Balance, Fall Risk
Conditions
Keywords
Postural Balance, Postural Control, Accidental Falls, Risk factors, Aged, virtual reality, video games, rehabilitation
Brief summary
Study, titled Effects of Kinect-Based Exergaming versus Wii Fit on Balance and Fall Risk among Healthy Older Adults, is a randomized controlled trial comparing the balance training effects of Xbox Kinect and Wii Fit. After obtaining informed consent, 46 healthy older adults will be randomly allocated (1:1) using sealed envelopes to a 6-week training program in either group. Static, Dynamic, and Anticipatory balance will be assessed at baseline and post-intervention using the Biodex Balance System for objective comparison.
Detailed description
Balance is a complex, multidimensional concept related to postural control, referring essentially to the ability to maintain a stable posture. Each year, an estimated 37.3 million individuals experience a fall that requires hospitalization and may lead to severe injuries, such as fractures and traumatic brain injuries. Traditional balance exercises reduce fall risk but may have low long-term adherence in seniors. The introduction of VR-based games engages participants in interactive balance exercises. The objective of this study is to evaluate the effects of Kinect-based exergaming compared to Wii Fit balance training on reducing fall risk in elderly individuals, focusing on parameters of Fall incidence, as well as Static, Dynamic, and Anticipatory balance. The study will be a non-blinded Randomized Controlled Trial (RCT), consisting of 2 groups. The Study will be conducted over 1 year at the Multidisciplinary Development Lab (MDL) of the Foundation University College of Physical Therapy (FUCP). A calculated sample of 46 subjects will be selected via a non-probability convenience sampling technique, followed by randomization in a 1:1 ratio to Group A (Kinect-based exergaming) or Group B (Wii Fit) using the sealed-envelope method. After CBRC registration, ethical approval will be obtained from the Ethical Review Commitee (ERC) of Foundation University Medical College (FUMC). Individuals fulfilling the inclusion criteria will be selected, followed by written informed consent after explaining the study purpose. Participants will then be randomly allocated to one of the 2 groups. At baseline, investigators will assess postural control using the Postural Stability System and balance confidence using the Falls Efficacy Scale. Objective static and dynamic balance will be evaluated using the Berg Balance Scale, while cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA). One group will be provided with Kinect-based exer-gaming balance training. The second group will be provided with the Wii Fit Balance Training. Exercise training would be performed over a 6-week intervention period, administering exercise training 3 days per week. All outcome measurements would be performed before and after the 6-week intervention period. Data will be entered and analyzed on SPSS v. 22.
Interventions
PROCEDUREVirtual Reality Balance Training
The total duration of the intervention protocol is 6 weeks. However, progression depends on the participant's comfort, performance, and adaptation to the training tasks. Training sessions will be done 3 days a week for 40- 50 minutes/day (18). Group 1 will receive Kinect-based exergaming balance training. Warm-up exercise will be for 5 minutes, including gentle stretching exercises, and 5 minutes will be given for a cool down, including deep breathing exercises Group (A) / (Kinect-based Exergaming balance training): 1. 20,000 leaks 2. Reflex ridge 3. River rush 4. Rally ball
PROCEDUREWii Fit balance training
The total duration of the intervention protocol is 6 weeks. However, progression depends on the participant's comfort, performance, and adaptation to the training tasks. Training sessions will be done 3 days a week for 40- 50 minutes/day (18). Group 2 will receive Wii Fit balance training. Warm-up exercise will be for 5 minutes, including gentle stretching exercises, and 5 minutes will be given for a cool down, including deep breathing exercises Group (B) / Wii Fit balance training: 1. Soccer header 2. Lotus Focus(Minimal) 3. Tightrope Walk 4. Ski slalom
Sponsors
Foundation University Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
This study will be conducted as a single-blinded randomized controlled trial. The outcome assessor will be blinded to group allocation to minimize detection bias. The assessor performing evaluations using the Berg Balance Scale, Falls Efficacy Scale, Montreal Cognitive Assessment, and Biodex Balance System will not be informed whether participants are assigned to the Xbox Kinect or Wii Fit group. Participants and therapists cannot be blinded due to the nature of the interventions.
Intervention model description
This study is a randomized controlled trial which will consists of two groups .one will receive kinect based exergaming and the second will recieve Wiifit balance training .both groups will be recruitted concurrently
Eligibility
Sex/Gender
ALL
Age
55 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Older adults aged ≥55, community-dwelling, with a BBS score between 21-50, including both mild to moderate Risk falls * Able to stand without assistive devices * Cognitively able to follow instructions, with a MoCA score ≥ 22 * Both Genders: Males and females
Exclusion criteria
* History of Neurological disorders affecting balance (e.g., Parkinson's disease, stroke) * Acute Vestibular disorders/Major Musculoskeletal impairments (e.g., Arthritis) * Participation in other balance training programs within the past 6 months * Any condition posing a safety risk (e.g., severe osteoporosis, uncontrolled hypertension
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postural stability | 6 weeks. | Static postural stability will be assessed using the Biodex Balance System SD at stability level 12. The Overall Stability Index (OSI) measures the variance of platform displacement during static standing. The Overall Stability Index (OSI) is expressed in degrees. Lower OSI values indicate better postural stability and reduced postural sway, whereas higher values indicate impaired balance control. Assessment will be performed at baseline and after 6 weeks of intervention. Intervention will be conducted 3 sessions per week for 6 weeks, with each session lasting 30-45 minutes |
| Balance | 6 weeks | Berg Balance scale will be used. 5-point ordinal scale (graded 0-4), Max score = 56 41-56 = low fall risk, 21-40 = medium fall risk, 0 -20 = high fall risk R=0.88-0.98. |
| Concern of Fall | 6 weeks | Fall Efficacy Scale will be used. 16 items Questionnaire. Individuals are instructed to score their concern of falling during an activity. Performed at the start of the treatment protocol, and after 8 weeks at the end of the intervention 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total of 64. 16 = no concern about falling, \> 16 = concern about falling |
| Cognition | 6 weeks | Montreal Cognitive Assessment (MoCA) A 30-item global cognitive screening tool scored from 0-30. Higher scores indicate better cognition. 26-30: Normal cognition 18-25: Mild cognitive impairment (MCI) 10-17: Moderate cognitive impairment ≤ 9: Severe cognitive impairment One extra point is added for individuals with ≤12 years of formal education to adjust for educational bias |
| Dynamic balance | 6 weeks | Dynamic balance will be assessed using the Biodex Balance System SD at stability level 6 under unstable surface conditions. Balance performance will be quantified using the Overall Stability Index (OSI). The Overall Stability Index (OSI) is expressed in degrees.Lower OSI scores represent improved dynamic balance and neuromuscular control, whereas higher values indicate poorer balance performance. Assessment will be performed at baseline and after 6 weeks of intervention. Intervention will be conducted 3 sessions per week for 6 weeks, with each session lasting 30-45 minutes |
| Limits of Stability | 6 weeks | Limits of Stability testing will be used to assess the participant's ability to intentionally displace the center of pressure toward visual targets without losing balance. Higher LOS scores indicate better anticipatory postural control and balance performance, whereas lower scores indicate impaired balance ability. Assessment will be performed at baseline and after 6 weeks of intervention. Intervention will be conducted 3 sessions per week for 6 weeks, with each session lasting 30-45 minutes |
| Fall Risk Index | 6 week | The Fall Risk Test using the Biodex Balance System will assess the participant's risk of falls under progressively unstable conditions. Higher Fall Risk Index scores indicate greater fall risk and poorer balance ability, whereas lower scores indicate improved balance and reduced fall risk. Assessment will be performed at baseline and after 6 weeks of intervention. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORNayab Khan, DPT
Foundation University Islamabad
Outcome results
None listed