Usability and Effects of an Exergame-Based Balance Training Program

Abstract

Background: Post-stroke recovery benefits from structured, intense, challenging, and repetitive therapy. Exergames have emerged as promising to achieve sustained therapy practice and patient motivation. This study assessed the usability and effects of exergames on balance and gait. Subjects and Methods: Sixteen elderly participants were provided with the study intervention based on five newly developed exergames. The participants were required to attend 36 training sessions; lasting for 20 minutes each. Adherence, attrition and acceptance were assessed together with (1) Berg Balance Scale, (2) 7-m Timed Up and Go, (3) Short Physical Performance Battery, (4) force platform stance tests, and (5) gait analysis. Results: Thirteen participants completed the study (18.8 percent attrition), without missing a single training session (100 percent adherence). Participants showed high acceptance of the intervention. Only minor adaptations in the program were needed based on the users' feedback. No changes in center of pressure area during quiet stance on both stable and unstable surfaces and no changes of walking parameters were detected. Scores for the Berg Balance Scale (P = 0.007; r = 0.51), the 7-m Timed Up and Go (P = 0.002; r = 0.56), and the Short Physical Performance Battery (P = 0.013; r = 0.48) increased significantly with moderate to large effect sizes. Conclusion: Participants evaluated the usability of the virtual reality training intervention positively. Results indicate that the intervention improves gait-and balance-related physical performance measures in untrained elderly. The present results warrant a clinical explorative study investigating the usability and effectiveness of the exergame-based program in stroke patients.

Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

“…The primary aim of the reviewed studies was to evaluate the potential effect of gaming/VR exercise on balance, either alone (9,12,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46), in combination with other physical abilities such as strength or mobility (11,13,(47)(48)(49)(50)(51), or in combination with falls or fear of falling, cognition, quality of life, or user experience (52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62). Seven studies investigated the effect of gaming/VR exercise on gait parameters (63)(64)(65)(66)(67)(68)(69), and six studies examined the effectiveness with regard to different physical functions and associated fall risk (10,(70)(71)(72)…”

“…The remaining studies included different patient groups living at home, in nursing or retirement homes, or in-hospital patients, either as the only study sample or in combination with healthy older adults ( Table 3). (33,59). Five of the custom-designed games targeted walking and stepping movements and used either a treadmill with a VR simulation (63,64,68), the Xavix Measured…”

“…As can be seen in Table 4, the studies utilizing commercially available exergames targeted a wide variety of physical functions and activities, with balance being the main target of improvement (see Table 4 for references). For the custom-designed games three functions were mainly targeted; balance (9,33,36,38,39,46,54,59,61), walking/stepping (41,51,(62)(63)(64)68), and strength (67, 79). …”

Algorithms Based on Computational Intelligence for Autonomous Physical Rehabilitation at Home

“…We h Unity 3D) can be used. Th guage to support a set of fe physical rehabilitation for b [7] has been developed as part of Rewire p e of Rewire is to develop a low-cost game-based platfo arged from the hospital, to pursue their rehabilitation au emote supervision of the clinicians. The Rewire platform omponents: a patient station (PS), a hospital station (H NS).…”

“…Using IGER, we have developed a set of eleven exergames for balance and posture rehabilitation, six of which have been thoroughly tested for usability with post-stroke patients [7]. IGER has also been used to create nine exergames for neglect rehabilitation, highlighting how the engine is flexible enough to be used for the rehabilitation of different pathologies.…”