The effectiveness and cost-effectiveness of strength and balance Exergames to reduce falls risk for people aged 55 years and older in UK assisted living facilities: A multi-centre, cluster randomised controlled trial

Background: Falls are the leading cause of fatal and non-fatal unintentional injuries in older people. The use of Exergames (active, gamified video-based exercises) is a possible innovative, community-based approach. This study aimed to determine the effectiveness of a tailored OTAGO/FaME based strength and balance Exergame programme for improving balance, maintaining function and reducing falls risk in older people. Methods: A two-arm cluster randomised controlled trial recruiting adults aged 55 years and older living in 18 assisted-living (sheltered housing) facilities (clusters) in the UK. Standard care (physiotherapy advice and leaflet) was compared to a tailored 12-week strength and balance Exergame programme, supported by physiotherapists or trained assistants. Complete-case analysis (intention to treat) was used to compare Berg Balance Scale (BBS) at baseline and at 12 weeks. Secondary outcomes included: fear of falling, mobility, falls risk, pain, mood, fatigue, cognition, healthcare utilisation and health-related quality of life; self-reported physical activity and falls. Results: Eighteen clusters were randomised (9 to each arm) with 56 participants allocated to the intervention and 50 to the control (78% female, mean age 78 years). Fourteen participants withdrew over the 12 weeks (both arms), mainly for ill health. There was an adjusted mean improvement in balance (BBS) of 6.2 (95% CI 2.4 to 10.0), reduced fear of falling (p=0.007) and pain (p=0.02) in Exergame group. Mean attendance at sessions was 69% (mean exercising time of 33 minutes/week). 24% of control group and 20% of Exergame group fell over trial period. The change in falls rates significantly favoured the intervention (incident rate ratio 0.31 (95% CI 0.16 to 0.62, p=0.001)). The point estimate of the incremental cost effectiveness ratio (ICER) was £15,209.80 per QALY. Using 10,000 bootstrap replications, at the lower bound of the NICE threshold of £20,000 per QALY, there was a 61% probability of Exergames being cost-effective, rising to 73% at the upper bound of £30,000 per QALY. Conclusions: Exergames, as delivered in this trial, improve balance, pain and fear of falling and are a cost-effective fall prevention strategy in assisted living facilities for people aged 55 years or older

Introducing an Edge-Native Deep Learning Platform for Exergames

Part 3: Deep Learning/LSTMInternational audienceThe recent advancements in the areas of computer vision and deep learning with the development of convolutional neural networks and the profusion of highly accurate general purpose pre-trained models, create new opportunities for the interaction of humans with systems and facilitate the development of advanced features for all types of platforms and applications. Research, consumer and industrial applications increasingly integrate deep learning frameworks into their operational flow, and as a result of the availability of high performance hardware (Computer Boards, GPUs, TPUs) also for individual consumers and home use, this functionality has been moved closer to the end-users, at the edge of the network. In this work, we exploit the aforementioned approaches and tools for the development of an edge-native platform for exergames, which includes innovative gameplay and features for the users. A prototype game was created using the platform that was deployed in the real-world scenario of a rehabilitation center. The proposed approach provides advanced user experience based on the automated, real-time pose and gesture detection, and in parallel maintains low-cost to enable wide adoption in multiple applications across domains and usage scenarios

Design and evaluation of a fall prevention multiplayer game for senior care centres

Preventing falls is extremely important today as people live long sedentary lives. Fall prevention platforms can help, by stimulating seniors to perform exercises that improve balance and muscular strength. However, existing platforms for fall prevention mostly target individual users exercising at home. This paper describes the design and evaluation of a multi-player fall prevention game platform, FallSensing Games, to be used in senior care centers. The game design was inspired by the Otago Exercise Programme and the evaluation focused on biomechanical parameters, game experience, and technology acceptance. Results showed that the game was easy to follow, that seniors performed exercises correctly, and that the game integrated well with the activities of the senior care centers. Lessons learned from this project may inspire the development of similar platforms, and, in this way, support group exercise practices at senior care centers

The Feasibility, Acceptability and Outcomes of Exergaming among Individuals with Cancer: a Systematic Review

Abstract Background Individuals with cancer have reduced quality of life, functionality, range of motion, strength, and an increase in pain and fatigue. Exergaming appears to be an effective rehabilitation tool for Parkinson’s disease, multiple sclerosis and post-stroke patients to improve functionality, balance and quality of life; however, the usefulness of exergaming in individuals with cancer is unknown. The aim of this systematic review is to describe exergaming interventions delivered to adults with a current or previous cancer diagnosis and to report the feasibility, acceptability and outcomes of such interventions. Methods Studies reporting on exergaming interventions delivered to individuals with a current or previous cancer diagnosis were included. 12 electronic databases were searched. Eight articles (seven interventions) were identified. Data were extracted and assessed for quality by two reviewers. Results Three interventions were delivered at hospital, two at home, one at a clinical laboratory, and one did not report. Two interventions were delivered by a physiotherapist, two by an occupational therapist, and one by a nurse, research staff and an exercise physiologist. The Nintendo Wii was used in four of seven studies, whilst the remaining three used the IREX system, BrightArm Duo Rehabilitation System or a custom made exergame. Studies showed that most participants enjoyed the exergaming intervention, and would recommend their use, with some preferring exergaming over standard care interventions. Adherence rates and enjoyment appear greater during exergaming than standard care. Exergaming interventions appear to support improvements balance, function, physical activity levels, strength, fatigue, emotions, cognition and pain. Conclusion Exergaming interventions delivered to individuals with cancer show great heterogeneity; differing in duration, frequency and gaming platform. The disease stage and severity of those included, and the outcome measures assessed also vary widely making it difficult to conclude its effectiveness at this time. However, adherence rates and enjoyment appear greater during exergaming compared to standard care, supporting the feasibility and acceptability of this type of intervention delivery for adults with cancer

The Feasibility, Acceptability and Outcomes of Exergaming among Individuals with Cancer: a Systematic Review

Asteroid mining has the potential to greatly reduce the cost of in-space manufacturing, production of propellant for space transportation and consumables for crewed spacecraft, compared to launching the required resources from the Earth’s deep gravity well. This paper discusses the top-level mission architecture and trajectory design for these resource-return missions, comparing high-thrust trajectories with continuous low-thrust solar-sail trajectories. The paper focuses on maximizing the economic Net Present Value, which takes the time-cost of finance into account and therefore balances the returned resource mass and mission duration. Different propulsion methods will then be compared in terms of maximum economic return and sets of attainable target asteroids. The paper provides one more step towards making commercial asteroid mining an economically viable reality by integrating trajectory design, propulsion technology and economic modelling