Making More of IT: Enabling Intensive Motor Cognitive Rehabilitation Exercises in Geriatrics Using Information Technology Solutions

Abstract

Although the health benefits of physical activity and exercise for older people are well established, a largely sedentary lifestyle still prevails in ageing western societies. Finding new ways to make exercise more accessible and acceptable for older adults must be developed to fully unleash its potential in preventing and weakening age-related physical and cognitive decline. Existing barriers to implement effective exercise-based treatment plans include motivational reservations on both the clinician's and patient's side, but also physical limitations caused by disease or deconditioning. Particularly in the more senior population, debilitating conditions do not allow adherence to currently recommended exercise regimes. A major rethinking of age- and user-adapted exercise is overdue. The high intensities required for physical and mental adaptations must be modifiable and personalized according to the functional status of each patient. Emerging information and communication technologies (ICT) have brought forward a plethora of attractive solutions for smart and adapted exercise, but there remains a vast gap between technological advancement and clinical relevance. Where in the beginning ICT for active ageing mainly focussed on aspects of usability and user experience, the current status of IT as applied in ageing populations noticeably shifted toward new services, applications, and devices that can be offered with the aim to prevent, compensate, care, and/or enhance daily life functioning of senior citizens. In this perspective paper, we aim to summarize the current state of the art in ICT-based interventions aimed at improved motor-cognitive control and make suggestions about how these could be combined with high-intensive interval exercise regimes to make rehabilitation for the impaired older adults more effective, and more fun.

Playing Exergames Facilitates Central Drive to the Ankle Dorsiflexors During Gait in Older Adults; a Quasi-Experimental Investigation

“…This study is the first to show enhanced neural drive due to an exergame intervention. This finding is relevant for our society that is currently challenged to find an answer for supporting public health policies aimed at helping senior citizens achieving the goals of primary and secondary (i.e., reducing readmission rates) prevention to remain independence in functioning (McCaskey et al, 2018). Physical activity and exercise for older adults may help in this context to foster physical and cognitive functioning at the highest possible levels (DiPietro, 2001; American College of Sports Medicine, 2004; Elsawy and Higgins, 2010; de Souto Barreto et al, 2016; Karssemeijer et al, 2017) and considering that motivation to continue and adhere to conventional exercise is often difficult (Phillips et al, 2004).…”

“…The exergame used in this study is a motor-cognitive exercise from which can be hypothesized that it improves the synapse communication in brain networks responsible for movement coordination and execution (Eggenberger et al, 2016; Schattin et al, 2016; McCaskey et al, 2018). This, in turn, could positively influence the communication from the motor area of the brain to the muscles.…”

Exergame-Driven High-Intensity Interval Training in Untrained Community Dwelling Older Adults: A Formative One Group Quasi- Experimental Feasibility Trial

“…To create a holistic and user-centered design, it is recommendable to work with interdisciplinary developer teams of experts from all related fields. In the context of personalized exergames for HIIT and rehabilitation in seniors, the team should consist of older people, therapists, movement and sports scientists, game designers, industrial and interaction designers as well as Human Computer Interaction researchers, who can provide relevant knowledge from their different perspectives (McCaskey et al, 2018).…”

Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study

“…Furthermore, using a composite sarcopenia phenotype applying two different widely accepted definitions for sarcopenia does not associate with independent aging [117]. This implies that training programs should be developed that explicitly target neural structures such as training programs that use motor-cognitive approaches through step-training exergames [80,[118][119][120] that also effect on leg muscles strength [121,122].…”