Adaptations of Prefrontal Brain Activity, Executive Functions, and Gait in Healthy Elderly Following Exergame and Balance Training: A Randomized-Controlled Study

Abstract

During aging, the prefrontal cortex (PFC) undergoes age-dependent neuronal changes influencing cognitive and motor functions. Motor-learning interventions are hypothesized to ameliorate motor and cognitive deficits in older adults. Especially, video game-based physical exercise might have the potential to train motor in combination with cognitive abilities in older adults. The aim of this study was to compare conventional balance training with video game-based physical exercise, a so-called exergame, on the relative power (RP) of electroencephalographic (EEG) frequencies over the PFC, executive function (EF), and gait performance. Twenty-seven participants (mean age 79.2 ± 7.3 years) were randomly assigned to one of two groups. All participants completed 24 trainings including three times a 30 min session/week. The EEG measurements showed that theta RP significantly decreased in favor of the exergame group [L(14) = 6.23, p = 0.007]. Comparing pre- vs. post-test, EFs improved both within the exergame (working memory: z = −2.28, p = 0.021; divided attention auditory: z = −2.51, p = 0.009; divided attention visual: z = −2.06, p = 0.040; go/no-go: z = −2.55, p = 0.008; set-shifting: z = −2.90, p = 0.002) and within the balance group (set-shifting: z = −2.04, p = 0.042). Moreover, spatio-temporal gait parameters primarily improved within the exergame group under dual-task conditions (speed normal walking: z = −2.90, p = 0.002; speed fast walking: z = −2.97, p = 0.001; cadence normal walking: z = −2.97, p = 0.001; stride length fast walking: z = −2.69, p = 0.005) and within the balance group under single-task conditions (speed normal walking: z = −2.54, p = 0.009; speed fast walking: z = −1.98, p = 0.049; cadence normal walking: z = −2.79, p = 0.003). These results indicate that exergame training as well as balance training positively influence prefrontal cortex activity and/or function in varying proportion.

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).…”

Combining Exergame Training with Omega-3 Fatty Acid Supplementation: Protocol for a Randomized Controlled Study Assessing the Effect on Neuronal Structure/Function in the Elderly Brain

“…The trial design is based on the results of the aforementioned animal studies and of the sole administration studies of either exergame training or omega-3 FA for older participants focusing on the brain. An exergame intervention was chosen because a combination of cognitive and motor training is expected to have positive effects on the elderly brain (Bamidis et al, 2014; Law et al, 2014; Schättin et al, 2016) and is able to ameliorate EFs in older adults (Eggenberger et al, 2016; Schättin et al, 2016). Motor training builds new synaptic connections while the cognitive part supports the preservation of the new build structure.…”

“…Furthermore, the investigators control adherence by a training adherence checklist. A previous trial testing the effects of similar games in older adults showed that this program will effect on EFs (Schättin et al, 2016). …”

Electrocortical dynamics differentiate athletes exhibiting low‐ and high‐ ACL injury risk biomechanics

“…Neurofeedback has been used effectively in the past to modulate symptoms of attention deficit/hyperactivity disorder (Monastra, Monastra, & George, 2002) and other psychiatric orders such as anxiety, depression, and psychosis (Cheon et al, 2015;Schoenberg & David, 2014). Moreover, an exercise-based game and balance training regime has been shown to be effective in altering both biomechanics and brain activity (Schättin, Arner, Gennaro, & de Bruin, 2016). Conceptually similar paradigms can be used to implicitly improve sensorimotor control related to ACL injury risk, as prior work has demonstrated (Bonnette et al, 2019).…”