Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study.

Patrizia Altorfer,Manuela Adcock,Eling D De Bruin,Eleftheria Giannouli,Florian Graf

doi:10.3389/fnagi.2021.739948

Abstract

Objective: The aim of this pilot randomized clinical trial was to test the feasibility and efficacy of an exergame-based cognitive-motor training program in geriatric inpatients.Methods: The study participants were randomly allocated to either the exergame intervention group or the control group. The control group received the standard rehabilitation treatment offered in the clinic. In addition to the standard rehabilitation program, the intervention group conducted supervised exergame training on 5 days per week using the Dividat Senso, an exergame system specifically designed for older adults. The primary outcome was feasibility, as measured by e.g., adherence rate, attrition rate, occurrence of adverse events, System Usability Scale (SUS) and NASA-TLX score. Secondary outcomes included measures of physical and cognitive functioning such as comfortable walking speed, maximal walking speed, dual task walking speed, Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), Color-Word Interference test (D-KEFS), Trail Making test A and B (TMT), Go/No-Go test and Step Reaction Time test (SRTT). All secondary outcome measures were assessed pre- and post-intervention.Results: Thirty-nine persons were included in the study. Average adherence rate was 99%, there were no intervention-related dropouts and no adverse events. The mean System Usability Scale (SUS) score was 83.6 and the mean NASA-TLX score 45.5. Significant time-group interaction effects were found for the dual task walking speed, the Go/No-Go test and Step Reaction Time test (SRTT).Conclusion: Exergaming is a feasible, safe and effective cognitive-motor training approach in inpatient rehabilitation of geriatric patients. Incorporating exergaming in the rehabilitation program of geriatric patients offers potential to reduce fall risk factors and to increase patients’ exercise motivation and rehabilitation success.

Highlights

The aging process is accompanied by a decline in physical and cognitive functions such as balance, gait, executive functions and psychomotor speed (Kramer et al, 1999; Park, 2000; Seidler et al, 2010; Reuter-Lorenz et al, 2015; Valenzuela et al, 2018; Cogliati et al, 2019)
It was shown that exergaming has a significant effect on stepping capacity and walking during dual task conditions
Since both are known fall risk factors (Muir-Hunter and Wittwer, 2016; Okubo et al, 2017, 2021; Bayot et al, 2020), exergaming on the Dividat Senso could be a beneficial supplement to conventional rehabilitation therapies to reduce fall risk of geriatric patients

Summary

Introduction

The aging process is accompanied by a decline in physical and cognitive functions such as balance, gait, executive functions and psychomotor speed (Kramer et al, 1999; Park, 2000; Seidler et al, 2010; Reuter-Lorenz et al, 2015; Valenzuela et al, 2018; Cogliati et al, 2019) These declines often lead to loss of independence in daily life, restricted social participation and are major risk factors for accidental falls (Rowe and Kahn, 1997; Kramer et al, 1999; Herman et al, 2010; Khow and Visvanathan, 2017). If stepping capacity is decreased, the risk for falls increases (Okubo et al, 2017, 2021)

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Discussion

Conclusion