Exergaming System Research Articles

Feasibility and effect of interactive telerehabilitation on balance in individuals with chronic stroke: a pilot study

BackgroundStroke survivors need continuing exercise intervention to maintain functional status. This study assessed the feasibility and efficacy of an interactive telerehabilitation exergaming system to improve balance in individuals with chronic stroke, compared to conventional one-on-one rehabilitation.MethodsIn this prospective case–control pilot study, 30 Taiwanese individuals with chronic stroke were enrolled and randomly allocated to an experimental group and a control group. All participants received intervention 3 times per week for 4 weeks in the study hospital. The experiment group underwent telerehabilitation using a Kinect camera-based interactive telerehabilitation system in an independent room to simulate home environment. In contrast, the control group received conventional one-on-one physiotherapy in a dedicated rehabilitation area. The effectiveness of interactive telerehabilitation in improving balance in stroke survivors was evaluated by comparing outcomes between the two groups. The primary outcome was Berg Balance Scale (BBS) scores. Secondary outcomes were performance of the Timed Up and Go (TUG) test, Modified Falls Efficacy Scale, Motricity Index, and Functional Ambulation Category.ResultsComparison of outcomes between experimental and control groups revealed no significant differences between groups at baseline and post-intervention for all outcome measures. However, BBS scores improved significantly in both groups (control group: p = 0.01, effect size = 0.49; experimental group: p = 0.01, effect size = 0.70). Completion times of TUG tests also improved significantly in the experimental group (p = 0.005, effect size = 0.70).ConclusionThe Kinect camera-based interactive telerehabilitation system demonstrates superior or equal efficacy compared to conventional one-on-one physiotherapy for improving balance in individuals with chronic stroke.Trial registration ClinicalTrials.gov. NCT03698357. Registered October 4, 2018, retrospectively registered.

Exergaming Platform for Older Adults Residing in Long-Term Care Homes: User-Centered Design, Development, and Usability Study.

BackgroundOlder 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. ObjectiveThis 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.MethodsThis 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. ResultsA 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. ConclusionsThis 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.

The Effects of Exergaming Training on Balance in Healthy Elderly Women-A Pilot Study.

Our aim was to observe, through objective testing using an assessment module incorporated in a new exergaming system, whether elderly people’s static and functional balance is improved by a balance exergaming training program based on movements performed in everyday life. Thirteen healthy elderly women participated in 12 sessions of balance-based exergaming training (three times a week, 30 min per session). All objective outcomes, the quiet standing test, functional balance test (FBT), and limit of stability (LOS) test, were measured on three occasions: before intervention, after six training sessions, and after the completion of the four-week program. The results showed a significant improvement in LOS performance after the intervention. In FBT, participants exhibited a significant decrease (p < 0.01; Kendall’s W = 0.5) in the average time to target hit after six trainings. The average center of pressure velocity increased after six and 12 sessions, however did not reach significance (p = 0.053); nevertheless the size of the effect was large (ηp2 = 0.22). The parameters of the quiet standing test were not significantly affected by the training. The results support the need for more definite and objective studies assessing exergaming for balance in elderly.

Design and Evaluation of an Augmented Reality-Based Exergame System to Reduce Fall Risk in the Elderly.

Falls are a major public health concern in today’s aging society. Virtual reality (VR) technology is a promising method for reducing fall risk. However, the absence of representations of the user’s body in a VR environment lessens the spatial sense of presence. In terms of user experience, augmented reality (AR) can provide a higher degree of presence and embodiment than VR. We developed an AR-based exergame system that is specifically designed for the elderly to reduce fall risk. Kinect2.0 was used to capture and generate 3D models of the elderly and immerse them in an interactive virtual environment. The software included three functional modules: fall risk assessment, cognitive–motor intervention (CMI) training, and training feedback. The User Experience Questionnaire (UEQ-S) was used to evaluate user experience. Twenty-five elders were enrolled in the study. It was shown that the average scores for each aspect were: pragmatic quality score (1.652 ± 0.868); hedonic quality score (1.880 ± 0.962); and overall score was 1.776 ± 0.819. The overall score was higher than 0.8, which means that the system exhibited a positive user experience. After comparing the average score in a dataset product of UEQ-S Data Analysis Tool, it was found that the pragmatic quality aspect was categorized as good, while the hedonic quality aspect was categorized as excellent. It revealed a positive evaluation from users.

The accuracy of self-report logbooks of adherence to prescribed home-based exercise in Parkinson’s disease

Purpose This study compared self-report logbooks of exercise performance to objective measures of performance to determine the accuracy of and patterns of misreporting in self-report logbooks in people with Parkinson’s disease. Materials and methods Fifteen participants from the intervention arm of a randomized control trial were prescribed a minimally supervised, 12-week, home-based upper limb exergame program (ACTRN 12614001048673). The exergame system provided an objective electronic measure of adherence for comparison with self-report logbooks. Results Logbooks showed excellent to good accuracy of overall reported adherence to prescribed sessions (Intraclass correlation (ICC) = 0.83) and games (ICC 0.71). Logbooks were also a good to fair representation of weekly adherence across participants for both sessions (ICC 0.66) and games (ICC 0.56). Individual participant ICCs ranged from minimal to perfect agreement between logbooks and electronic records (ICC sessions range: −0.02 to 1; games range: −0.24 to 0.99). The pattern of logbook reporting suggested some participants were biasing entries to match prescribed exercise. Conclusions Self-report logbooks may provide an accurate measure of overall adherence. However, the accuracy of individual logbooks was highly variable indicating caution is needed in using self-report measures to assess individual adherence in intervention studies and for clinical decision making. Clinical Trial Registration: Registered in Australia and New Zealand Clinical Trials Registry (https://www.anzctr.org.au/): Registration number: ACTRN12614001048673. Implications for rehabilitation Adherence to prescribed unsupervised exercise is usually self-reported. Self-reported logbooks gave a good to excellent indication of exercise adherence overall when compared to electronically captured records for a group of participants with mild to moderate Parkinson’s disease. There were high levels of variability in the accuracy of individual logbooks with a tendency to record prescribed rather than actual exercise. Logbooks may be accurate to monitor group adherence, but caution is required when using them to assess an individual’s adherence to an exercise prescription.

Feasibility, Safety and Efficacy of a Virtual Reality Exergame System to Supplement Upper Extremity Rehabilitation Post-Stroke: A Pilot Randomized Clinical Trial and Proof of Principle.

(1) Background: Increasing the amount of therapy time has been shown to improve motor function in stroke survivors. However, it is often not possible to increase the amount of therapy time provided in the current one-on-one therapy models. Rehabilitation-based virtual reality exergame systems, such as Jintronix, can be offered to stroke survivors as an adjunct to traditional therapy. The goal of this study was to examine the safety and feasibility of providing additional therapy using an exergame system and assess its preliminary clinical efficacy. (2) Methods: Stroke survivors receiving outpatient rehabilitation services participated in this pilot randomized control trial in which the intervention group received 4 weeks of exergaming sessions in addition to traditional therapy sessions. (3) Results: Nine subjects in the intervention and nine subjects in the control group completed the study. The intervention group had at least two extra sessions per week, with an average duration of 44 min per session and no serious adverse events (falls, dizziness, or pain). The efficacy measures showed statistically meaningful improvements in the activities of daily living measures (i.e., MAL-QOM (motor activity log-quality of movement) and both mobility and physical domains of the SIS (stroke impact scale) with mean difference of 1.0%, 5.5%, and 6.7% between the intervention and control group, respectively) at post-intervention. (4) Conclusion: Using virtual reality exergaming technology as an adjunct to traditional therapy is feasible and safe in post-stroke rehabilitation and may be beneficial to upper extremity functional recovery.

Comparison of the effects of two different exergaming systems on balance, functionality, fatigue, and quality of life in people with multiple sclerosis: A randomized controlled trial

BackgroundBalance disorders, fatigue, and walking impairments are the most common symptoms of multiple sclerosis (MS), which lead to a decrease in quality of life. To cope with these disability-increasing symptoms, it is important to select and regularly apply appropriate rehabilitation approaches. In recent years, virtual reality approaches have been suggested as a potentially useful tool in rehabilitation. Exergaming systems are used in the treatment of symptoms associated with MS, but there are few randomized controlled studies investigating the efficacy of these systems. ObjectiveTo investigate and compare the effects of exercise training with two different exergaming systems on balance, functionality, fatigue, and quality of life in people with multiple sclerosis (PwMS). MethodsForty-seven volunteer PwMS were included in the study and randomized to the group I (Nintendo Wii Fit), group II (Balance Trainer), and group III (control group). The participants in the study groups underwent an exercise program under the supervision of a physiotherapist on 2 days a week for 8 weeks. Outcome measures were the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Six-Minute Walk Test (6MWT), Fatigue Severity Scale (FSS), and Multiple Sclerosis International Quality of Life Questionnaire (MusiQol), which were performed before and after the treatment. ResultsForty-two participants completed the study protocol. All parameters evaluated in group I and II showed statistically significant improvement after treatment. Changes in all outcome measures were found to be superior in group I compared with group III. Similarly, all measures except the 6MWT were found to be superior in group II compared with group III. Changes in BBS and MusiQol were found to be superior in group I compared with group II. ConclusionIn comparison with no intervention, exergaming with Nintendo Wii Fit and Balance Trainer improves balance, increases functionality, reduces fatigue severity, and increases quality of life in PwMS.

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Rehabilitation has proven effective to significantly reduce fall risk in seniors; however, low adherence to home rehabilitation and a lack of feedback on performance and progress indicate that seniors might not receive the amount of therapy necessary to reduce their risk of falling. We present a tailored exergame system for the home (called Recov-R) to motivate seniors to exercise and facilitate effective recovery by promoting optimal quality of movement during exercise. Based on an 8-week field study, with 38 participants, we present results on the use of the Recov-R system, versus standard care, in the home. Our findings suggest that the use of the system can increase adherence to exercise and reduce fall risk by improving outcomes of physical function—mobility and balance. We also highlight opportunities, based on these results, for the design of effective exergame technologies for musculoskeletal rehabilitation in the home.

A study exploring the usability of an exergaming platform for senior fitness testing.

This study proposes a structural usability model to identify the relationship between the user interface design and the usability of an exergame system that includes a software system and a separate hardware device. The model consisted of two dimensions: the interface design, which was evaluated using Nielsen's heuristic evaluation method, and the usability, as defined by ISO 9241-11. An empirical study used the iFit exergame system to test the physical fitness of 101 seniors in order to evaluate the model's validity. The results showed a strong correlation between the interface design and the usability of the exergame system. An improved interface enabled users to interact with the system better, and the usability of the whole system was enhanced, including the device and the system itself. The results show that the proposed usability model can be used to evaluate other exergame systems.

Exergaming-Based Dexterity Training in Persons With Parkinson Disease: A Pilot Feasibility Study.

Many individuals with Parkinson disease (PD) suffer from impaired dexterity, which impacts activities of daily living and quality of life. Exergaming, video game-based training with augmented virtual reality, may have value for improving function. The aim of the present pilot study was to comprehensively evaluate the feasibility of a dexterity training program using exergaming, in individuals with PD. Ten participants with PD (aged between 55 and 75 years, Hoehn and Yahr stages II-IV) trained over a period of 4 weeks, twice a week for 30 minutes. Baseline (T0) and postintervention (T1) assessments were done. Primary outcomes with respect to feasibility were the adherence rate, open-end questions, the level of participation (Pittsburgh Rehabilitation Participation Scale), and the usability (System Usability Scale). Dexterous function was measured with the Nine-Hole Peg Test and the Dexterity Questionnaire-24. Upper limb motor impairment was assessed by a modified version of the Movement Disorders Society Unified Parkinson's Disease Rating Scale III. Finally, quality of life was assessed by the 39-item Parkinson's Disease Questionnaire (PDQ-39). Adherence rate was 99%, motivation increased significantly from 3.9 to 4.8 (Pittsburgh Rehabilitation Participation Scale, P = 0.03), and system usability of the exergaming system was acceptable to very good. Regarding potential efficacy, participants with impaired dexterity at T0 significantly improved in the Nine-Hole Peg Test and the PDQ-39. The outcomes of this pilot study suggest that exergaming is feasible and has potential to improve dexterity in individuals with PD. Its efficacy should be investigated in a properly powered randomized controlled trial.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A270).

Feasibility of the AHA Exergame System in Parkinson's Disease Patients

Feasibility of the AHA Exergame System in Parkinson's Disease Patients

Development of an EMG-based exergaming system for isometric muscle training and its effectiveness to enhance motivation, performance and muscle strength

Abstract Isometric exercises can be used for general strength conditioning or rehabilitation. To maximize their benefits without excess muscle fatigue, such exercises must be performed under medical prescription, which also needs to specify their intensity and duration. However, at home or at a clinic they are rarely real-time monitored or evaluated, which may delay or prevent goal achievement, with negative influence on participants’ motivation. Therefore, in this paper, it is introduced the development and clinical evaluation of an exergaming platform based on ElectroMyoGraphy (EMG) for the real-time monitoring and performance assessment of personalized isometric exercises. The system enables medical personnel to create personalized exergame sessions that oversee in real time the behavior of the main character in a game, based on the muscle force of the user, estimated from an EMG signal. In addition, it evaluates exercise performance, in terms of muscle contraction duration and relative effort during work and rest intervals. A data storage capability enables users to upload results in a cloud database, which can be accessed remotely by healthcare providers through an application. The system operates firstly by obtaining an EMG-force model for isometric contractions of the flexor digitorum superficialis muscle, which was then integrated in the exergaming platform. Then, a 4-week randomized controlled clinical trial was conducted with tailored isometric handgrip exercises using the proposed system versus conventional handgrip exercises to assess motivation and grip strength in patients with distal radius fracture. Exercise performance and subjective workload ratings were additionally evaluated. Results notably show that handgrip exercises with the proposed system yield an improvement in grip strength of 40.2% over conventional handgrip exercises, while experiencing higher motivation levels, contrasting with lower frustration and mental demand levels. However, continued research is ongoing to generalize the findings of the clinical trial to a larger patient population.

Kinect-based exergaming to improve frailty status and physical performances in the frail and pre frail elderly

Frailty is a multisystem degeneration. It is becoming recognized that frailty may be a pre-disability state. Exercise training is proved to improve physical performance and health status in the elderly. Kinect is an affordable and accessible exergaming systems. Whether Kinect-based exergaming is efficient in improving physical performances and reverse the deterioration process in frail and pre-frail elderly require further investigation. The purpose of this study is to investigate the effect of Kinect-based exergaming on frailty status, physical performances in pre-frail and frail elderly. We recruited frail and pre-frail elderly people in the elderly day care centers and institutions. Participants were randomized to two group and received 60 minutes Kinect-based exergaming or multi-component exercise for 36 sessions over 12 weeks according to their group assignment. Programs in both groups include muscle strengthening, aerobic exercise, balance training and cognitive training. Outcome measures include frailty status and physical performances. Fifty-two pre-frail and frail elderly finished all the intervention and assessment. Both groups showed improvements in frailty scores after intervention. The frailty components revealed that weakness, exhaustion, low physical activity, and slow walking speed were reversed in both group, but unintentional weight loss did not significantly changed. Both groups also showed improvements in most parts of the physical performances after intervention. For between group differences, Kinect-based exergaming group showed more improvement in forward reaching distance than multi-component exercise group. Kinect-based exergaming can reverse the frailty status and improve physical performances. Our results provided information to support the possibility of therapeutic use of exergaming training in the frail and pre-frail elderly.

Development of a Hardware/Software System for Proprioception Exergaming

Physiotherapy and rehabilitation are getting ever more relevance as an integral part of healthcare devising and employing new, effective methodologies and tools. However, not seldom are such tools boring and difficult to use properly for achieving the given training and therapeutic goals. Exergaming, the combination of physical exercise and video gaming, may help to overcome these issues by offering enjoyment and motivation. However, the literature lacks papers investigating how to integrate such devices into a serious game combining effectiveness and enjoyment. In this paper, we focus on the Balance Board (BB), a device used in gyms and in several health-related applications [1], and present an exergaming system for proprioception training. The system includes a BB, which was instrumented to act as a motion controller for an ad-hoc developed, simple 3D video game. The system aims to provide enjoyable training with the BB, boosting equilibrium exercising through the simulation of downhill skiing. We validated the score computation and tested the efficacy of the system in a user test with 40 participants, in ecological settings. The evaluation concerned user performance and a game experience questionnaire. The results showed statistically significant improvement in players’ ability to use the BB. Users also reported a positive gameplay experience.

Can telerehabilitation games lead to functional improvement of upper extremities in individuals with Parkinson's disease?

Parkinson’s disease (PD) is treated by medication, less with deep brain stimulation and physiotherapy. Different opinions on the clinical meaningfulness of the physiotherapy or recommended intensive physiotherapy were found. Our objectives were to design intensive target-based physiotherapy for upper extremities suitable for telerehabilitation services and examine the clinical meaningfulness of the exergaming at an unchanged medication plan. A telerehabilitation exergaming system using the Kinect sensor was developed; 28 patients with PD participated in the study. The system followed the participants’ movements and adapted the difficulty level of the game in real time. The outcomes of the study showed that seven out of 26 participants could set up the equipment at home alone. Clinical outcomes of Box and Blocks Test (mean: 47 vs. 52, P=0.002, Cohen’s d=0.40), UPDRS III (mean: 27 vs. 29, P=0.001, d=0.22), and daily activity Jebsen’s test; writing a letter (mean: 24.0 vs. 20.6, P=0.003, d=0.23); and moving light objects (mean: 4.4 vs. 3.9, P=0.006, d=0.46) were statistically significant (P<0.05) and considered clinically meaningful. The Nine-Hole Peg Test showed a statistically nonsignificant improvement (mean: 28.0 vs. 26.5, P=0.089, d=0.22). The participants claimed problems with mobility but less with activities of daily living and emotional well-being (PDQ-39). The findings lead to preliminary conclusions that exergaming is feasible, but may require technical assistance, whereas clinically meaningful results could be achieved according to validated instruments and an unchanged medication plan in individuals with PD.

Virtual reality exergaming as adjunctive therapy in a sub-acute stroke rehabilitation setting: facilitators and barriers

Purpose: To identify the facilitators and barriers perceived by clinicians to using an Exergaming Room as adjunct to conventional therapy.Design: Phenomenological qualitative study using an interpretive description methodology.Subjects: Ten clinicians (four physical therapists, six occupational therapists) from the Stroke Program at the Jewish Rehabilitation Hospital (nine female, one male, age range 25–50 years old) who referred clients to the Exergaming Room.Methods: Ten to twenty minute semi-structured interviews were conducted with each clinician. Convenience sampling was used. A thematic analysis was performed on the data collected by grouping all the open codes into facilitators and barriers, and then categorized into levels, themes and subthemes.Results: Facilitators and barriers were divided into three levels: organizational, individual and technological. Major facilitators at the organizational level were: institutional support; at the individual level: personal experience of referring clinician, presence of an expert clinician, and relevance of the Exergaming Room for stroke clients; and at the technological level: perceived ease of use of the exergames and possibility of providing additional therapy. Key barriers to successful implementation of the Exergaming Room at the organizational level were: scheduling difficulties and lack of staffing; at the individual level: client functional limitations; at the technological level: low precision in motion capture of the exergame systems.Conclusions: Multiple factors affect the implementation of new technology in rehabilitation settings. In order to successfully integrate exergame systems into practice, institutions are encouraged to take the identified factors (facilitators and barriers) into account.Implications for RehabilitationClinicians who have referred individuals with stroke to an “exergames” room over a 1-year period at a rehabilitation hospital have found the service to be highly relevant to their clients.The presence of an expert clinician, who evaluates the clients and builds an exergames activity program, was seen as an important facilitator by referring clinicians in the use of this service.An ideal Exergames Room should offer a wide variety of activities, including some that focus on motor, cognitive and/or communications abilities.

Exploring the Communication of Progress in Home-based Falls Rehabilitation using Exergame Technologies

Little is known on how to effectively represent rehabilitation progress, over a period of time, using exercise game (exergame) technologies. Progress in falls rehabilitation, which consists of improved performance in balance and muscle strength, is essential to assuring seniors of a reduced risk of falling. In this paper, we build on our previous research into exergames for falls, and we investigate how an exergame system can be used to communicate long-term progress to seniors. Using a multiphase user-centered requirements gathering process, we first investigated stakeholder perspectives regarding progress in self-managed rehabilitation. Following this we describe the home-based evaluation of our prototype exergame system, which highlights rehabilitation progress, with seniors, over a period of 2 months. Progress, in our system is communicated using charts of exercise performance and frequency, as well as medals awarded for achieving longer-term rehabilitation milestones. We report on seniors' opinions and preferences regarding the potential of our exergame system to communicate this rehabilitation progress in a meaningful way. Finally we discuss implications for design, based on our studies, to inform the development of more effective exergame systems for long-term unassisted rehabilitation in the home.

Dance Exergame System for Health Using Wearable Devices

This paper proposed a dance training game applied using game theory by using wearable devices. The system extracts the teacher’s motions by using motion capture sensor technology. The pressure on the foot was sensed while dancing, and the motions of the ankle were extracted. The exergame enables students to watch the teacher’s dance in all directions by using an avatar and gaining the effects of both exercise and education by repeatedly practicing avatar’s dancing. To overcome the space constraints of the special equipment in the course of acquiring and measuring the students’ movements and to allow students to practice at any place, the movements of the user’s foot were measured by using a sock type wearable device that the user wears in their lives normally.

Evaluation of effects of balance training from using wobble board-based exergaming system by MSE and MMSE techniques

Balance is an important criterion in assessing health. The lack of exercise of most young people leads to an increased risk of balance abnormity as part of irregular lifestyles. This paper examines the effect of training with an interactive exercise game on young people’s balance after 1 month. The experiment and analysis followed a three-stage design. Initially, gait function testing was conducted to determine a datum point for the situation at the outset; next, a Gym Top balance trainer was used for training; finally, balance was measured with a force plate and center of pressure signals were collected. Differences in balance before and after training were analyzed with multiscale entropy and multivariate multiscale entropy methods. 12 healthy young people were recruited for the experiment. Statistical analysis of the gait test observations revealed that the number of times of standing and sitting increased significantly after training. Multiscale entropy analysis showed that the multiscale entropy curve was higher after training than before training. Multivariate multiscale entropy analysis showed that balance after training was greater than before training. These results demonstrate that the balance of young people was improved after training with a balance trainer eight times a month.

Study protocol: effect of playful training on functional abilities of older adults - a randomized controlled trial

BackgroundLoss of functional capabilities due to inactivity is one of the most common reasons for fall accidents, and it has been well established that loss of capabilities can be effectively reduced by physical activity. Pilot studies indicate a possible improvement in functional abilities of community dwelling elderly as a result of short-term playing with an exergame system in the form of interactive modular tiles. Such playful training may be motivational to perform and viewed by the subjects to offer life-fulfilling quality, while providing improvement in physical abilities, e.g. related to prevent fall accidents. The RCT will test for a variety of health parameters of community-dwelling elderly playing on interactive modular tiles.MethodsThe study will be a single blinded, randomized controlled trial with 60 community-dwelling adults 70+ years. The trial will consist an intervention group of 30 participants training with the interactive modular tiles, and a control group of 30 participants that will receive the usual care provided to non-patient elderly. The intervention period will be 12 weeks. The intervention group will perform group training (4–5 individuals for 1 h training session with each participant receiving 13 min training) on the interactive tiles twice a week. Follow-up tests include 6-min Walk Test (6MWT), the 8-ft Timed Up & Go Test (TUG), and the Chair-Stand Test (CS) from the Senior Fitness Test, along with balancing tests (static test on Wii Board and Line Walk test). Secondary outcomes related to adherence, motivation and acceptability will be investigated through semi-structured interviews. Data will be collected from pre- and post-tests. Data will be analyzed for statistically significant differences by checking that there is a Gaussian distribution and then using paired t-test, otherwise using Wilcoxon signed-rank test. “Intention to treat” analysis will be done.DiscussionThe trial tests for increased mobility, agility, balancing and general fitness of community-dwelling elderly as a result of playing, in this case on modular interactive tiles. A positive outcome may help preventing loss of functional capabilities due to inactivity.Trial registrationClinicalTrials.gov: Nr. NCT02496702, Initial Release date 7/7–2015.