Physical activity programs for balance and fall prevention in elderly: A systematic review

BACKGROUND: Due to demographic changes the world's population is progressively ageing. The physiological decay of the elderly adult may lead to a reduction in the ability to balance and an increased risk of falls becoming an important issue among the elderly. In order to counteract the decay in the ability to balance, physical activity has been proven to be effective. The aim of this study is to systematically review the scientific literature in order to identify physical activity programs able to increase balance in the elderly. METHODS: This review is based on the data from Medline-NLM, Pubmed, ScienceDirect, and SPORTDiscuss and includes randomized control trials that have analyzed balance and physical activity in healthy elderly over 65 years of age during the last decade. A final number of 8 manuscripts were included in the qualitative synthesis, which comprised 200 elderly with a mean age of 75.1 ± 4.4 years. The sample size of the studies varied from 9 to 61 and the intervention periods from 8 to 32 weeks. RESULTS: Eight articles were considered eligible and included in the quantitative synthesis. The articles investigated the effects of resistance and aerobic exercise, balance training, T-bow© and wobble board training, aerobic step and stability ball training, adapted physical activity and Wii Fit training on balance outcomes. Balance measures of the studies showed improvements between 16% and 42% compared to baseline assessments. CONCLUSIONS: Balance is a multifactorial quality that can be effectively increased by different exercise training means. It is fundamental to promote physical activity in the aging adult, being that a negative effect on balance performance has been seen in the no-intervention control groups

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082

A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

BACKGROUND: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall.STUDY DESIGN: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments.RESULTS: Balance game training had a significant effect on levels of functional balance and balance confidence (P Peer reviewedFinal Published versio

Activity-promoting gaming systems in exercise and rehabilitation

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation

Custom-designed motion-based games for older adults: a review of literature in human-computer interaction

Many older adults, particularly persons living in senior residences and care homes, lead sedentary lifestyles, which reduces their life expectancy. Motion-based video games encourage physical activity and might be an opportunity for these adults to remain active and engaged; however, research efforts in the field have frequently focused on younger audiences and little is known about the requirements and benefits of motion-based games for elderly players. In this paper, we present an overview of motion-based video games and other interactive technologies for older adults. First, we summarize existing approaches towards the definition of motion-based video games – often referred to as exergames – and suggest a categorization of motion-based applications into active video games, exergames, and augmented sports. Second, we use this scheme to classify case studies addressing design efforts particularly directed towards older adults. Third, we analyze these case studies with a focus on potential target audiences, benefits, challenges in their deployment, and future design opportunities to investigate whether motion-based video games can be applied to encourage physical activity among older adults. In this context, special attention is paid to evaluation routines and their implications regarding the deployment of such games in the daily lives of older adults. The results show that many case studies examine isolated aspects of motion-based game design for older adults, and despite the broad range of issues in motion-based interaction for older adults covered by the sum of all research projects, there appears to be a disconnect between laboratory-based research and the deployment of motion-based video games in the daily lives of senior citizens. Our literature review suggests that despite research results suggesting various benefits of motion-based play for older adults, most work in the field of game design for senior citizens has focused on the implementation of accessible user interfaces, and that little is known about the long-term deployment of video games for this audience, which is a crucial step if these games are to be implemented in activity programs of senior residences, care homes, or in therapy

Virtual Reality: An Evidence-Based Guide for Occupational Therapy

Problem: Virtual reality (VR) is an emerging technology that serves to position the user in control of a virtual environment to maximize interest and function. VR is a context for intervention included in the Occupational Therapy Practice Framework: Domain and Process 3rd edition (OTPF-3; AOTA, 2014). It is crucial that occupational therapy (OT) practitioners enhance their knowledge about VR technology used by their clients to provide effective client-centered practice (AOTA, 2010). There is a lack of organization of the literature and research evidence regarding the use of VR as an intervention modality. While there has been a significant increase in recent literature supporting the use of VR in OT, there is a need for manuals and resources to guide clinicians in using VR as a therapeutic modality (Levac & Miller, 2013; Proffitt & Lange, 2015). Methods: An extensive literature review for articles regarding the use of the Xbox Kinect and Nintendo Wii within OT was conducted using five databases. Relevant data was extracted from each article related to the use of the Xbox Kinect or Nintendo Wii in intervention to synthesize the findings into charts. The construction of the charts followed the organization of the OTPF-3 (AOTA, 2014). Product: The authors of this product created an evidence-based resource to guide OT practitioners\u27 use of VR. The intended purpose of this product, Virtual Reality: An Evidence-Based Guide, is to assist OT practitioners\u27 adaptation and/or modification of VR activities to address individual client needs. Using this product as a guide to current knowledge and evidence regarding intervention in the context of VR, OT practitioners will be better equipped to make safe and effective choices. To further support development of literature regarding VR, the authors of this product recommended areas for future research

The effect of the Nintendo Wii Fit and exercise in improving balance and quality of life in community dwelling elders

Thesis (M.S.)--Boston UniversityOBJECTIVE: The aim of this research study was to see if Nintendo Wii Fit is better able to improve balance in the elderly population when compared to the Matter of Balance program, which is evidence.-based and designed to promote health, balance and wellbeing to decrease the risk of falls. PARTICIPANTS: Residents of an independent living senior housing facility in the Boston area were recruited to participate in this study. A total of 32 residents ages 63 to 90 participated: Wii Fit n=11, Matter of Balance n=11, and Control n=1O. Methods: Participants were separated into three groups. Experimental group 1: The Wii Fit Group performed balance games on the Wii Fit in individual sessions twice a week for three weeks. Experimental group 2: The Matter of Balance Group performed exercises from the Matter of Balance Program in a group setting twice a week for three weeks. The control group received no intervention. Participants in the Wii Fit group had the addition of supplemental home exercises. Two balance and one health and wellness measure were used to determine whether there were any changes following intervention: the Berg Balance Scale, the Tinetti Gait and Balance Assessment, and the Short Form-36 Health Survey (SF-36). RESULTS: Repeated measures ANOV As were used to determine whether there was an effect of the interventions on balance, health and well-being and whether there were any differences between intervention groups. Scores were significantly improved at post-test for both balance assessments: Berg Balance Scale (F1,29= 17.034, p < 0.001); Tinetti Gait and Balance Assessment (F1,29 = 9.715, p < 0.004). The mean increases in balance scores were larger, but not significantly so, for the exercise groups as compared to the control group. Results from the Wii Fit Enjoyment Questionnaire showed that 81% of participants reported high levels of enjoyment while playing the Wii games. DISCUSSION AND CONCLUSION: The Wii Fit is an enjoyable form of exercise as self-reported from an elderly population. Balance improved in the Wii Fit group following intervention, but only a small amount and not significantly more than improvements made by the MOB-exercise and non-exercise control groups. It is likely that the three week duration of the Wii Fit intervention was too short a period to make a large and significant impact on elders' balance

Effect of Different Types of Physical Activity on Activities of Daily Living in Older Adults : Systematic Review and Meta-Analysis

Peer reviewedPostprin

Falls prevention advice and visual feedback to those at risk of falling : study protocol for a pilot randomized controlled trial

Studies have shown that functional strength and balance exercises can reduce the risk of falling in older people if they are done on a regular basis. However, the repetitive nature of these exercises; combined with the inherent lack of feedback of progress may discourage seniors from exercising in the home, thereby rendering such an intervention ineffective. This study hypothesizes that the use of visual feedback and multimodal games will be more effective in encouraging adherence to home rehabilitation than standard care; thereby promoting independence and improving the quality of life in older adults at risk of falling

Modern Technology and an Aging Population: Can the Use of the Wii Fit Gaming System Improve Functional Balance in Community Dwelling Seniors?

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in finding ways to improve balance in seniors, the high incidence of falls continues to plague this demographic. Many of the current treatments to improve balance are too expensive, not accessible, or not motivating for seniors. This research project explored the effect of using a readily available video-game system to address these barriers. The Wii Fit gaming system was used with participants three times each week for 30 minutes and the resulting changes were documented. The Berg Balance Scale and Timed Up and Go test, both frequently used by professionals to assess balance in seniors, were used to document balance change. Every participant showed improvement. The Activities-specific Balance Confidence scale, which is used to measure a person\u27s fear of falling, was also used to assess the participant\u27s confidence in their balance as well as the level of fear associated with falling. The results of this test were positive but not to the extent of the balance tests. Finally, each participant was interviewed to assess how easy to use the participants felt the Wii Fit was as well as the motivational qualities of the Wii Fit as a balance tool. Answers given by the participants in the interview were generally positive. These results indicate that the Wii Fit gaming system may be beneficial for improving balance in seniors