Background Falling is one of the most common and serious age-related issues, and falls can significantly impair the quality of life of older adults. Approximately one-third of people over 65 experience a fall annually. Previous research has shown that physical exercise could help reduce falls among older adults and improve their health. However, older adults often find it challenging to follow and adhere to physical exercise programs. Interventions using mixed reality (MR) technology could help address these issues. MR combines artificial augmented computer-generated elements with the real world. It has frequently been used for training and rehabilitation purposes. Objective The aim of this systematic literature review and meta-analysis was to investigate the use of the full spectrum of MR technologies for fall prevention intervention and summarize evidence of the effectiveness of this approach. Methods In our qualitative synthesis, we analyzed a number of features of the selected studies, including aim, type of exercise, technology used for intervention, study sample size, participant demographics and history of falls, study design, involvement of health professionals or caregivers, duration and frequency of the intervention, study outcome measures, and results of the study. To systematically assess the results of the selected studies and identify the common effect of MR interventions, a meta-analysis was performed. Results Seven databases were searched, and the initial search yielded 5838 results. With the considered inclusion and exclusion criteria, 21 studies were included in the qualitative synthesis and 12 were included in meta-analysis. The majority of studies demonstrated a positive effect of an MR intervention on fall risk factors among older participants. The meta-analysis demonstrated a statistically significant difference in Berg Balance Scale score between the intervention and control groups (ES: 0.564; 95% CI 0.246-0.882; P<.001) with heterogeneity statistics of I2=54.9% and Q=17.74 (P=.02), and a statistical difference in Timed Up and Go test scores between the intervention and control groups (ES: 0.318; 95% CI 0.025-0.662; P<.001) with heterogeneity statistics of I2=77.6% and Q=44.63 (P<.001). The corresponding funnel plot and the Egger test for small-study effects (P=.76 and P=.11 for Berg Balance Scale and Timed Up and Go, respectively) indicate that a minor publication bias in the studies might be present in the Berg Balance Scale results. Conclusions The literature review and meta-analysis demonstrate that the use of MR interventions can have a positive effect on physical functions in the elderly. MR has the potential to help older users perform physical exercises that could improve their health conditions. However, more research on the effect of MR fall prevention interventions should be conducted with special focus given to MR usability issues.
People are living longer nowadays. Unfortunately, this positive tendency is marred by various age-related health issues, which people experience. Falling is one of the most serious and common of them. Falls negatively influences elderly’ everyday living and significantly decreases quality of their life. Physical exercises is a proven method for preventing falls. However, it is only effective when training is regular and exercise techniques are correct. This paper presents a prototype of an augmented reality exergame for elderly people to perform physical exercise at home. The research is focusing on developing a solution for both above-mentioned issues: augmentation with Microsoft Kinect and various sensors assists in creating a safe game environment, which can helps to perform exercises with right technique; gamification elements contribute to users’ motivation to train regularly. A user-centered design approach was adopted to guide the design and development iterative process. User testing of the first prototype was performed and demonstrated positive attitudes from participants. Feedback from user testing will be used for the next development iterations.
BACKGROUND Falling is one of the most common and serious age-related issues, and falls can significantly impair the quality of life of older adults. Approximately one-third of people over 65 experience a fall annually. Previous research has shown that physical exercise could help reduce falls among older adults and improve their health. However, the elderly often find it challenging to follow and adhere to physical exercise programs. Interventions using mixed reality technology could help to address these issues. Mixed reality is a combination of artificial augmented computer-generated elements with the real world. It have frequently been used for training and rehabilitation purposes. OBJECTIVE The aim of this systematic literature review and meta-analysis was to investigate the use of the full spectrum of mixed reality technologies for fall prevention intervention and summarize evidence of the effectiveness of this approach. METHODS In our qualitative synthesis, we analyzed a number of features of the selected studies, including aim, type of exercise, technology used for intervention, study sample size, participant demographics and history of falls, study design, involvement of health professionals or caregivers, duration and frequency of the intervention, study outcome measures, and results of the study. To systematically assess the results of the selected studies and identify the common effect of MR interventions, a meta-analysis was performed. RESULTS Seven databases were searched, and the initial search yielded 5838 results. With the considered inclusion and exclusion criteria, 21 studies were included in the qualitative synthesis, and 12 were included in meta-analysis. The majority of studies demonstrated a positive effect of a mixed reality intervention on fall risk factors among older participants. The meta-analysis demonstrated a statistically significant difference in Berg balance scale score between the intervention and control groups (ES: 0.564, 95% CI: 0.246–0.882; p < 0.001) with heterogeneity statistics of I2 = 54.9 % and Q = 17.74 (p = 0.023), and a statistical difference in Timed Up and Go test scores between the intervention and control groups (ES: 0.318, 95% CI: 0.025–0.662; p < 0.001) with heterogeneity statistics of I2 = 77.6% and Q = 44.63 (p = 0.000). The corresponding funnel plot and the Egger’s test for small-study effects (p = 0.763 and p = 0.110 for BBS and TUG, respectively) indicate that a minor publication bias in the studies might be present in the Berg balance scale results. CONCLUSIONS The literature review and meta-analysis demonstrate that the use of mixed reality interventions can have a positive effect on physical functions in the elderly. Mixed reality has the potential to help older users to perform physical exercises that could improve their health conditions. However, more research on the effect of MR fall prevention interventions should be conducted with special focus given to MR usability issues.
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