Effects of stepping exergames under stable versus unstable conditions on balance and strength in healthy community-dwelling older adults: A three-armed randomized controlled trial

Morat, Mareike; Bakker, Julia; Hammes, Verena; Morat, Tobias; Giannouli, Eleftheria; Zijlstra, Wiebren; Donath, Lars

doi:10.1016/j.exger.2019.110719

Cited by 34 publications

(52 citation statements)

References 28 publications

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“…After reading full‐text copies, 101 studies were excluded from this review due to the following reasons: (i) two studies applied an acute intervention; (ii) one study used a non‐validated method for strength assessment; (iii) 45 studies did not apply an exergame intervention; (iv) four studies did not apply any intervention; (v) 39 studies did not measure muscle strength according to the criteria adopted in this review; and (vi) 11 studies applied combined interventions. At the end of the process, 47 publications meeting the eligibility criteria were included for qualitative analysis 31‐46,58‐88 . Eleven 63,68,72,73,78‐80,83,86‐88 of these 47 studies applied a study design that did not allow for the comparison of exergames versus a non‐exercise control group, or exergames versus a usual care intervention, or a usual care plus exergames versus a usual care intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Considering that exergames require body weight bearing exercises, 28 they might be a useful tool for increasing muscle strength. Nonetheless, as there are currently many different approaches (e.g., different game interfaces, pace of the games, and difficulty of the tasks) to performing exergames, 23,28 there is still no consensus on the effects of exergames on the wide range of muscle strength measures such as handgrip strength, 33,34,38 maximum voluntary isometric contraction (MVIC), 31,39‐42 isokinetic strength, 34,43‐45 and one‐repetition maximum (1RM) strength 46 …”

Section: Introductionmentioning

confidence: 99%

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The effects of exergames on muscle strength: A systematic review and meta‐analysis

Viana

Oliveira

Dankel

et al. 2021

Scandinavian Med Sci Sports

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This systematic review and meta‐analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand‐searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non‐randomized exergame intervention studies with or without a non‐exercise group and/or a “usual care intervention group” (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty‐seven and 25 studies were included in the qualitative review and meta‐analysis, respectively. The between‐groups meta‐analyses showed no significant differences between exergames and non‐exercise control groups for handgrip strength in heathy/unhealthy middle‐aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of exergames on muscle strength: A systematic review and meta‐analysis

Viana

Oliveira

Dankel

et al. 2021

Scandinavian Med Sci Sports

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“…The use of VRSs was the main intervention technique. Seven studies used VRSs specifically designed for rehabilitation [ 34 , 39 , 42 , 44 , 45 , 46 , 47 ]. The rest of the studies used virtual reality active video games (Nintendo ® Wii, XBox ® , Sony ® PlayStation and Xavi Sport ® ).…”

Section: Resultsmentioning

confidence: 99%

“…The authors think this may be a chance finding. Morat 2019 [ 46 ] n = 45 VOL = 15 VOL + US = 15 Cc = 15 69 (64–74) 62% female <60 years; healthy Community-dwelling adults Cologne, Germany Dvidat, Senso Dvidat Senso+ Postoromed 8 weeks 3 times/week Without intervention TUG, Y-balance test, motor dual-task No follow-up Exergames under stable and unstable conditions are a feasible training tool with high adherence rates to improve functional balance and calf strength. Exergames, especially under unstable conditions, improve factors that are relevant for fall prevention, such as balance, functional mobility and strength.…”

Section: Table A1mentioning

confidence: 99%

Effectiveness of Virtual Reality Systems to Improve the Activities of Daily Life in Older People

Corregidor-Sánchez

Segura‐Fragoso

Criado-Álvarez

et al. 2020

IJERPH

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(1) This review aims to evaluate the effectiveness of treatments with virtual reality systems (VRSs) on the functional autonomy of older adults versus conventional treatment. (3) Methods: Systematic review and meta-analysis. An electronic data search was carried out, following the PRISMA statement, up to February 2020. We combined results from clinical trials using VRSs for the improvement of basic and instrumental activities of daily living. The guidelines of the Cochrane Handbook for Systematic Reviews of Interventions were followed for calculations and risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. (4) Results: The final analysis included 23 studies with a population of 1595 participants. A moderate, but clinically significant, effect was found for basic activities of daily living (BADLs), (Standard Medium Deviation, SMD 0.61; 95% CI: −0.15–1.37; P < 0.001). A small effect was found for instrumental ADLs (Instrumental Activities of daily living, IADLs) (SMD −0.34; 95% CI: −0.82–0.15; P < 0.001). Functional ambulation was the BADL which improved the most (SMD −0.63; 95% CI: −0.86, −0.40; P < 0.001). (5) Conclusion: The use of VRSs is an innovative and feasible technique to support and improve the functional autonomy of community-dwelling older adults. Due to the very low quality of the evidence for our main outcomes, the effects of a VRS on the BADLs and IADLs are uncertain. Clinical trials of a higher methodological quality are necessary to increase the level of knowledge of its actual effectiveness.

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“…Interactive, exercise-based video gaming (exergaming) can offer attractive and effective training tools to improve stepping ability in older adults [ 14 – 16 ]. Stepping exergames typically require players to perform volitional and inhibitory stepping movements while interacting with stepping targets and distractors [ 14 , 15 ], or trigger reactive stepping when balance is disturbed under unstable surface conditions [ 17 ] to complete computer-controlled, cognitively challenging tasks projected onto a display screen. Such complex motor-cognitive stepping exergame tasks involve the interaction between the sensory, information-processing (e.g.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and sustainability of a motor-cognitive stepping exergame training on stepping performance in older adults: a randomized controlled trial

Hauer

Litz

Günther-Lange

et al. 2020

Eur Rev Aging Phys Act

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Background Training effects reported for stepping exergames on stepping performances in older adults often based on not comprehensively validated outcomes measures, and follow-up data on their sustainability are lacking. The aim of this study is to evaluate the effectiveness and sustainability of a motor-cognitive stepping exergame training on the stepping performance in older adults. Methods Fifty-eight older adults (78.3 ± 6.5 years) participated in the randomized controlled trial with a 10-week intervention and 10-week follow-up period. The intervention group (IG: n = 29) took part in a once-weekly exercise program including strength and balance exercises supplemented with an additional stepping exergame training. The control group (CG: n = 29) only performed the strength and balance exercises. Outcome measures included stepping reaction times (SRTs) and games scores for individual stepping exergame levels and for the overall exergame performance, as measured by an assessment strategy previously validated in older adults. Results SRTs and/or games scores for 7 out of 10 levels and the overall exergame performance significantly improved in the IG compared to the CG during the intervention (p ≤ 0.001–0.039, ηp2 = 0.090–0.445). Training gains were sustained for 2 levels and for the overall exergame performance (p = 0.017–0.033, ηp2 = 0.127–0.193). Conclusion The study demonstrates that the additional stepping exergame training effectively and sustainably improves the performance in complex motor-cognitive stepping exergame tasks in older adults, which can be relevant for preventing falls. Future research is needed to evaluate the effectiveness of such training on reducing the number of falls. Trial registration ISRCTN registry, ISRCTN14855620, 06/06/2019 (retrospectively registered).

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Effects of stepping exergames under stable versus unstable conditions on balance and strength in healthy community-dwelling older adults: A three-armed randomized controlled trial

Cited by 34 publications

References 28 publications

The effects of exergames on muscle strength: A systematic review and meta‐analysis

The effects of exergames on muscle strength: A systematic review and meta‐analysis

Effectiveness of Virtual Reality Systems to Improve the Activities of Daily Life in Older People

Effectiveness and sustainability of a motor-cognitive stepping exergame training on stepping performance in older adults: a randomized controlled trial

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