Feasibility and effects of cognitive–motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients: a randomized controlled pilot study

Abstract

Background People with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive–motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD. Methods Forty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1–4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effects Results Adherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time–group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2. Discussion Exergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted. Trial registration: The study has been registered at ClinicalTrials.gov (ID: NCT04872153).

Acceptance, safety, and impact on quality of life of exergame for elderly patients with neurodegenerative diseases: A systematic review and meta-analysis

“…Acceptance was associated with exergame being enjoyable, easy-to-use, and motivational [14]. Low attrition was observed in an RCTs which was associated with easy-to-use characteristic of the exergame [19]. The adherence rate was high as reported in three studies [14,19,27], where some studies reported the adherence rate of 97% [19] and 80% [27]…”

“…In this present systematic review, fourteen studies assessing the QoL were included. Twelve of which reporting about Parkinson's disease and the other two -Alzheimer's disease [14,15,[24][25][26][27][28][16][17][18][19][20][21][22][23]. Most of Parkinson's disease studies used PDQ-39 and EQ-5D.…”

“…As many as nine studies were found to have passed all Cochrane's risk of bias criteria, indicating them as high-quality studies [14,15,[17][18][19]22,23,25,26]. Five studies were found to have some concerns [16,21,24,27,28], where three of them were derived from missing outcome data [16,21,24], while two others were because of deviation from the intended intervention and biased measurement [27,28], respectively.…”

“…The results of the random effect meta-analysis of the QoL-based on PDQ-39 have been presented in Figure 3. The effect of exergame therapy on QoL was assessed in nine studies [14,15,[17][18][19]22,23,25,26] according to PDQ-39 overall mean score. The effect of exergame therapy on QoL favored the experimental group but was not statistically significant (n= 9, SMD= -0.08, 95%CI: -0.31-0.16, p= 0.53).…”

“…Six studies performed the observation on the occurrence of adverse events. All studies reported the absence of adverse events during the intervention [14,16,17,19,25,27].…”