217. [PMID: 30325875 DOI: 10.1097/rnj.0000000000000186] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of the study was to evaluate the feasibility, acceptability, and efficacy of a multifaceted walking intervention (MWI) aimed to maintain the functional mobility, activities of daily living function, and quality of life of long-term care home residents with dementia. DESIGN/METHODS A quasiexperimental time-series design was used. The 4-month intervention provided one-on-one walking 2-4 days a week, guided by an individualized communication care plan and interviews with collaterals and staff. RESULTS The MWI was feasible based on high recruitment and adherence rates (86% and 94%, respectively) and highly acceptable to stakeholders. Residents (n = 25) showed significant improvements after the intervention: Timed Up-and-Go (-8.85 seconds, p = .00), Two-Minute Walk Test (27.47 m, p = .00), Functional Independence Measure (0.72, p = .00), and Alzheimer's Disease-Related Quality of Life (2.44, p = .05). CONCLUSION The MWI was feasible and improved functional mobility compared to usual care. CLINICAL RELEVANCE Physical activity delivered with a person-centered care was feasible and may be beneficial to mitigate decline in long-term care home residents with dementia.
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22
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Chu CH, Biss RK, Cooper L, Quan AML, Matulis H. Exergaming Platform for Older Adults Residing in Long-Term Care Homes: User-Centered Design, Development, and Usability Study. JMIR Serious Games 2021; 9:e22370. [PMID: 33687337 PMCID: PMC7988392 DOI: 10.2196/22370] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/12/2020] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background Older adults (OAs) residing in long-term care (LTC) homes are often unable to engage in adequate amounts of physical activity because of multiple comorbidities, including frailty and severe cognitive impairments. This level of physical inactivity is associated with declines in cognitive and functional abilities and can be further compounded by social isolation. Exergaming, defined as a combination of exercise and gaming, has the potential to engage OAs in exercise and encourage social interaction. However, previously used systems such as the Nintendo Wii are no longer commercially available, and the physical design of other exergames is not suitable for OAs (ie, fall risks, accessibility issues, and games geared toward a younger population) with diverse physical and cognitive impairments. Objective This study aims to design and develop a novel, user-centered, evidence-based exergaming system for use among OAs in LTC homes. In addition, we aim to identify facilitators and barriers to the implementation of our exergaming intervention, the MouvMat, into LTC homes according to staff input. Methods This study used a user-centered design (UCD) process that consisted of 4 rounds of usability testing. The exergame was developed and finalized based on existing evidence, end user and stakeholder input, and user testing. Semistructured interviews and standardized and validated scales were used iteratively to evaluate the acceptability, usability, and physical activity enjoyment of the MouvMat. Results A total of 28 participants, 13 LTC residents, and 15 staff and family members participated in the UCD process for over 18 months to design and develop the novel exergaming intervention, the MouvMat. The iterative use of validated scales (System Usability Scale, 8-item Physical Activity Enjoyment Scale, and modified Treatment Evaluation Inventory) indicated an upward trend in the acceptability, usability, and enjoyment scores of MouvMat over 4 rounds of usability testing, suggesting that identified areas for refinement and improvement were appropriately addressed by the team. A qualitative analysis of semistructured interview data found that residents enjoyed engaging with the prototype and appreciated the opportunity to increase their PA. In addition, staff and stakeholders were drawn to MouvMat’s ability to increase residents’ autonomous PA. The intended and perceived benefits of MouvMat use, that is, improved physical and cognitive health, were the most common facilitators of its use identified by study participants. Conclusions This study was successful in applying UCD to collaborate with LTC residents, despite the high number of physical and sensory impairments that this population experiences. By following a UCD process, an exergaming intervention that meets diverse requirements (ie, hardware design features and motivation) and considers environmental barriers and residents’ physical and cognitive needs was developed. The effectiveness of MouvMat in improving physical and cognitive abilities should be explored in future multisite randomized controlled trials.
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Affiliation(s)
- Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Renée K Biss
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Lara Cooper
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Amanda My Linh Quan
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Henrique Matulis
- Department of Mechanical & Industrial Engineering, University of Toronto, Toronto, ON, Canada
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23
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Alhasan H, Alshehri MA, Wheeler PC, Fong DTP. Effects of Interactive Videogames on Postural Control and Risk of Fall Outcomes in Frail and Pre-frail Older Adults: A Systematic Review and Meta-Analysis. Games Health J 2021; 10:83-94. [PMID: 33651955 DOI: 10.1089/g4h.2020.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Interactive videogames (IVGs) have been used to reduce risk of falls in the older adult and improve postural control (PC) outcomes. Objective: To systematically review trials that examine whether IVGs training is effective in improving PC and managing falls in frail and pre-frail older adults. Data Sources: Four databases were searched, Scopus, Web of science, PubMed, and MEDLINE, from January 2007 to March 2019. Eligibility Criteria: Frail and pre-frail older adults aged 65+. Interventions were any Nintendo® Wii™ training. The outcome measures were PC and risk of falls as measured by any validated outcome measure. Studies Appraisal Method: The PEDro (Physiotherapy Evidence Database) scale and Cochrane risk-of-bias tool were used by two independent authors. Results: Eleven papers were included, involving 388 participants, with a mean age of 79 ± 5.7 years. The mean duration of IVGs sessions was 8.8 ± 3.8 weeks, the mean total number of sessions was 20 ± 11.1 session, and the mean length of training was 44 ± 15.7 minutes. Meta-Analysis: IVGs achieved better results compared with traditional exercises and control on the Berg Balance Scale (mean difference [MD] 2.80; 95% confidence interval [CI] 1.21 to 4.39; P < 0.001; I2 = 16%), as well as in the short term on Timed Up and Go (MD -1.23; 95% CI -2.37 to -0.09; P = 0.03; I2 = 0%). Limitation: Definitive judgement could not be made due to the variability in training, training duration and outcomes measurement. Conclusion: IVGs is a promising modality that has a positive effect on PC but not on the outcome of falls, so it should be prescribed with caution among frail older adults. Systematic Review Registration: PROSPERO registration number: CRD42019129611.
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Affiliation(s)
- Hammad Alhasan
- National Centre for Sport and Exercise Medicine - East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.,Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mansour Abdullah Alshehri
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia.,NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Patrick C Wheeler
- National Centre for Sport and Exercise Medicine - East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.,Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine - East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
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24
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A Feasibility Study for Implementation "Health Arcade": A Study Protocol for Prototype of Multidomain Intervention Based on Gamification Technologies in Acutely Hospitalized Older Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218058. [PMID: 33139664 PMCID: PMC7662354 DOI: 10.3390/ijerph17218058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
The aim of this article is to present the research protocol for a study that will evaluate the feasibility of implementation of Health Arcade prototype multidomain intervention based on physical and cognitive training using gamification technologies at improving care for older people hospitalized with an acute illness. A total of 40 older people will be recruited in a tertiary public hospital at Pamplona, Spain. The intervention duration will be four to nine consecutive days. Additionally, the patients will receive encouragement for maintaining active during hospital stay and for reducing sedentary time. Primary implementation-related outcomes will be the adherence to treatment (i.e., number of games and days completed during the intervention period), reaction or response time, and number of success and failures in each game per day. Secondary implementation-related outcomes will be self-perceived grade of difficulty, satisfaction, enjoyment per game and session, and self-perceived difficulties in handling the prototype hardware. Other health-related outcomes will also be assessed such as functional capacity in activities of daily living, mood status, quality of life, handgrip strength, physical activity levels, and mobility. The current study will provide additional evidence to support the implementation of multidomain interventions designed to target older persons with an acute illness based on friendly technology. The proposed intervention will increase accessibility of in-clinical geriatrics services, improve function, promote recovery of the health, and reduce economic costs.
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25
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Cuevas-Lara C, Izquierdo M, Sáez de Asteasu ML, Ramírez-Vélez R, Zambom-Ferraresi F, Zambom-Ferraresi F, Martínez-Velilla N. Impact of Game-Based Interventions on Health-Related Outcomes in Hospitalized Older Patients: A Systematic Review. J Am Med Dir Assoc 2020; 22:364-371.e1. [PMID: 32873472 DOI: 10.1016/j.jamda.2020.07.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the effectiveness of game-based interventions compared with usual care on health-related outcomes for acutely hospitalized older patients. DESIGN Systematic review of randomized controlled trials (RCT) and nonrandomized trials. SETTING AND PARTICIPANTS Adults aged 65 years or older admitted to an Acute Care for Elderly unit were selected. MEASURES Health-related outcomes (eg, functional capacity, quality of life, adherence to treatment). RESULTS Four RCTs were included in the review. The interventions were based on the implementation of serious-game programs using Nintendo Wii in acute medical patients. Across the included studies, no significant differences were observed between groups on functional capacity and health-related quality of life. Significant differences were found between groups on the adherence to treatment (in favor of the control group), but no differences were obtained in other outcomes such as enjoyment and motivation. CONCLUSIONS AND IMPLICATIONS In general, there is very limited evidence for the efficacy to reach conclusions about the effects of game-based interventions on health-related outcomes in acutely hospitalized older patients. Future studies are needed to improve our knowledge in the field; however, we consider that these strategies should be considered in the future complementary to usual care.
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Affiliation(s)
- César Cuevas-Lara
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain.
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Mikel L Sáez de Asteasu
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Fabiola Zambom-Ferraresi
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain.
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26
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Besnier F, Gayda M, Nigam A, Juneau M, Bherer L. Cardiac Rehabilitation During Quarantine in COVID-19 Pandemic: Challenges for Center-Based Programs. Arch Phys Med Rehabil 2020; 101:1835-1838. [PMID: 32599060 PMCID: PMC7319913 DOI: 10.1016/j.apmr.2020.06.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022]
Abstract
Because of the coronavirus disease 2019 (COVID-19) epidemic, many cardiac rehabilitation (CR) services and programs are stopped. Because CR is a class I level A recommendation with clinical benefits that are now well documented, the cessation of CR programs can lead to dramatic consequences in terms of public health. We propose here a viewpoint of significant interest about the sudden need to develop remote home-based CR programs both in clinical research and in clinical care routine. This last decade, the literature on remote home-based CR programs has been increasing, but to date only clinical research experiences have been implemented. Benefits are numerous and the relevance of this approach has obviously increased with the actual health emergency. The COVID-19 crisis, the important prevalence of smartphones, and high-speed Internet during confinement should be viewed as an opportunity to promote a major shift in CR programs with the use of telemedicine to advance the health of a larger number of individuals with cardiac disease.
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Affiliation(s)
- Florent Besnier
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC.
| | - Mathieu Gayda
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC
| | - Anil Nigam
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC
| | - Martin Juneau
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC
| | - Louis Bherer
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC; Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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27
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Ingadottir B, Jaarsma T, Klompstra L, Aidemark J, Askenäs L, Bahat Y, Ben Gal O, Berglund A, Berglund E, Höchsmann C, Plotnik M, Trappenburg JC, Schmidt-Trucksäss A, Strömberg A. Let the games begin: Serious games in prevention and rehabilitation to improve outcomes in patients with cardiovascular disease. Eur J Cardiovasc Nurs 2020; 19:558-560. [PMID: 32538132 DOI: 10.1177/1474515120934058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Brynja Ingadottir
- University of Iceland and Landspitali - the National University Hospital of Iceland, Iceland
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Jan Aidemark
- Department of Informatics, Linnaeus University, Sweden
| | - Linda Askenäs
- Department of Informatics, Linnaeus University, Sweden
| | - Yotam Bahat
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel
| | - Oran Ben Gal
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel
| | - Aseel Berglund
- Department of Computer and Information Science, Linköping University, Sweden
| | - Erik Berglund
- Department of Computer and Information Science, Linköping University, Sweden
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Ingestive Behavior, Weight Management & Health Promotion Laboratory, USA
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel.,Department of Physiology and Pharmacology, Tel Aviv University, Israel
| | - Jaap Ca Trappenburg
- Department of Public Health, Healthcare Innovation and Evaluation and Medical Humanities, Julius Center, The Netherlands
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.,Department of Cardiology, Linköping University, Sweden
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28
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Kühn S, Gallinat J, Mascherek A. Effects of computer gaming on cognition, brain structure, and function: a critical reflection on existing literature
. DIALOGUES IN CLINICAL NEUROSCIENCE 2020; 21:319-330. [PMID: 31749656 PMCID: PMC6829166 DOI: 10.31887/dcns.2019.21.3/skuehn] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Video gaming as a popular form of leisure activity and its effect on cognition,
brain function, and structure has come into focus in the field of neuroscience.
Visuospatial cognition and attention seem to benefit the most, whereas for executive
functions, memory, and general cognition, the results are contradictory. The particular
characteristics of video games driving these effects remain poorly understood. We
critically discuss major challenges for the existing research, namely, the lack of
precise definitions of video gaming, the lack of distinct choice of cognitive ability
under study, and the lack of standardized study protocols. Less research exists on
neural changes in addition to cognitive changes due to video gaming. Existing studies
reveal evidence for the involvement of similar brain regions in functional and
structural changes. There seems to be a predominance in the hippocampal, prefrontal, and
parietal brain regions; however, studies differ immensely, which makes a meta-analytic
interpretation vulnerable. We conclude that theoretical work is urgently
needed.
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Affiliation(s)
- Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anna Mascherek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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29
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Coats AJS. Exergaming for heart failure: an idea so good it just ought to work. Eur J Heart Fail 2020; 23:125-126. [PMID: 32391941 DOI: 10.1002/ejhf.1842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 01/27/2023] Open
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30
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Tao G, Miller WC, Eng JJ, Lindstrom H, Imam B, Payne M. Self-directed usage of an in-home exergame after a supervised telerehabilitation training program for older adults with lower-limb amputation. Prosthet Orthot Int 2020; 44:52-59. [PMID: 32114933 DOI: 10.1177/0309364620906272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND While home-based exergames help overcome accessibility barriers to rehabilitation, it is unclear what constitutes effective intervention design in using exergames to support self-efficacy and engagement. OBJECTIVE Examine usage of an in-home exergame, compared to control, unsupervised after supervised training by older persons with lower-limb amputation. STUDY DESIGN Secondary analysis of a multi-site parallel evaluator-masked randomized control trial. METHODS WiiNWalk uses the WiiFit and teleconferencing for in-home group-based exergame therapy with clinical supervision. Participants engaged in a 4-week supervised training phase followed by a 4-week unsupervised phase in experimental (WiiNWalk) and attention control groups. Usage between phases and between groups was compared using unsupervised/supervised ratio of session count (over 4 weeks) and session time (mean min/session over 4 weeks) for each phase. RESULTS Participants: n=36 experimental, n=28 control, unilateral lower-limb amputation, age > 50 years, prosthesis usage ≥ 2 hours/day. Session count ratio unsupervised/supervised, median and interquartile range (IQR), was less than parity (p<0.01) for experimental (0.25, IQR 0.00 -0.68) and control (0.18, IQR 0.00 -0.67) groups, with no different between groups (p=0.92). Experimental session time unsupervised/supervised showed consistency (1.12, IQR 0.80 -1.41) between phases (p=0.24); control showed lower (0.76, IQR 0.57 -1.08) ratios compared to experimental (p=0.027). CONCLUSIONS Unsupervised exercise duration remained consistent with supervised, but frequency was reduced. Social and clinical guidance features may remain necessary for sustained lower-limb amputation exergame engagement at home. CLINICAL RELEVANCE This study provides context regarding when prosthesis users are more likely to use exergames such as Wii Fit for exercise therapy. Clinicians may consider our results when applying exergames in their practice or when developing new exergame intervention strategies.
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Affiliation(s)
- Gordon Tao
- The University of British Columbia, Vancouver, BC, Canada
| | | | - Janice J Eng
- The University of British Columbia, Vancouver, BC, Canada
| | | | - Bita Imam
- The University of British Columbia, Vancouver, BC, Canada
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31
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Jaarsma T, Klompstra L, Ben Gal T, Ben Avraham B, Boyne J, Bäck M, Chialà O, Dickstein K, Evangelista L, Hagenow A, Hoes AW, Hägglund E, Piepoli MF, Vellone E, Zuithoff NPA, Mårtensson J, Strömberg A. Effects of exergaming on exercise capacity in patients with heart failure: results of an international multicentre randomized controlled trial. Eur J Heart Fail 2020; 23:114-124. [PMID: 32167657 DOI: 10.1002/ejhf.1754] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/09/2020] [Accepted: 01/16/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | - Tuvia Ben Gal
- Heart Failure Unit, Cardiology department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Binyamin Ben Avraham
- Heart Failure Unit, Cardiology department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Maria Bäck
- Department of Health, Medicine and Caring Sciences, Division of Physiotherapy, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Oronzo Chialà
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Kenneth Dickstein
- University of Bergen, Stavanger University Hospital, Stavanger, Norway
| | | | - Andreas Hagenow
- Center for Clinical Research Südbrandenburg, Elsterweda, Germany
| | - Arno W Hoes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Eva Hägglund
- Department of Cardiology, Karolinska Theme of Heart and Vessel, Heart Failure, Karolinska University Hospital, Stockholm, Sweden
| | - Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza, Italy.,University of Parma, IT2 Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicolaas P A Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Jan Mårtensson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden.,Department of Cardiology, Linköping University, Linköping, Sweden
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32
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Kim C, Sung J, Lee JH, Kim WS, Lee GJ, Jee S, Jung IY, Rah UW, Kim BO, Choi KH, Kwon BS, Yoo SD, Bang HJ, Shin HI, Kim YW, Jung H, Kim EJ, Lee JH, Jung IH, Jung JS, Lee JY, Han JY, Han EY, Won YH, Han W, Baek S, Joa KL, Lee SJ, Kim AR, Lee SY, Kim J, Choi HE, Lee BJ, Kim S. Clinical Practice Guideline for Cardiac Rehabilitation in Korea: Recommendations for Cardiac Rehabilitation and Secondary Prevention after Acute Coronary Syndrome. Korean Circ J 2019; 49:1066-1111. [PMID: 31646772 PMCID: PMC6813162 DOI: 10.4070/kcj.2019.0194] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/23/2019] [Indexed: 02/07/2023] Open
Abstract
Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine-Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine-Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Won Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Center, Seongnam, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University College of Medicine, Cheongju, Korea.
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine-Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea
| | - Il Young Jung
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine-Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea
| | - Ueon Woo Rah
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea
| | - Byung Ok Kim
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bum Sun Kwon
- Department of Rehabilitation Medicine, Dongguk University School of Medicine, Goyang, Korea
| | - Seung Don Yoo
- Department of Rehabilitation Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Wook Kim
- Department and Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Heeyoune Jung
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Eung Ju Kim
- Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | | | - In Hyun Jung
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Jae Seung Jung
- Department of Thoracic and Cardiovascular Surgery, Anam Hospital, Korea University Medical Center, Seoul, Korea
| | - Jong Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Young Han
- Department of Rehabilitation Medicine, Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Woosik Han
- Department of Thoracic Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine-Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Kyung Lim Joa
- Department of Rehabilitation Medicine, Inha University Hospital, Incheon, Korea
| | - Sook Joung Lee
- Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Jihee Kim
- Department of Rehabilitation Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Hee Eun Choi
- Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Byeong Ju Lee
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - Soon Kim
- Research Institute for Social Science, Ewha Woman's University, Seoul, Korea
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33
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Mannheim I, Schwartz E, Xi W, Buttigieg SC, McDonnell-Naughton M, Wouters EJM, van Zaalen Y. Inclusion of Older Adults in the Research and Design of Digital Technology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193718. [PMID: 31581632 PMCID: PMC6801827 DOI: 10.3390/ijerph16193718] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/24/2019] [Accepted: 09/30/2019] [Indexed: 01/09/2023]
Abstract
Digital technology holds a promise to improve older adults' well-being and promote ageing in place. However, there seems to be a discrepancy between digital technologies that are developed and what older adults actually want and need. Ageing is stereotypically framed as a problem needed to be fixed, and older adults are considered to be frail and incompetent. Not surprisingly, many of the technologies developed for the use of older adults focus on care. The exclusion of older adults from the research and design of digital technology is often based on such negative stereotypes. In this opinion article, we argue that the inclusion rather than exclusion of older adults in the design process and research of digital technology is essential if technology is to fulfill the promise of improving well-being. We emphasize why this is important while also providing guidelines, evidence from the literature, and examples on how to do so. We unequivocally state that designers and researchers should make every effort to ensure the involvement of older adults in the design process and research of digital technology. Based on this paper, we suggest that ageism in the design process of digital technology might play a role as a possible barrier of adopting technology.
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Affiliation(s)
- Ittay Mannheim
- School of Allied Health Professions, Fontys University of Applied Science, Eindhoven 5631 BN, The Netherlands.
- Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg 5037 DB, The Netherlands.
| | - Ella Schwartz
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel.
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel.
| | - Wanyu Xi
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel.
| | - Sandra C Buttigieg
- Health Services Management, Faculty of Health Sciences, University of Malta, Msida MSD 2090, Malta.
- Health Services Management Centre, School of Social Policy, College of Social Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Mary McDonnell-Naughton
- Department of Nursing and Health Care Athlone Institute of Technology, Athlone N37 HD68, Ireland.
| | - Eveline J M Wouters
- School of Allied Health Professions, Fontys University of Applied Science, Eindhoven 5631 BN, The Netherlands.
- Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg 5037 DB, The Netherlands.
| | - Yvonne van Zaalen
- School of Allied Health Professions, Fontys University of Applied Science, Eindhoven 5631 BN, The Netherlands.
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Himmelmeier RM, Nouchi R, Saito T, Burin D, Wiltfang J, Kawashima R. Study Protocol: Does an Acute Intervention of High-Intensity Physical Exercise Followed by a Brain Training Video Game Have Immediate Effects on Brain Activity of Older People During Stroop Task in fMRI?-A Randomized Controlled Trial With Crossover Design. Front Aging Neurosci 2019; 11:260. [PMID: 31619984 PMCID: PMC6759467 DOI: 10.3389/fnagi.2019.00260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 09/03/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Elderly people are affected by processes leading to decline in various aspects of daily living that impair their quality of life. Regarding neurological aspects, executive functions have been shown to be valuable for daily life and to slow decline during aging. Most intervention studies intended to improve cognitive functions during aging specifically address long-term destructive processes and countermeasures. However, to an increasing degree, studies also investigate the acute benefits that prove to be useful for daily life, such as physical exercise or video games in the form of exercise video gaming (“exergaming”). Because little is known about the change in cognitive ability following acute intervention of a combination of physical exercise and video gaming, especially for older people, this work is designed as an attempt to address this matter. Methods: This study is a randomized crossover controlled trial to test the response to an acute bout of high-intensity physical exercise followed by a short session with a brain training (Brain Age) video game in physically active and cognitively healthy older adults (60–70 years). The response is measured using Stroop task performance (cognitive task for executive function) and related brain activity assessed with functional magnetic resonance imaging (fMRI). The control conditions are low-intensity physical exercise and Tetris for video gaming. Discussion: This study is intended to provide insight into the alteration of executive function and its related brain activity from an acute intervention with a combination of physical exercise and video gaming in older people. The protocol might not be implementable in daily life to improve cognitive abilities. However, the results can support future studies that investigate cognition and the combination of physical exercise and video gaming. Moreover, it can provide real-life implications. Trial registration: This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000033054). Registered 19 July 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037687.
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Affiliation(s)
- Robin Maximilian Himmelmeier
- Department of Functional Brain Image, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.,Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Rui Nouchi
- Department of Functional Brain Image, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.,Smart Aging Research Center (SARC), Tohoku University, Sendai, Japan
| | - Toshiki Saito
- Department of Functional Brain Image, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Dalila Burin
- Department of Functional Brain Image, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.,Smart Aging Research Center (SARC), Tohoku University, Sendai, Japan
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.,iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Ryuta Kawashima
- Department of Functional Brain Image, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.,Smart Aging Research Center (SARC), Tohoku University, Sendai, Japan
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Zores F, Iliou MC, Gellen B, Kubas S, Berthelot E, Guillo P, Bauer F, Lamblin N, Bosser G, Damy T, Cohen-Solal A, Beauvais F. Physical activity for patients with heart failure: Position paper from the heart failure (GICC) and cardiac rehabilitation (GERS-P) Working Groups of the French Society of Cardiology. Arch Cardiovasc Dis 2019; 112:723-731. [PMID: 31542331 DOI: 10.1016/j.acvd.2019.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/02/2019] [Accepted: 07/22/2019] [Indexed: 12/12/2022]
Abstract
Physical activity is important in heart failure to improve functional capacity, quality of life and prognosis, and is a class IA recommendation in the European Society of Cardiology guidelines (Ponikowski et al., 2016). The benefits of exercise training are widely recognized. Cardiac rehabilitation centres offer tailored exercise training to patients with heart failure, as part of specialized multidisciplinary care, alongside pharmacological treatment optimization and patient education. After cardiac rehabilitation, maintenance of regular physical activity long term is essential, as the benefits of exercise training vanish within a few weeks. Unfortunately, only 10% of patients benefit from a cardiac rehabilitation programme after hospitalization for acute heart failure, and the majority of patients do not pursue long-term physical activity. In this paper, two Working Groups of the French Society of Cardiology (the heart failure group [Groupe Insuffisance Cardiaque et Cardiomyopathies; GICC] and the cardiac rehabilitation group [Groupe Exercice Réadaptation Sport et Prévention; GERS-P]) discuss the obstacles to broader access to cardiac rehabilitation centres, and propose ways to improve the diffusion of cardiac rehabilitation programmes and encourage long-term adherence to physical activity.
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Affiliation(s)
- Florian Zores
- Groupe médical spécialisé, 67000 Strasbourg, France.
| | - Marie-Christine Iliou
- Service de réadaptation cardiaque et prévention secondaire, hôpital Corentin-Celton, AP-HP, 92130 Issy-les-Moulineaux, France
| | | | | | - Emmanuelle Berthelot
- Pôle Thorax, service de cardiologie, hôpital Bicêtre, AP-HP, 94270 Le-Kremlin-Bicêtre, France
| | | | - Fabrice Bauer
- Service de cardiologie, CHU de Rouen, 76000 Rouen, France
| | - Nicolas Lamblin
- Inserm, institut Pasteur, U1167, université de Lille, CHU de Lille, 59000 Lille, France
| | - Gilles Bosser
- Cardiology Department, University Hospital, 54511 Vandoeuvre-lès-Nancy, France; EA 3450, Development, Adaptation and Disadvantage, Faculty of Medicine, University of Lorraine, 54600 Villers-lès-Nancy, France
| | - Thibaud Damy
- CHU d'Henri-Mondor, AP-HP, 94010 Créteil, France
| | - Alain Cohen-Solal
- UMR-S 942, service de cardiologie, hôpital Lariboisière, université de Paris, AP-HP, 75010 Paris, France
| | - Florence Beauvais
- UMR-S 942, service de cardiologie, hôpital Lariboisière, université de Paris, AP-HP, 75010 Paris, France
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36
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Bond S, Laddu DR, Ozemek C, Lavie CJ, Arena R. Exergaming and Virtual Reality for Health: Implications for Cardiac Rehabilitation. Curr Probl Cardiol 2019; 46:100472. [PMID: 31606141 DOI: 10.1016/j.cpcardiol.2019.100472] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 08/29/2019] [Indexed: 12/13/2022]
Abstract
Cardiac Rehabilitation (CR) programs, focused on improving the health trajectory of patients with cardiovascular disease, strive to increase physical activity (PA) and cardiorespiratory fitness. However, historically low compliance with recommended PA has prompted exploration of alternatives to traditional courses of exercise therapy. One alternative, exergaming, or the requirement of physical exercise inherent to a video game's activities, has shown to have a promising impact in improving patient self-efficacy for exercise training using digital hardware (eg, the Wii or the Xbox Kinect). Furthermore, novel technologies in virtual reality can provide an engaging, immersive environment for exergaming techniques, maximizing goal-oriented training and building self-efficacy for patients during CR. Many groundbreaking institutions are already calculating energy expenditure of commercially successful virtual reality games and finding promise in the cardiometabolic responses to a number of virtual reality games. Research is still limited in establishing the efficacy of these games, but virtual reality and exergaming are quickly proving to be appropriate and equivalent alternatives to traditional exercise programs. Though studies have examined the impact of prescriptive exergaming on PA, they have yet to examine the potential for genuine integration of game-based motivational techniques and immersive environments into clinical interaction. The purpose of this review is to describe the current body of evidence and the impact and future potential of virtual reality and exergaming. Further, we will introduce the concept of a "Clinical Arcade" as a new approach to integration of these techniques in CR care.
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37
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Kim C, Sung J, Lee JH, Kim WS, Lee GJ, Jee S, Jung IY, Rah UW, Kim BO, Choi KH, Kwon BS, Yoo SD, Bang HJ, Shin HI, Kim YW, Jung H, Kim EJ, Lee JH, Jung IH, Jung JS, Lee JY, Han JY, Han EY, Won YH, Han W, Baek S, Joa KL, Lee SJ, Kim AR, Lee SY, Kim J, Choi HE, Lee BJ, Kim S. Clinical Practice Guideline for Cardiac Rehabilitation in Korea. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 52:248-285. [PMID: 31404368 PMCID: PMC6687042 DOI: 10.5090/kjtcs.2019.52.4.248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 06/29/2019] [Accepted: 07/06/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. RESULTS CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. CONCLUSION Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine,
Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine–Heart Vascular Stroke Institute, Samsung Medical Center, Seoul,
Korea
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine–Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan,
Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine,
Korea
- Gyeonggi Regional Cardiocerebrovascular Center, Seongnam,
Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju,
Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Il-Young Jung
- Department of Rehabilitation Medicine, Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Ueon Woo Rah
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon,
Korea
| | - Byung Ok Kim
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine,
Korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Bum Sun Kwon
- Department of Rehabilitation Medicine, Dongguk University School of Medicine, Goyang,
Korea
| | - Seung Don Yoo
- Department of Rehabilitation Medicine, Kyung Hee University College of Medicine, Seoul,
Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju,
Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul,
Korea
| | - Yong Wook Kim
- Department and Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul,
Korea
| | - Heeyoune Jung
- National Traffic Injury Rehabilitation Hospital, Yangpyeong,
Korea
| | - Eung Ju Kim
- Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul,
Korea
| | | | - In Hyun Jung
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine,
Korea
| | - Jae-Seung Jung
- Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Seoul,
Korea
| | - Jong-Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Jae-Young Han
- Department of Rehabilitation Medicine, Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju,
Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju,
Korea
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Research Institute of Chonbuk National University Hospital, Jeonju,
Korea
| | - Woosik Han
- Department of Thoracic Surgery, Chungnam National University Hospital, Daejeon,
Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine–Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon,
Korea
| | - Kyung-Lim Joa
- Department of Rehabilitation Medicine, Inha University Hospital, Incheon,
Korea
| | - Sook Joung Lee
- Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon,
Korea
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu,
Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju,
Korea
| | - Jihee Kim
- Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan,
Korea
| | - Hee Eun Choi
- Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan,
Korea
| | - Byeong-Ju Lee
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan,
Korea
| | - Soon Kim
- Research Institute for Social Science, Ewha Woman’s University, Seoul,
Korea
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38
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Reis E, Postolache G, Teixeira L, Arriaga P, Lima ML, Postolache O. Exergames for motor rehabilitation in older adults: an umbrella review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1639012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Eduardo Reis
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Gabriela Postolache
- Researcher at Instituto de Telecomunicaçőes, Avenida Rovisco Pais 1, Lisbon, Portugal
| | - Luís Teixeira
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
- Champalimaud Foundation, Lisbon, Portugal
| | - Patrícia Arriaga
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Maria Luísa Lima
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Octavian Postolache
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
- Instituto de Telecomunicações, Lisbon, Portugal
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39
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García-Bravo S, Cuesta-Gómez A, Campuzano-Ruiz R, López-Navas MJ, Domínguez-Paniagua J, Araújo-Narváez A, Barreñada-Copete E, García-Bravo C, Flórez-García MT, Botas-Rodríguez J, Cano-de-la-Cuerda R. Virtual reality and video games in cardiac rehabilitation programs. A systematic review. Disabil Rehabil 2019; 43:448-457. [PMID: 31258015 DOI: 10.1080/09638288.2019.1631892] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To carry out a systematic review about the information about the application of of virtual reality and videogames in cardiac rehabilitation. METHODS A systematic review was conducted. Jadad scale was applied to evaluate the methodological quality of the articles included and the degree of evidence and the level of recommendation were determined through the Oxford Center for Evidence-Based Medicine. PRISMA guidelines statement for systematic reviews were followed. RESULTS The total number of articles included in the present review was 10, with heterogeneity in the study populations, cardiac rehabilitation phases, technology used and protocols. Most of the studies showed an increase in heart rate, less pain, a greater ability to walk, higher energy levels, an increase in physical activity and improvements of motivation and adherence. The methodological quality of the studies was between acceptable and poor. CONCLUSIONS The use of virtual reality and videogames could be considered as complementary tools of physical training in patients with cardiovascular diseases in the different phases of cardiac rehabilitation. However, it is also necessary to carry out studies with adequate methodological quality to determine the ideal technological systems, target populations and clearly protocols to study their effects in the short, medium and long-term assessments.Implications for rehabilitationThe use of virtual reality and videogames could be considered as complementary tools for physical training in patients with cardiovascular diseases.Interactive virtual reality using exergames may promote heart rate, fatigue perception, physical activity and reduce pain in patients with cardiovascular diseases.Virtual reality and videogames enhance motivation and adherence in cardiac rehabilitation programs.
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Affiliation(s)
- Sara García-Bravo
- International Doctorate School, Rey Juan Carlos University, Madrid, Spain.,Physiocare Physiotherapy Clinic, Madrid, Spain
| | - Alicia Cuesta-Gómez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Raquel Campuzano-Ruiz
- Cardiac Rehabilitation Unit, Alcorcón Foundation Universitary Hospital, Alcorcón, Spain
| | | | | | - Aurora Araújo-Narváez
- Cardiac Rehabilitation Unit, Alcorcón Foundation Universitary Hospital, Alcorcón, Spain
| | | | - Cristina García-Bravo
- International Doctorate School, Rey Juan Carlos University, Madrid, Spain.,Physiocare Physiotherapy Clinic, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | | | | | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
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40
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Kim C, Sung J, Lee JH, Kim WS, Lee GJ, Jee S, Jung IY, Rah UW, Kim BO, Choi KH, Kwon BS, Yoo SD, Bang HJ, Shin HI, Kim YW, Jung H, Kim EJ, Lee JH, Jung IH, Jung JS, Lee JY, Han JY, Han EY, Won YH, Han W, Baek S, Joa KL, Lee SJ, Kim AR, Lee SY, Kim J, Choi HE, Lee BJ, Kim S. Clinical Practice Guideline for Cardiac Rehabilitation in Korea. Ann Rehabil Med 2019; 43:355-443. [PMID: 31311260 PMCID: PMC6637050 DOI: 10.5535/arm.2019.43.3.355] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/31/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and three additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and two general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, three rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. PRINCIPAL CONCLUSIONS CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Inje University School of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine–Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine–Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Center, Seongnam, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Cheongju, Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine–Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea
| | - Il-Young Jung
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine–Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea
| | - Ueon Woo Rah
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea
| | - Byung Ok Kim
- Department of Internal Medicine, Inje University School of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bum Sun Kwon
- Department of Rehabilitation Medicine, Dongguk University School of Medicine, Goyang, Korea
| | - Seung Don Yoo
- Department of Rehabilitation Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Cheongju, Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | - Yong Wook Kim
- Department and Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Heeyoune Jung
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Eung Ju Kim
- Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | | | - In Hyun Jung
- Department of Internal Medicine, Inje University School of Medicine, Sanggye Paik Hospital, Seoul, Korea
| | - Jae-Seung Jung
- Department of Thoracic and Cardiovascular Surgery, Anam Hospital, Korea University Medical Center, Seoul, Korea
| | - Jong-Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Young Han
- Department of Rehabilitation Medicine, Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Woosik Han
- Department of Thoracic Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine–Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Kyung-Lim Joa
- Department of Rehabilitation Medicine, Inha University Hospital, Incheon, Korea
| | - Sook Joung Lee
- Daejeon St. Mary’s Hospital. College of Medicine, The Catholic university of Korea, Daejeon, Korea
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, School of Medicine Kyungpook National University, Daegu, Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Jihee Kim
- Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Hee Eun Choi
- Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Byeong-Ju Lee
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - Soon Kim
- Research Institute for Social Science, Ewha Woman’s University, Seoul, Korea
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Radhakrishnan K, Baranowski T, Julien C, Thomaz E, Kim M. Role of Digital Games in Self-Management of Cardiovascular Diseases: A Scoping Review. Games Health J 2019; 8:65-73. [PMID: 30199275 PMCID: PMC6909707 DOI: 10.1089/g4h.2018.0011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Examine research on the use of digital games to improve self-management (SM) behaviors in patients diagnosed with cardiovascular diagnoses of hypertension, coronary artery disease, heart failure, or myocardial infarction. MATERIALS AND METHODS For this scoping review, the CINAHL, PubMed, and Web of Science databases were searched for studies published from January 1, 2008 to December 20, 2017 using terms relevant to digital games and cardiovascular diseases (CVDs). RESULTS Eight articles met the inclusion/exclusion criteria, seven of which presented studies with participants 50 years or older. Five of the eight studies assessed physical activity. Only two studies included a control group. Digital games significantly improved exercise capacity and energy expenditure but did not affect quality of life, self-efficacy, anxiety, or depression. Digital games were found enjoyable by 79%-93% of participants, including those with lower education or age; however, barriers to game use included being tired or bored, lack of interest in digital games, poor perception of fitness through games, sensor limitations, conflicts with daily life routine, and preferences for group exercise. Average adherence ranged from 70% to 100% over 2 weeks to 6 months of study duration, with higher adherence rates in studies that included human contact through supervision or social support. CONCLUSION Paucity of studies about digital games for CVD SM behaviors precludes the need to undertake a full systematic review. Future studies examining digital games should include larger sample sizes, longer durations, game-design guided by behavioral change theoretical frameworks, and CVD SM behaviors in addition to physical activity behaviors.
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Affiliation(s)
| | - Thomas Baranowski
- Department of Pediatrics-Nutrition, Baylor College of Medicine, Houston, Texas
| | - Christine Julien
- Mobile and Pervasive Computing Laboratory, Department of Electrical and Computer Engineering, The University of Texas–Austin, Austin, Texas
| | - Edison Thomaz
- Department of Electrical and Computer Engineering, School of Information, The University of Texas–Austin, Austin, Texas
| | - Miyong Kim
- School of Nursing, The University of Texas–Austin, Austin, Texas
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Cacciata M, Stromberg A, Lee JA, Sorkin D, Lombardo D, Clancy S, Nyamathi A, Evangelista LS. Effect of exergaming on health-related quality of life in older adults: A systematic review. Int J Nurs Stud 2019; 93:30-40. [PMID: 30861452 DOI: 10.1016/j.ijnurstu.2019.01.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Exercise through video or virtual reality games (i.e. exergames) has grown in popularity among older adults; however, there is limited evidence on efficacy of exergaming on well-being related to health in this population. This systematic review examined the effectiveness of exergaming on health-related quality of life in older adults. METHODS PRISMA guidelines for this systematic review. Several databases were searched using keywords to identify peer-reviewed journal articles in English. Randomized control trials that evaluated the effect of exergaming on health-related quality of life in older adults when compared to a control group and published between January 2007 to May 2017 were included. RESULTS Nine articles that in total included 614 older adults with varying levels of disability, mean age 73.6 + 7.9 years old, and 67% female were analyzed. Significant improvements in health-related quality of life of older adults engaged in exergaming were reported in three studies. Sample sizes were small in 7 of the studies (N < 60). The study participants, exergaming platforms, health-related quality of life instruments, study settings and length, duration and frequency of exergaming varied across studies. CONCLUSION Exergaming is a new emerging form of exercise that is popular among older adults. However, findings from this analysis were not strong enough to warrant recommendation due to the small sample sizes and heterogeneity in the study participants, exergaming platforms, health-related quality of life instruments, length, duration and frequency of the intervention and study settings. Further research is needed with larger sample sizes and less heterogeneity to adequately explore the true effects of exergaming on health-related quality of life of older adults.
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Affiliation(s)
- Marysol Cacciata
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA.
| | - Anna Stromberg
- Department of Medical and Health Services, Linkoping University, Sweden
| | - Jung-Ah Lee
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA
| | - Dara Sorkin
- Division of General Internal Medicine, University of California, Irvine, USA
| | - Dawn Lombardo
- Heart Failure Program, University of California Irvine Health, USA
| | - Steve Clancy
- Health Sciences and Nursing Science, University of California, Irvine, USA
| | - Adeline Nyamathi
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA
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Tough D, Robinson J, Gowling S, Raby P, Dixon J, Harrison SL. The feasibility, acceptability and outcomes of exergaming among individuals with cancer: a systematic review. BMC Cancer 2018; 18:1151. [PMID: 30463615 PMCID: PMC6249900 DOI: 10.1186/s12885-018-5068-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 11/08/2018] [Indexed: 11/25/2022] Open
Abstract
Background Individuals with cancer have reduced quality of life, functionality, range of motion, strength, and an increase in pain and fatigue. Exergaming appears to be an effective rehabilitation tool for Parkinson’s disease, multiple sclerosis and post-stroke patients to improve functionality, balance and quality of life; however, the usefulness of exergaming in individuals with cancer is unknown. The aim of this systematic review is to describe exergaming interventions delivered to adults with a current or previous cancer diagnosis and to report the feasibility, acceptability and outcomes of such interventions. Methods Studies reporting on exergaming interventions delivered to individuals with a current or previous cancer diagnosis were included. 12 electronic databases were searched. Eight articles (seven interventions) were identified. Data were extracted and assessed for quality by two reviewers. Results Three interventions were delivered at hospital, two at home, one at a clinical laboratory, and one did not report. Two interventions were delivered by a physiotherapist, two by an occupational therapist, and one by a nurse, research staff and an exercise physiologist. The Nintendo Wii was used in four of seven studies, whilst the remaining three used the IREX system, BrightArm Duo Rehabilitation System or a custom made exergame. Studies showed that most participants enjoyed the exergaming intervention, and would recommend their use, with some preferring exergaming over standard care interventions. Adherence rates and enjoyment appear greater during exergaming than standard care. Exergaming interventions appear to support improvements balance, function, physical activity levels, strength, fatigue, emotions, cognition and pain. Conclusion Exergaming interventions delivered to individuals with cancer show great heterogeneity; differing in duration, frequency and gaming platform. The disease stage and severity of those included, and the outcome measures assessed also vary widely making it difficult to conclude its effectiveness at this time. However, adherence rates and enjoyment appear greater during exergaming compared to standard care, supporting the feasibility and acceptability of this type of intervention delivery for adults with cancer.
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Affiliation(s)
- Daniel Tough
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK.
| | - Jonathan Robinson
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Steven Gowling
- Department of Sport and Exercise Sciences, University of Sunderland, Sunderland, SR1 3SD, UK
| | - Peter Raby
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - John Dixon
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Samantha L Harrison
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
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Chen CK, Tsai TH, Lin YC, Lin CC, Hsu SC, Chung CY, Pei YC, Wong AMK. Acceptance of different design exergames in elders. PLoS One 2018; 13:e0200185. [PMID: 29975755 PMCID: PMC6033453 DOI: 10.1371/journal.pone.0200185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 06/21/2018] [Indexed: 11/18/2022] Open
Abstract
For promoting the successful aging of elderly residents of Chang Gung Silver Village in Taiwan, five interactive exergames were developed to promote the well-being of the elderly. The exergames included both physical games and cognitive games, and were implemented using various computer-based technologies in the Chang Gung Silver Village. The exergames were trialed by 39 elderly residents (15 male, 24 female; mean age 79.5 ± 17.5 years) of Chang Gung Silver Village. Following the trials, the participants were requested to complete a Technology Acceptance Model 2 (TAM2) questionnaire. The results showed that the perceived playfulness and perceived usefulness of the exergames were significantly related to the users’ usage behavior and intention to use for both the physical games and the cognitive games. However, a relationship between the output quality of the game and the usage behavior was apparent only in the case of the cognitive exergames. Finally, the impact of social influence on the intention to use and the usage behavior was more pronounced for the physical exergames. Overall, the results revealed that the acceptance of exergames by the elderly depends not so much on the awareness of fun in using the game, but the perceived usefulness of the related physical and cognitive abilities.
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Affiliation(s)
- Chih-Kuang Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Tsai-Hsuan Tsai
- Department of Industrial Design, Chang Gung University, Taoyuan, Taiwan
| | - Yin-Chou Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Chih Lin
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Su-Chu Hsu
- Department of New Media Art, Taipei National University of the Arts, Taipei, Taiwan
| | - Chia-Ying Chung
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Cheng Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Alice M. K. Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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Ferrar KE, Smith AE, Davison K. Pacing, Conventional Physical Activity and Active Video Games to Increase Physical Activity for Adults with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e117. [PMID: 28765100 PMCID: PMC5558045 DOI: 10.2196/resprot.7242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/24/2017] [Accepted: 04/24/2017] [Indexed: 11/28/2022] Open
Abstract
Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious illness of biological origin characterized by profound physical and cognitive exhaustion and postexertion malaise. Pacing is a common strategy used to manage available energy and complete activities of daily living; yet little research has investigated this as a strategy to increase physical activity levels. Typically, people living with ME/CFS are faced by unique barriers to physical activity participation and are less physically active than healthy peers. As such they are at increased risk of physical inactivity–related health consequences. Active video games may be a feasible and acceptable avenue to deliver physical activity intervention by overcoming many of the reported barriers to participation. Objective The primary objective of this pilot study is to determine the feasibility and acceptability of active video games to increase physical activity levels of people with ME/CFS. The secondary aims are to explore the preliminary effectiveness of pacing and active video gaming to pacing alone and pacing plus conventional physical activity to increase the physical activity levels of adults with ME/CFS and explore the relationship between physical activity and cumulative inflammatory load (allostatic load). Methods This study will use a mixed method design, with a 3-arm pilot randomized controlled trial, exit interviews, and collection of feasibility and process data. A total of 30 adults with ME/CFS will be randomized to receive either (1) pacing, (2) pacing and conventional physical activity, or (3) pacing and active video gaming. The intervention duration will be 6 months, and participants will be followed up for 6 months postintervention completion. The intervention will be conducted in the participant’s home, and activity intensity will be determined by continuously monitored heart rate and ratings of perceived exertion. Feasibility and acceptability and process data will be collected during and at the end of the intervention. Health-related outcomes (eg, physical activity, blood samples, quality of life, and functioning) will be collected at baseline, end of intervention, and 6 months after intervention completion. Results This protocol was developed after 6 months of extensive stakeholder and community consultation. Enrollment began in January 2017; as of publication, 12 participants were enrolled. Baseline testing is scheduled to commence in mid-2017. Conclusions This pilot study will provide essential feasibility and acceptability data which will guide the use of active video games for people with ME/CFS to increase their physical activity levels. Physical activity promotion in this clinical population has been poorly and under-researched, and any exploration of alternative physical activity options for this population is much needed. Trial Registration Australia New Zealand Clinical Trials Registry: ACTRN12616000285459; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370224 (Archived by WebCite at http://www.webcitation.org/6qgOLhWWf)
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Affiliation(s)
- Katia Elizabeth Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
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Klompstra L, Jaarsma T, Mårtensson J, Strömberg A. Exergaming Through the Eyes of Patients with Heart Failure: A Qualitative Content Analysis Study. Games Health J 2017; 6:152-158. [DOI: 10.1089/g4h.2016.0087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Leonie Klompstra
- Division of Nursing, Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Division of Nursing, Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Jan Mårtensson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anna Strömberg
- Division of Nursing, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Program in Nursing Science, University of California Irvine, Irvine, California
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Sadeghi H, Hakim MN, Hamid TA, Amri SB, Razeghi M, Farazdaghi M, Shakoor E. The effect of exergaming on knee proprioception in older men: A randomized controlled trial. Arch Gerontol Geriatr 2017; 69:144-150. [DOI: 10.1016/j.archger.2016.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
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Baranowski T. Exergaming: Hope for future physical activity? or blight on mankind? JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:44-46. [PMID: 30356568 PMCID: PMC6188910 DOI: 10.1016/j.jshs.2016.11.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 05/07/2023]
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Zeng N, Pope Z, Lee JE, Gao Z. A systematic review of active video games on rehabilitative outcomes among older patients. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:33-43. [PMID: 30356538 PMCID: PMC6188917 DOI: 10.1016/j.jshs.2016.12.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/02/2016] [Accepted: 09/05/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although current research supports the use of active video games (AVGs) in rehabilitation, the evidence has yet to be systematically reviewed or synthesized. The current project systematically reviewed literature, summarized findings, and evaluated the effectiveness of AVGs as a therapeutic tool in improving physical, psychological, and cognitive rehabilitative outcomes among older adults with chronic diseases. METHODS Seven databases (Academic Search Complete, Communication & Mass Media Complete, ERIC, PsycINFO, PubMed, SPORTDiscus, and Medline) were searched for studies that evaluated the effectiveness of AVG-based rehabilitation among older patients. The initial search yielded 946 articles; after evaluating against inclusion criteria and removing duplicates, 19 studies of AVG-based rehabilitation remained. RESULTS Most studies were quasi-experimental in design, with physical functioning the primary outcome investigated with regard to the use of AVGs in rehabilitation. Overall, 9 studies found significant improvements for all study outcomes, whereas 9 studies were mixed, with significant improvements on several study outcomes but no effects observed on other outcomes after AVG-based treatments. One study failed to find any benefits of AVG-based rehabilitation. CONCLUSION Findings indicate AVGs have potential in rehabilitation for older patients, with several randomized clinical trials reporting positive effects on rehabilitative outcomes. However, existing evidence is insufficient to support the advantages of AVGs over standard therapy. Given the limited number of studies and concerns with study design quality, more research is warranted to make more definitive conclusions regarding the ability of AVGs to improve rehabilitative outcomes in older patients.
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Affiliation(s)
- Nan Zeng
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zachary Pope
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jung Eun Lee
- Department of Applied Human Sciences, University of Minnesota-Duluth, Duluth, MN 55812, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
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Valiani V, Lauzé M, Martel D, Pahor M, Manini TM, Anton S, Aubertin-Leheudre M. A New Adaptive Home-based Exercise Technology among Older Adults Living in Nursing Home: A Pilot Study on Feasibility, Acceptability and Physical Performance. J Nutr Health Aging 2017; 21:819-824. [PMID: 28717812 PMCID: PMC5592337 DOI: 10.1007/s12603-016-0820-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To explore the feasibility and acceptability of a new home-based exercise technology among older adults and to evaluate its efficacy on physical performance measures. DESIGN Longitudinal clinical trial. SETTING Oak Hammock at the University of Florida, a nursing home located in Gainesville, Florida. PARTICIPANTS Twelve pre-disabled older adults (≥75 years) living in a nursing home with a Short Physical Performance Battery (SPPB) score between 6 and 9 and no diagnosis of dementia. INTERVENTION Thirty minutes of light intensity exercise (aerobic, strength and balance) two times per week for four weeks using a home-based physical activity technology called Jintronix. MEASUREMENTS Feasibility and acceptability were assessed through a 9-item self-administered questionnaire and by exploring the percentage of quality of movements and time performing exercise which was calculated automatically by Jintronix technology. Physical performance measures were assessed through the SPPB score at baseline, after 4 weeks of intervention and after 3 months from the completion of the intervention. RESULTS Twelve older adults (80.5±4.2 years old) performed light intensity exercise with Jintronix for a total of 51.9±7.9 minutes per week. Participants reached 87% score of quality of movements in strength and balance exercises, a global appreciation score of 91.7% and a global difficulty score of 36%. Compared to baseline, there was a significant improvement in SPPB score at the end of the intervention and at 3 months following the completion of the exercise program (0.67±0.98 and 1.08±0.99 respectively, p-value <0.05). CONCLUSION Jintronix technology is feasible and acceptable among pre-disabled older adults without dementia living in nursing home and is beneficial in improving their physical performance.
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Affiliation(s)
- V Valiani
- Vincenzo Valiani, MD, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville FL, 32611, Phone: 352-273-9390, Fax: 352-273-9920, or
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