A Randomized Controlled Pilot Study of Home-Based Step Training in Older People Using Videogame Technology
Identifieur interne : 000190 ( Pmc/Curation ); précédent : 000189; suivant : 000191A Randomized Controlled Pilot Study of Home-Based Step Training in Older People Using Videogame Technology
Auteurs : Daniel Schoene [Australie] ; Stephen R. Lord [Australie] ; Kim Delbaere [Australie] ; Connie Severino [Australie] ; Thomas A. Davies [Australie] ; Stuart T. Smith [Australie]Source :
- PLoS ONE [ 1932-6203 ] ; 2013.
Abstract
Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people.
To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people.
Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention).
Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia.
Intervention group (IG) participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2–3 sessions per week for 15–20 minutes each) for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT) task once each week.
CSRT, the Physiological Profile Assessment (PPA), neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up.
Thirty-two participants completed the study (86.5%). IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F31,1 = 18.203, p<.001), PPA composite scores (F31,1 = 12.706, p = 0.001), as well as the postural sway (F31,1 = 4.226, p = 0.049) and contrast sensitivity (F31,1 = 4.415, p = 0.044) PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F31,1 = 4.226, p = 0.049).
Step pad training can be safely undertaken at home to improve physical and cognitive parameters of fall risk in older people without major cognitive and physical impairments.
Australian New Zealand Clinical Trials Registry
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DOI: 10.1371/journal.pone.0057734
PubMed: 23472104
PubMed Central: 3589451
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Smith</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23472104</idno><idno type="pmc">3589451</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589451</idno><idno type="RBID">PMC:3589451</idno><idno type="doi">10.1371/journal.pone.0057734</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000302</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000302</idno><idno type="wicri:Area/Pmc/Curation">000190</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000190</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Randomized Controlled Pilot Study of Home-Based Step Training in Older People Using Videogame Technology</title><author><name sortKey="Schoene, Daniel" sort="Schoene, Daniel" uniqKey="Schoene D" first="Daniel" last="Schoene">Daniel Schoene</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Lord, Stephen R" sort="Lord, Stephen R" uniqKey="Lord S" first="Stephen R." last="Lord">Stephen R. Lord</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Delbaere, Kim" sort="Delbaere, Kim" uniqKey="Delbaere K" first="Kim" last="Delbaere">Kim Delbaere</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Severino, Connie" sort="Severino, Connie" uniqKey="Severino C" first="Connie" last="Severino">Connie Severino</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Davies, Thomas A" sort="Davies, Thomas A" uniqKey="Davies T" first="Thomas A." last="Davies">Thomas A. Davies</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Smith, Stuart T" sort="Smith, Stuart T" uniqKey="Smith S" first="Stuart T." last="Smith">Stuart T. Smith</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people.</p></sec><sec><title>Purpose</title><p>To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people.</p></sec><sec><title>Design</title><p>Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention).</p></sec><sec><title>Setting/Participants</title><p>Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia.</p></sec><sec><title>Intervention</title><p>Intervention group (IG) participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2–3 sessions per week for 15–20 minutes each) for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT) task once each week.</p></sec><sec><title>Main Outcome Measures</title><p>CSRT, the Physiological Profile Assessment (PPA), neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up.</p></sec><sec><title>Results</title><p>Thirty-two participants completed the study (86.5%). IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F<sub>31,1</sub> = 18.203, p<.001), PPA composite scores (F<sub>31,1</sub> = 12.706, p = 0.001), as well as the postural sway (F<sub>31,1</sub> = 4.226, p = 0.049) and contrast sensitivity (F<sub>31,1</sub> = 4.415, p = 0.044) PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F<sub>31,1</sub> = 4.226, p = 0.049).</p></sec><sec><title>Conclusions</title><p>Step pad training can be safely undertaken at home to improve physical and cognitive parameters of fall risk in older people without major cognitive and physical impairments.</p></sec><sec><title>Trial Registration</title><p>Australian New Zealand Clinical Trials Registry <ext-link ext-link-type="uri" xlink:href="https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347574">ACTRN12611001081909</ext-link>.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Masud, T" uniqKey="Masud T">T Masud</name></author><author><name sortKey="Morris, Ro" uniqKey="Morris R">RO Morris</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anstey, Kj" uniqKey="Anstey K">KJ 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23472104</article-id><article-id pub-id-type="pmc">3589451</article-id><article-id pub-id-type="publisher-id">PONE-D-12-31063</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0057734</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biology</subject><subj-group><subject>Neuroscience</subject><subj-group><subject>Cognitive Neuroscience</subject><subj-group><subject>Positioning Reactions</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Computer Science</subject><subj-group><subject>Computer Applications</subject></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Engineering</subject><subj-group><subject>Bioengineering</subject><subj-group><subject>Medical Devices</subject></subj-group></subj-group><subj-group><subject>Human Factors Engineering</subject><subj-group><subject>Man Computer Interface</subject><subj-group><subject>Graphical User Interface</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Clinical Research Design</subject><subj-group><subject>Clinical Trials</subject></subj-group></subj-group><subj-group><subject>Geriatrics</subject><subj-group><subject>Rehabilitation</subject></subj-group></subj-group><subj-group><subject>Neurology</subject><subj-group><subject>Cognitive Neurology</subject></subj-group></subj-group><subj-group><subject>Non-Clinical Medicine</subject><subj-group><subject>Health Care Policy</subject><subj-group><subject>Elderly Care</subject></subj-group></subj-group></subj-group><subj-group><subject>Physiotherapy and Rehabilitation</subject></subj-group><subj-group><subject>Public Health</subject><subj-group><subject>Behavioral and Social Aspects of Health</subject><subject>Preventive Medicine</subject></subj-group></subj-group><subj-group><subject>Sports and Exercise Medicine</subject></subj-group></subj-group></article-categories><title-group><article-title>A Randomized Controlled Pilot Study of Home-Based Step Training in Older People Using Videogame Technology</article-title><alt-title alt-title-type="running-head">Home-Based Videogame Step Training</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Schoene</surname><given-names>Daniel</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lord</surname><given-names>Stephen R.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Delbaere</surname><given-names>Kim</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Severino</surname><given-names>Connie</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Davies</surname><given-names>Thomas A.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Stuart T.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia</addr-line></aff><aff id="aff2"><label>2</label><addr-line>School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Berthold</surname><given-names>Heiner K.</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Charité University Medicine Berlin, Germany</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>s.smith@neura.edu.au</email></corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>SRL declares that the FallScreen fall risk assessment tool is commercially available through Neuroscience Research Australia (NeuRA); any profits from sales of the assessments are shared between the inventor (SRL), the falls and balance research group at NeuRA, and the NeuRA central fund. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.</p></fn><fn fn-type="con"><p>Conceived and designed the experiments: DS STS SRL KD. Performed the experiments: DS CS TD. Analyzed the data: DS KD SRL STS. Wrote the paper: DS STS KD SRL.</p></fn></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>5</day><month>3</month><year>2013</year></pub-date><volume>8</volume><issue>3</issue><elocation-id>e57734</elocation-id><history><date date-type="received"><day>27</day><month>9</month><year>2012</year></date><date date-type="accepted"><day>24</day><month>1</month><year>2013</year></date></history><permissions><copyright-year>2013</copyright-year><copyright-holder>Schoene et al</copyright-holder><license><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><sec><title>Background</title><p>Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people.</p></sec><sec><title>Purpose</title><p>To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people.</p></sec><sec><title>Design</title><p>Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention).</p></sec><sec><title>Setting/Participants</title><p>Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia.</p></sec><sec><title>Intervention</title><p>Intervention group (IG) participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2–3 sessions per week for 15–20 minutes each) for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT) task once each week.</p></sec><sec><title>Main Outcome Measures</title><p>CSRT, the Physiological Profile Assessment (PPA), neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up.</p></sec><sec><title>Results</title><p>Thirty-two participants completed the study (86.5%). IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F<sub>31,1</sub> = 18.203, p<.001), PPA composite scores (F<sub>31,1</sub> = 12.706, p = 0.001), as well as the postural sway (F<sub>31,1</sub> = 4.226, p = 0.049) and contrast sensitivity (F<sub>31,1</sub> = 4.415, p = 0.044) PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F<sub>31,1</sub> = 4.226, p = 0.049).</p></sec><sec><title>Conclusions</title><p>Step pad training can be safely undertaken at home to improve physical and cognitive parameters of fall risk in older people without major cognitive and physical impairments.</p></sec><sec><title>Trial Registration</title><p>Australian New Zealand Clinical Trials Registry <ext-link ext-link-type="uri" xlink:href="https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347574">ACTRN12611001081909</ext-link>.</p></sec></abstract><funding-group><funding-statement>This study was financially supported by a National Health and Medical Research Council (NHMRC) project grant (grant number 568724) (<ext-link ext-link-type="uri" xlink:href="http://www.nhmrc.gov.au">http://www.nhmrc.gov.au</ext-link>). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><page-count count="8"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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