Feasibility of Strength-Balance Training Extended with Computer Game Dancing in Older People; Does it Affect Dual Task Costs of Walking?

Abstract

Background: It is suggested that one of the reasons for the lack of effect in fall prevention programs is insufficient attention given to cognitive functions in the design of interventions. New treatments have to be piloted to test whether they are feasible and effective. The aim of this pilot study was to elucidate the feasibility and efficacy of an assisted living-based, twelve weeks combined physical-computer-game-training program for older people to inform a future Phase III trial. Secondary aim was elucidating the effects of the training program on brain associated spatial and temporal characteristics of gait. Materials and methods: We investigated the effects of a program with computer game dancing against usual care physical interventions in Swiss assisted living facilities. A controlled clinical trial experimental design was employed whereby participants in a facility were either allocated to 12 weeks usual care physical training (control group) or to 12 weeks physical training with integrated computer game dancing (experimental group). Main outcome measures were adherence rates, relative dual task costs of walking, and falls efficacy. Results: Adherence rate of the physical-computer-game-training was excellent with 96%. Results indicate a positive effect of the computer game dancing program on relative dual task costs of walking. The program significantly lowered the fear of falling. Conclusions: The findings from this pilot study suggests that a multicentre randomized clinical trial comparing usual care with physical-computer-game-training in older people in assisted living facilities is feasible. Pilot studies can improve the design of larger trials. A training programme with computer game dancing affects brain related walking functions, as opposed to usual care that showed no such effect.