Novel Mat Exergaming to Improve the Physical Performance, Cognitive Function, and Dual-Task Walking and Decrease the Fall Risk of Community-Dwelling Older Adults

Abstract

Physical exercise and cognitive training were previously demonstrated to improve the physical functioning and decrease the incidence of falls for older adults. This study aimed to utilize an interactive exergame mat system to develop a novel cognitive–physical training program and explore the training effects on physical performance, cognitive function, dual-task walking (DTW), and fall risk compared to the control condition. In this quasi-experimental non-randomized controlled intervention study, 110 community-dwelling older adults participated. The exercise group ( n = 56; mean age, 70.7 ± 4.6 years) performed ladder-type, three-by-three grid-type, and circle-type mat exergames with simultaneous cognitive–physical training (EMAT), while the control group ( n = 54; mean age, 72.0 ± 5.7 years) underwent a multicomponent exercise intervention focused on physical and cognitive training. A 2 h training session was completed weekly for 3 months. Functional fitness (including upper- and lower-extremity strength and flexibility, grasp strength, aerobic endurance, static balance, dynamic balance and agility), a foot tapping test (FTT), the Montreal Cognitive Assessment (MoCA), DTW, and a fall risk questionnaire (FRQ) were assessed before and after the interventions. The EMAT program enhanced upper-extremity strength, lower-extremity strength and flexibility, aerobic endurance, and dynamic balance and agility; improved DTW and FTT performances; and decreased FRQ score. EMAT also showed a significant advantage over control in terms of lower-extremity strength and flexibility, aerobic endurance, dynamic balance and agility, and FRQ score (all P < 0.05). The current study provides evidence of the effects of a novel mat exergaming program on physical and cognitive performance. EMAT effectively reduced the fall risk and increased the dual-task ability of walking, factors that are important in fall prevention for community-dwelling older adults.

Physical Fitness among Community-Dwelling Older Women with and without Risk of Falling—The Taipei Study, Taiwan

“…In this study, a fall refers to an event that results in a person coming to rest inadvertently on the ground or floor or other lower level. The 12-item fall risk questionnaire (FRQ) was used to evaluate risk factors associated with falls, such as history of falls, fear of falling, gait and balance problems, leg muscle weakness, impaired sensation and proprioception, depression, and side effects of medications [ 12 , 19 ]. It was developed based on evidence and has clinical acceptability, and it was found to have good concurrent validity.…”

“…The handgrip strength of participants’ dominant hands was assessed using a hand dynamometer (TTM-YD, Tokyo, Japan). Participants were asked to stand with their arms by the side of the body and were given verbal encouragement to give their maximum effort [ 12 ]. The best value of two trials with 1-min breaks was taken.…”

“…Early identification of deficiencies in potential fall candidates (without falling experience) could help avoid the occurrence of falls. Functional fitness is an essential indicator of independence and quality of life in older adults in the late years, and it is also one of the most commonly reported indicators in fall-related research [ 10 , 11 , 12 , 13 ]. The handgrip strength test, as well as the single-leg stand test for static balance are frequently used in Asian countries and territories [ 9 , 14 , 15 ].…”

Can Exergames Be Improved to Better Enhance Behavioral Adaptability in Older Adults? An Ecological Dynamics Perspective

“…These elements create dual task situations [i.e., Thinking while moving situations, (Herold et al, 2018)], in which the player needs to focus on two or more things simultaneously. Strikingly, few studies investigated the effects of exergames on dual-task performance [for noticeable exceptions, see (Schättin et al, 2016;Peng et al, 2020)] but, recently, Gallou-Guyot et al ( 2020) compared (indirectly) conventional MCDT training and exergaming. They did not observe any superiority of the latter over the former, though some studies suggested the opposite [e.g.…”

<p>Effects of Arch Support Insoles on Single- and Dual-Task Gait Performance Among Community-Dwelling Older Adults</p>

“…Gait performance was measured under three conditions in a random order based on a random number table: (1) walking (single task); (2) walking while verbally counting backward in decrements of three from a random number between 90 and 100 (cognitive dual-task walking); and (3) walking while carrying a tray (size: 38 × 28 × 5 cm 3 ) that was 80% full of water (motor dual-task walking). In line with a previous study, 26 our dual-task walking testing protocol comprised cognitive and motor dual-tasks because in their daily life, people tend to combine walking and executing a cognitive or motor task.…”