Combining Stochastic Resonance Vibration With Exergaming for Motor-Cognitive Training in Long-Term Care; A Sham-Control Randomized Controlled Pilot Trial

Abstract

Purpose: Physical and mental functions allow classifying older adults as “Go-Go” (independent functioning); “Slow-Go” (in need of care with a slight handicap); and “No-Go” (in need of care with severe functional limitation). The latter group exhibits reduced exercise tolerance. More recently technology-based motor-cognitive types of training services emerged as a possible training service. This study examined the use of technology including stochastic resonance whole-body vibration and Exergame-dance training for motor-cognitive training in care home dwelling adults.Methods: Seventeen older adults (10 women, 7 men, age range: 79–98) were randomly assigned to the intervention (IG, n = 9) or the sham group (SG, n = 8). IG performed five sets of 1-min whole-body vibration with 1-min rest in between, three times a week for the first 4 weeks of the training period with varying frequency. From weeks five to eight the Exergame-dance training was conducted after the vibration sessions. SG performed a stochastic resonance whole-body vibration training with the same terms applied, however, with a fixed frequency of 1 Hz, Noise 1. From weeks five to eight a passive trampoline-programme of 5 min was applied following the vibration sessions. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes were the Trail Making Test A and B (TMT A & B) and the Falls Efficacy Scale–International (FES-I). Outcomes were measured at baseline, after 4 and 8 weeks of intervention and at follow-up (4 weeks after the intervention). The non-parametric Puri and Sen rank-order test was applied, followed by an ANOVA for repeated measures to analyse main and interaction effects. Mann–Whitney U-Test was used to determine differences between the groups.Results: The post-hoc analysis showed significant effects on the SPPB total score with large effect sizes from baseline to 8 weeks (+72%, p = 0.005, η2 = 0.423). The TMT part B displayed significant improvements with large effect sizes from baseline to 8 weeks (+17.5%, p = 0.002, η2 = 0.779) and to follow-up (+21%, p = 0.001, η2 = 0.827).Conclusion: The technology based 8-week training programme consisting of a combination of stochastic resonance whole-body vibration and Exergame-dance training showed beneficial effects on both physical and cognitive performance in older care home dwelling adults.

Effectiveness and Acceptability of e- and m-Health Interventions to Promote Physical Activity and Prevent Falls in Nursing Homes—A Systematic Review

“…Two studies ( Rogan et al, 2016 ; Babadi and Daneshmandi, 2021 ) found a significant improvement compared to control, while the others ( Keogh et al, 2014 ; de Bruin et al, 2020 ) did not. However, in the study of de Bruin et al (2020) , the small sample size and the p -value (0.055) suggest that more data would be needed for definite interpretation. In the study by Keogh et al (2014) , residents chose the frequency and duration of exergaming, resulting in only 30 min of exergaming per week on average.…”

“…From the additional search, another 75 articles were included in the full-text screening, of which 8 met the inclusion criteria. Thus, a total of 28 articles were included in this systematic review ( Chan et al, 2001 ; Brandt and Paniagua, 2011 ; Keogh et al, 2012 ; Pichierri et al, 2012 ; Ulbrecht et al, 2012 ; Janssen et al, 2013 ; Keogh et al, 2014 ; Fu et al, 2015 ; Grigorova-Petrova et al, 2015 ; Rogan et al, 2016 ; Yesilyaprak et al, 2016 ; Delbroek et al, 2017 ; Monteiro-Junior et al, 2017 ; Hutchinson et al, 2018 ; Kamińska et al, 2018 ; Sun et al, 2018 ; Taylor et al, 2018 ; Wu et al, 2019 ; de Bruin et al, 2020 ; Cicek et al, 2020 ; Fakhro et al, 2020 ; Rica et al, 2020 ; Babadi and Daneshmandi, 2021 ; Huang et al, 2021 ; Loggia et al, 2021 ; Marinus et al, 2021 ; Ramnath et al, 2021 ; Zahedian-Nasab et al, 2021 ). The PRISMA flow diagram of the study selection process is shown in Figure 1 .…”

“…Other performance-oriented balance tests evaluating the risk of falls were the Short Physical Performance Battery (SPPB, Guralnik et al, 1994 ) used in two studies ( Rogan et al, 2016 ; de Bruin et al, 2020 ), the Tinetti Scale (TS, Tinetti, 1986 , sometimes referred to as Performance Oriented Mobility Assessment) also used by two studies ( Delbroek et al, 2017 ; Sun et al, 2018 ), the Fullerton Advanced Balance scale (FAB, Rose et al, 2006 ) in Babadi and Daneshmandi (2021) , the Four Square Step Test (FSST, Dite and Temple, 2002 ) in Keogh et al (2012) and Keogh et al (2014) , the Dynamic Gait Index (DGI, Shumway-Cook and Woollacott, 2007 ) in Kamińska et al (2018) and the Short-form Physiological Profile Assessment (S-PPA, Lord et al, 2003 ) in Fu et al (2015) .…”

“…Five studies ( Fu et al, 2015 ; Kamińska et al, 2018 ; Sun et al, 2018 ; de Bruin et al, 2020 ; Babadi and Daneshmandi, 2021 ) reported significant improvements for the exergaming group post intervention, while two ( Keogh et al, 2012 ; Delbroek et al, 2017 ) did not. When compared to usual care ( Keogh et al, 2014 ; Babadi and Daneshmandi, 2021 ) or sham interventions, which were expected to have no effects ( Rogan et al, 2016 ; de Bruin et al, 2020 ), heterogenous effects were reported. Two studies ( Rogan et al, 2016 ; Babadi and Daneshmandi, 2021 ) found a significant improvement compared to control, while the others ( Keogh et al, 2014 ; de Bruin et al, 2020 ) did not.…”

“…When compared to usual care ( Keogh et al, 2014 ; Babadi and Daneshmandi, 2021 ) or sham interventions, which were expected to have no effects ( Rogan et al, 2016 ; de Bruin et al, 2020 ), heterogenous effects were reported. Two studies ( Rogan et al, 2016 ; Babadi and Daneshmandi, 2021 ) found a significant improvement compared to control, while the others ( Keogh et al, 2014 ; de Bruin et al, 2020 ) did not. However, in the study of de Bruin et al (2020) , the small sample size and the p -value (0.055) suggest that more data would be needed for definite interpretation.…”