A New Approach to Improve Cognition, Muscle Strength, and Postural Balance in Community-Dwelling Elderly with a 3-D Virtual Reality Kayak Program

Abstract

Aging is usually accompanied with deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity. Recently, intervention methods with virtual reality have been introduced, providing an enjoyable therapy for elderly. The aim of this study was to investigate whether a 3-D virtual reality kayak program could improve the cognitive function, muscle strength, and balance of communitydwelling elderly. Importantly, kayaking involves most of the upper body musculature and needs the balance control. Seventy-two participants were randomly allocated into the kayak program group (n = 36) and the control group (n = 36). The two groups were well matched with respect to general characteristics at baseline. The participants in both groups performed a conventional exercise program for 30 min, and then the 3-D virtual reality kayak program was performed in the kayak program group for 20 min, two times a week for 6 weeks. Cognitive function was measured using the Montreal Cognitive Assessment. Muscle strength was measured using the arm curl and handgrip strength tests. Standing and sitting balance was measured using the Good Balance system. The post-test was performed in the same manner as the pre-test; the overall outcomes such as cognitive function (p < 0.05), muscle strength (p < 0.05), and balance (standing and sitting balance, p < 0.05) were significantly improved in kayak program group compared to the control group. We propose that the 3-D virtual reality kayak program is a promising intervention method for improving the cognitive function, muscle strength, and balance of elderly.

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial

“…Moreover, VRE increased MoCA scores which may affect balance since cognition and postural balance are associated in older persons [ 71 – 73 ]. The present findings agrees with previous reports [ 15 , 16 ] on the effect of VRE on balance.…”

“…Virtual reality-based exercise (VRE) involves both physical and mental exercises and requires players to respond to sensory input to perform various tasks in technological stimulated scenarios [ 17 ]. VRE, such as playing virtual reality games, could be an alternative to PE for exercise therapy since VRE improves motor, and cognitive abilities [ 16 , 17 , 33 – 36 ] as well as muscle strength and balance in older persons [ 15 , 16 ]. However, meta-analytic studies in action video game training [ 34 , 35 ] and computerized cognitive training [ 36 ] demonstrate small benefit in both overall cognition and specific cognitive domains in older persons.…”

The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials

“…Seven studies used the Nintendo Wii exergaming system with a variety of software packages (Ackerman et al, 2010;Hughes et al, 2014;Maillot et al, 2012;Pompeu et al, 2011;Şimşek and Çekok, 2016;Staiano et al, 2012;Zimmermann et al, 2014), four used interactive dance games with pressure-sensitive dance platforms used to response to visual cues for foot movements (Eggenberger et al, 2016;Eggenberger, 2015;Schattin et al, 2016;Schoene et al, 2013), three used interactive cycling/treadmill training wherein participants completed various tasks or avoided obstacles while pedaling/walking around virtual tracks (AndersonHanley et al, 2016;Barcelos et al, 2015;Mirelman et al, 2016) one used virtual-reality kayaking requiring coordinated upper-body movement to navigate virtual lakes/rivers (Park and Yim, 2016), one used the Microsoft Kinect system to deliver an aerobic exercise routine (Kimhy et al, 2015), and one used interactive co-ordination training involving throwing/catching games in a virtual environment (Chan et al, 2010). Control conditions were waitlist/usual treatment (N=5), aerobic exercise (N=5), balance, stretching and strengthening exercises (N=4) and health education sessions, reading, cognitive remediation or memory training (all N=1).…”

Correlation between static postural balance, falls and pick torque isokinetic of extensors and flexors of the knee in elderly

“…Generally, due to aging, there is a deterioration of several sense organs that directly affect these variables (1,2) . Postural imbalance is a limiting factor in the life of the elderly (3) and added to the instability resulting from muscle weakness, end up compromising gait, Making it slow, cautious, drawn, accompanied by gingi, causing a greater propensity for falls (4,5) .…”

“…Among the consequences of the fall are: reduced functionality, loss of independence and, in some cases, death. In addition, falling leads to increased health costs and defines a series of social problems (2) . Thus, it is extremely important to evaluate postural balance, falls and muscle strength in the elderly, in order to elucidate the efficient alternatives that can be applied to fall prevention and rehabilitation after the same in the elderly.…”