None listed
Conditions
Brief summary
One in three people 65 years and older fall each year with consequences for the individual and a high burden for society. Stepping is often the last protective option to prevent a fall. Studies have shown that impaired stepping is prevalent in older people and that impaired stepping is associated with high risk of falls. In this study a low-cost computer game device (dance pad) that enables a human-computer interaction via movements (exergame) will be used to as a home-based interactive step training in independent living older people. This randomised controlled pilot trial aims at improving parameters of fall-risk and physical function. Further aim is to investigate whether this step training to cognitive stimuli on a screen (TV) can improve parameters of cognitive function. This study proposes to test the hypothesis that: a short-term volitional step training intervention using a dance pad can significantly improve risk factors for falls as well as measures of cognition in independent living older people. The intervention will last 8 weeks and participants are asked to play a game of step co-ordination at least 2-3 times per week for 15 to 20 minutes and to do a choice stepping reaction time task once a week. People in the control group will maintain their usual activities. Primary outcome measure will be the choice stepping reaction time (CSRT). Further outcomes are the Physiological Profile Assessment (PPA), tests of combined motor and cognitive function, tests of physical performance, tests of cognitive functions, and a iconographic measure of Fear of Falling.
Interventions
Subjects will play an adapted open source active computer game (exergame) via their TV. A step pad and a computer unit will be provided to them.
While stepping on the step pad subjects interact with the computer. The game idea is to step as accurately as possible in terms of direction and timing. Arrows drift up the screen; when they reach a location on top of screen the subject's task is to step on the corresponding arrow of the step pad.
They will play this game to music but will not step in
Subjects will play an adapted open source active computer game (exergame) via their TV. A step pad and a computer unit will be provided to them. While stepping on the step pad subjects interact with the computer. The game idea is to step as accurately as possible in terms of direction and timing. Arrows drift up the screen; when they reach a location on top of screen the subject's task is to step on the corresponding arrow of the step pad. They will play this game to music but will not step in the rhythm to the music. In addition they will be distracted by other elements on the screen for which their task is not to step. Participants will be asked to play as many times as they want with the recommended dose of 2-3 sessions per week for 15-20 minutes over a period of 8 weeks. The participants can play more often if they want to. In addition subjects will be asked to do a choice stepping reaction time task once a week. In this game/test subjects step as quickly as they can in different step directions depending on arrows changing their color on the screen. The intervention will be unsupervised. Participants will be instructed at the beginning of the study period in their homes when the system will be installed. To control for compliance people will be contacted by phone in week 1, 2, 3 and 6.
Sponsors
Prof Stephen R Lord
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
age>65 years independent living ambulant with or without walking aid able to step unassisted on the step pad
Exclusion criteria
cognitive impairment (MMSE<24) neurodegenerative diseases (e.g. Parkinson) health problems that affect stepping ability (e.g. acute painful joint inflammation, mobility problems after stroke) unstable health conditions
Outcome results
None listed