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Swanenburg J1,2, Straumann D3, de Bruin ED4,5
1UniversityHospital Zurich, Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, Zurich, Switzerland, 2Balgrist University Hospital, Integrative Spinal Research ISR, Zurich, Switzerland, 3University Hospital Zurich, Department of Neurology, University of Zurich, Zurich, Switzerland, 4Karolinska Institutet, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden, 5ETH Zurich, Institute of Human Movement Sciences and Sport, Department Health Sciences and Technology, Zurich, Switzerland
Background: The use of Exergames designed to improve physical and cognitive functioning is relatively new in rehabilitation. As such, exergaming allows training of skills, handling of tools and procedures; however, these aspects are often not assessed for their potential before being adopted in clinical settings.
Purpose: 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.
Methods: A pre-test-post-test one-group study design comprising 10 older adults (mean age of 73.5 ± 7.6 years, 4 male) investigated feasibility of eight exergaming training sessions (for a total of 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 game scores were evaluated for 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 significant improved DVA (z= -2.50, p = 0.01, d = 1.35) with nine out of ten participants improving. FGA also significantly improvement 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 participants improved continuously during the course of the intervention for every game.
Conclusion(s): This proof-of-concept study suggests that the use of exergaming that requires active stepping movements and 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 improve.
Implications: This study promoted active head movements in unsupported locomotion while standing, which pictures an ecologically valid daily living situation. It can be hypothesized that using exergaming acquired skills lead to transfer effects in form of improved gait initiation.
Keywords: Vestibular, exergaming, gait
Funding acknowledgements: None
Purpose: 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.
Methods: A pre-test-post-test one-group study design comprising 10 older adults (mean age of 73.5 ± 7.6 years, 4 male) investigated feasibility of eight exergaming training sessions (for a total of 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 game scores were evaluated for 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 significant improved DVA (z= -2.50, p = 0.01, d = 1.35) with nine out of ten participants improving. FGA also significantly improvement 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 participants improved continuously during the course of the intervention for every game.
Conclusion(s): This proof-of-concept study suggests that the use of exergaming that requires active stepping movements and 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 improve.
Implications: This study promoted active head movements in unsupported locomotion while standing, which pictures an ecologically valid daily living situation. It can be hypothesized that using exergaming acquired skills lead to transfer effects in form of improved gait initiation.
Keywords: Vestibular, exergaming, gait
Funding acknowledgements: None
Topic: Robotics & technology; Older people; Disability & rehabilitation
Ethics approval required: Yes
Institution: Swissmedic
Ethics committee: Ethics committee of Canton Zurich
Ethics number: BASEC 2016–1220
All authors, affiliations and abstracts have been published as submitted.
