Detailed Search Results
| Author/Association: | Szturm T, Betker AL, Moussavi Z, Desai A, Goodman V |
| Title: | Effects of an interactive computer game exercise regimen on balance impairment in frail community-dwelling older adults: a randomized controlled trial [with consumer summary] |
| Source: | Physical Therapy 2011 Oct;91(10):1449-1462 |
| Method: | clinical trial |
| Method Score: | 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | THE BOTTOM LINE: WHAT DO WE ALREADY KNOW ABOUT THIS TOPIC: Some of the exercise programs used to restore balance and improve motor function in older adults with balance impairments and mobility limitations can be time-intensive and repetitive, which can affect patient participation and motivation. Some studies suggest that computer games or virtual reality technology have tremendous potential as rehabilitation tools by improving patient motivation and participation. WHAT NEW INFORMATION DOES THIS STUDY OFFER: This study found that it is feasible to couple graded, dynamic balance exercises on fixed and compliant surfaces with an interactive video game. This combination resulted in greater improvement in dynamic standing balance control than a typical exercise program, but this effect did not transfer to gait function. IF YOURE A PATIENT, WHAT MIGHT THESE FINDINGS MEAN FOR YOU: The advancement in pressure and motion sensors and computer technologies provides better feedback for patients and may allow movement tasks to be customized more specifically to the individuals needs. Because these high-quality and engaging therapies are now increasingly accessible and affordable for daily clinical practice, your physical therapist may prescribe an exercise program that incorporates computer games to help improve your balance and mobility. |
| Abstract: | BACKGROUND: Due to the many problems associated with reduced balance and mobility, providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills. OBJECTIVES: The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging, interactive video game paradigm. The intervention focused on performing targeted dynamic tasks, which included reactive balance controls and environmental interaction. DESIGN: This study was a randomized controlled trial. SETTING: The study was conducted in a geriatric day hospital. PARTICIPANTS: Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study. INTERVENTIONS: Participants were randomly assigned to either a control group or an experimental group. The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital. The experimental group received a program of dynamic balance exercises coupled with video game play, using a center-of-pressure position signal as the computer mouse. The tasks were performed while standing on a fixed floor surface, with progression to a compliant sponge pad. Each group received 16 sessions, scheduled 2 per week, with each session lasting 45 minutes. MEASUREMENTS: Data for the following measures were obtained before and after treatment: Berg Balance Scale, Timed Up and Go Test, Activities-specific Balance Confidence Scale, modified Clinical Test of Sensory Interaction and Balance, and spatiotemporal gait variables assessed in an instrumented carpet system test. RESULTS: Findings demonstrated significant improvements in posttreatment balance performance scores for both groups, and change scores were significantly greater in the experimental group compared with the control group. No significant treatment effect was observed in either group for the Timed Up and Go Test or spatiotemporal gait variables. LIMITATIONS: The sample size was small, and there were group differences at baseline in some performance measures. CONCLUSION: Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise. This coupling, in turn, resulted in a greater improvement in dynamic standing balance control compared with the typical exercise program. However, there was no transfer of effect to gait function. Full text (sometimes free) may be available at these link(s):  help |
