Telerehabilitation with virtual reality in older adults.

Clinical trial parallel in older adults. Two-arm, parallel-groups and randomised. Intervention exposure exercise program version "face to face" (control group) or "remote" (exposure group) both with Nintendo Wii balance board. A virtual reality-based exercise protocol using Wii therapy (W-t) with Nintendo Wii balance board an “exposure-group” performed by older adult properly trained for 6 months in W-t. An older adult trained in W-t will be the therapist of his older adult peers which belong to a geriatrics Club, a physical space close to their homes that seeks to provide recreational and sports activities for older adults who attend daily. The elderly therapist will be guided remotely from the telerehabilitation center of the Universidad de Talca. W-t will be have for 6 weeks of training, which will have at a frequency of three times per week reaching 18 sessions in total and four weeks of follow-up in the older adults. Each participants will execute three series of exercise with manual guidance and verbal instructions for the first 3 weeks and only verbal instructions by an older adult therapist in the following weeks. The protocol has three series of exercises and activates postural balance in the three planes of motion: sagittal, frontal and transversal. The games –Snowboard, Penguin Slide and Super Hula Hoop- will be used for the first two series of exercise, and the yoga game will be used for the third series. In the first series of exercise, the older adults stand with their arms and hands at their sides in the relaxed manner. In the second series of exercises, each game will be repeated in the standing position with their hands on their waists. Between the first and the second series of exercises, there will be a one to two minute break, where the participants will sit on a chair until they had recovered. The third series of exercises will consist of keeping their posture as relaxed as possible during the yoga game with their eyes open and then repeating it with their eyes closed. W-t will consist of a virtual reality training session using the Nintendo Wii balance board console for 25 min each session. W-t is based on previous studies. So, the strategies used to monitor adherence to the intervention have: session attendance checklists in an excell and direct observation by study personnel (physioterapist and elderly therapist).