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A Randomized Controlled Pilot Study of Home-Based Step Training in Older People Using Videogame Technology
Journal article   Open access   Peer reviewed

A Randomized Controlled Pilot Study of Home-Based Step Training in Older People Using Videogame Technology

D Schoene, S R Lord, K Delbaere, C Severino, T A Davies and Stuart T Smith
PLoS One, Vol.8(3), e57734
2013
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https://doi.org/10.1371/journal.pone.0057734View
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Abstract

clinical effectiveness elderly care exercise fall risk home care independent living
Background: Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people. Purpose: To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people. Design: Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention). Setting/Participants: Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia. Intervention: Intervention group (IG) participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2-3 sessions per week for 15-20 minutes each) for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT) task once each week. Main Outcome Measures: CSRT, the Physiological Profile Assessment (PPA), neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up. Results: Thirty-two participants completed the study (86.5%). IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F31,1 = 18.203, p<.001), PPA composite scores (F31,1 = 12.706, p = 0.001), as well as the postural sway (F31,1 = 4.226, p = 0.049) and contrast sensitivity (F31,1 = 4.415, p = 0.044) PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F31,1 = 4.226, p = 0.049). Conclusions: Step pad training can be safely undertaken at home to improve physical and cognitive parameters of fall risk in older people without major cognitive and physical impairments. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12611001081909. © 2013 Schoene et al.

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Geriatrics & Gerontology

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