EFFECTS OF KINECT ADVENTURES GAMES VERSUS CONVENTIONAL PHYSICAL THERAPY IN MOTOR AND COGNITIVE OUTCOMES OF ELDERLY: RANDOMIZED CLINICAL TRIAL

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Bueno GC1, Bacha JMR1, Freitas TB2, Nuvolini RA1, Gomes GCV1, Viveiro LAP1, Varise EM3, Silva KG1, Greve JMD4, Torriani-Pasin C2, Pompeu JE1
1University of Sao Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Faculty of Medicine, Sao Paulo, Brazil, 2University of Sao Paulo, Motor Behavior Laboratory, School of Physical Education and Sport, Sao Paulo, Brazil, 3University of Sao Paulo, Department of Neuroscience and Behavior, Institute of Psychology, Sao Paulo, Brazil, 4University of Sao Paulo, Institute of Orthopedics and Traumatology of Faculty of Medicine, Sao Paulo, Brazil

Background: The number and proportion of elderly in the global population are rapidly increasing. The aging is associated with a functional decline in the most of physiological system, among them the musculoskeletal and sensory systems that can affect postural control, gait, cardiorespiratory fitness and cognition of the elderly. The Conventional Physical Therapy through Multimodal Training (balance training, aerobic exercises, muscle strength) can reduce these declines and may provide an increase in the functional reserve of the impaired functions. Another modality that has recently been studied in both the prevention and rehabilitation of motor and cognitive functions of the elderly is the Interactive Video Game that can stimulate motor and cognitive and motor functions while offer feedback about the task performance and its results.

Purpose: To compare the effectiveness of the interactive video game Kinect Adventures versus Conventional Physical Therapy based on Multimodal Training on postural control, gait, cardiorespiratory fitness, and cognition of community-dwelling elderly people.

Methods: The study was a randomized clinical trial in which 46 elderly individuals were selected, mean age 69.3 (5.34) years. Participants were allocated to the Kinect Adventures Games Group (Experimental Group -EG), or the Conventional Physical Therapy(Control Group - CG), 23 individuals in each group. Participants of both groups participated in 14 training sessions lasting one hour each, twice a week. The EG intervention was the practice of four Kinect Adventures Games. The CG intervention was a Multimodal Training (warming up, balance training, aerobic exercises, muscular strengthening and cool-down). The primary outcome was postural control (Mini-Balance Evaluation Systems Test) and secondary outcomes were gait (Functional Gait Assessment), cardiorespiratory fitness (Six-minute step test), and cognition (Montreal Cognitive Assessment). Participants were assessed before (pre), after (post) and 30 days after the training (follow up). The Study was registered in the Brazilian Registry of Clinical Trials (RBR-4z4f48). Statistical analysis was performed using ANOVA of repeated measures and the post hoc test of Tukey, adopting alfa of 0.05.

Results: Both groups presented a significant improvement in the postural control, gait and cognition after training (post) that was maintained after 30 days (follow-up) (post hoc Tukey test; P 0.05). Regarding cardiorespiratory fitness, the EG presented improvement after training (post) that was maintained after 30 days (follow-up). CG showed improvement only 30 days (follow-up) after training (post hoc Tukey tests; P 0.05).

Conclusion(s): There were no significant differences between Kinect Adventures Games training and Conventional Physical Therapy.Both interventions provided positive effects on postural control, gait, cardiorespiratory fitness and cognition of community-dwelling elderly people.

Implications: The Kinect Adventures Games can be used as a new tool to improve postural control, gait, cardiorespiratory fitness and cognition of community-dwelling elderly people.

Keywords: Aged, Virtual Reality Exposure Therapy, Postural Balance

Funding acknowledgements: University of Sao Paulo.

Topic: Older people; Robotics & technology

Ethics approval required: Yes
Institution: University of Sao Paulo
Ethics committee: Faculty of Medicine, University of São Paulo.
Ethics number: 45547415.8.0000.0065.


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