None listed
Conditions
Brief summary
With advanced ageing, physical and cognitive functions decline and these age-related changes increase the risk of falls. Above the age of 65 years, about one third of individuals experience at least one fall every year with about half of those who fall in this period do so multiple times. As stepping and specific cognitive functions are risk factors for falls in older people, this study aims at improving these functions to reduce risk. In this randomised controlled trial, participants will use low-cost computer game technology to play a range of games that combine stepping and specific cognitive functions. Earlier studies have shown that this intervention type and mode of delivery is feasible and safe. In this phase III trial, participants will be recommended to perform the exergames three or more times per week for 20 minutes for a period of three months. At the end of the trial, physical and cognitive functions associated with fall risk will be assessed. Falls will also be recorded over a period of six months. Using this novel approach of delivery, we hypothesize that playing exergames can improve both physical and cognitive functioning and reduce the risk of falls.
Interventions
A step training system will be provided to participants. This will consist of a computer unit, a dongle and a step pad. The participant’s TV will be used for the display screen. The dongle will be plugged into the computer and link with the step pad. In addition, a USB modem will be provided to enable the upload of data to a central server via the internet.
Intervention participants will play the exergames (exercise + video games) by giving step responses on the pad. Several games will be playe
A step training system will be provided to participants. This will consist of a computer unit, a dongle and a step pad. The participant’s TV will be used for the display screen. The dongle will be plugged into the computer and link with the step pad. In addition, a USB modem will be provided to enable the upload of data to a central server via the internet. Intervention participants will play the exergames (exercise + video games) by giving step responses on the pad. Several games will be played: a modified version of Tetris (rotation of down-drifting objects), a choice stepping reaction time task (rapid stepping), Dance Dance Revolution (step coordination including go/no-go tasks and tasks of divided attention), and a Trail-Stepping task (set-shifting). In all games, participants are required to step after or while solving cognitive tasks thus combining balance training and cognitive exercises. They will receive feedback about their performance. Participants will be asked to play as many times as they want with the recommended dose of 3 or more sessions per week for 20 minutes for a period of 3 months. The intervention will be unsupervised and participants will exercise in their own homes. Instructions will be provided at the beginning of the study period when the system is installed. To encourage adherence, participants will be contacted by phone after weeks 1, 4, 8, 12 or if data upload shows non-adherence in between (non-use of the system for 5 days). In addition participants will be provided with a phone number to call if they have questions or problems related to system.
Sponsors
Stephen R Lord
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
age greater than or equal to 70 years ambulant with or without walking aids able to step unassisted (no assistive devices or personal support) on step pad no major cognitive impairment (Mini-Cog >=3)
Exclusion criteria
unable to understand instructions (non-english speaking background) health problems that affect stepping ability (e.g. acute painful joint inflammation, mobility problems after stroke) unstable health conditions neurodegenerative disease blind or colour-blind no HDMI source on TV
Outcome results
None listed