Abstract
Background: The use of Exergames designed to improve physical and cognitive functioning is relatively new in rehabilitation. Exergaming allows the training of skills, the handling of tools, and procedures; however, often, the potential of these aspects are not assessed before they are adopted in clinical settings. This study aimed at exploring the effects of exergaming on vestibular functions and gait in healthy community dwelling older adults using a proof-of-concept study design registered under ClinicalTrials.gov NCT03160352.Methods: A pre-test-post-test one-group study design comprising 10 older adults (mean age of 73.5 ± 7.6 years, four males) investigated the feasibility of eight exergaming training sessions (for 160 min) and the effects on dynamic visual acuity (DVA), functional gait assessment (FGA), and extended timed get-up-and-go (ETGUG). The simulator sickness questionnaire (SSQ) and the game scores were evaluated for the feasibility of the intervention. Wilcoxon test and Cohen’s d (d) were chosen to test for differences and for effect size estimation.Results: Exergaming led to a significantly improved DVA (z = −2.50, p = 0.01, d = 1.35) with improvements in 9 out of 10 participants. In addition, the FGA significantly improved with a large effect size (z = −2.25, p = 0.02, d = 1.17). Specifically, component tasks such as walking with horizontal head turns (p = 0.03), gait with a narrow base of support (p = 0.03), ambulating backward (p = 0.05) significantly improved. The ETGUG component task Gait initiation significantly improved (p = 0.04). No change was found in gait speed and SSQ. The game scores of the participants improved continuously during the course of the intervention for every game.Discussion: This proof-of-concept study suggests that the use of exergaming that requires active stepping movements and that contains moving game projection is feasible and facilitates gaze stability during head movements in healthy community dwelling older adults. Aspects of functional gait and gait initiation also improved. Future research aimed at testing this exergaming intervention in patients suffering from vestibular impairments is warranted.
Highlights
A decline in vestibular function with increasing age is observable in the general population (Agrawal et al, 2009; Tjernstrom et al, 2016)
The results of the dynamic visual acuity (DVA) post-measurements on the right showed an artifact; the result of post-measurement on the left side was used for the calculations
The results show that the use of exergaming facilitates gaze stability during head movement as measured by the computerized DVA test
Summary
A decline in vestibular function with increasing age is observable in the general population (Agrawal et al, 2009; Tjernstrom et al, 2016). The prevalence of vestibular dysfunction is about 35% for those 40 years of age and above and reaches 85% in individuals aged 80 and above (Agrawal et al, 2013; Arshad and Seemungal, 2016) This decline may lead to vertigo, dizziness, and poor postural stability (Swanenburg et al, 2009; Deveze et al, 2014). One additional important goal of vestibular rehabilitation is the improvement of gait, especially during head movements (Han et al, 2011) as a measure to prevent falls in individuals with vestibular dysfunction (Agrawal et al, 2013). This study aimed at exploring the effects of exergaming on vestibular functions and gait in healthy community dwelling older adults using a proof-of-concept study design registered under ClinicalTrials.gov NCT03160352
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