Postural control aften an exergame training

The present study consists of a short-term exergame training preceded and followed by three balance tests. One group of 15 older adults will play the exergame and one group of 15 older adults will play a conventional ‘fun’ game (Angry Birds) on the iPad. With this study insights will be gained in within-subject improvements in postural control and balance recovery reactions after a short-term exergame training. Results of this experiment will provide further insights in the prospects and possible effects of a long-term exergame training to prevent fall risk, required before a large clinical (randomized) trial can be conducted to validate the exergame training.

Falls are one of the greatest concerns among older adults, because the incidents are high and they lead to severe consequences. The extent of the problem will continue to expand as the number of older people is expected to increase dramatically over the next few decades. An important risk factor for falls in older adults is an impaired postural control, which is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. A growing number of studies show the potential of video games incorporating training (exergames) to improve postural control. However, scarce evidence is available that these interventions actually contribute to a decrease in fall risk. In a previous study (METC nr. 2013/271) indicators for improved postural control were identified, by examining age-related differences in postural control and balance recovery reactions in response to a ‘near’ fall. By studying the effects of a short-term exergame balance training (ice-skating game) on these indicators, insight into within subject improvements on postural control and/or balance recovery reactions after playing an exergame will be gained. The results will provide further insights in the prospects and possible effects of a long-term exergame training to prevent fall risk, required before a large clinical (randomized) trial can be conducted to validate the exergame training.

Before-after design. The three balance tests are performed as pretest on the first day before the exergame training and as post-test on the second day after the exergame training.

The total exergame training consists of 45 minutes; the first day the game will be played in two blocks of 15 minutes. The second day the participants perform one block of 15 minutes exergame training, to avoid that fatigue would affect the results on the posttest. Depending on the scores, which are based on the speed and the accuracy (avoiding holes in the ice and bending to cross a bridge) of the ice-skater, the difficulty level will increase. Although the game will then become more difficult (number of holes to avoid increases; the distance to skate is longer) the same lateral weight-shifting movements are required to move the avatar on the screen.

As pre- and posttest three balance tests are performed:

- Balance perturbation test:A ‘near fall’ will be simulated by sudden, laterally directed, platform translations, during the performance of multiple reaching tasks.

- Target-directed weight-shifting test:Participants will perform several target-directed weight-shifting movements to targets in different directions, by leaning with their whole body while keeping both feet in place.

- The Narrow Ridge Balance Test: People will stand for 20 seconds with one leg on ridges of decreasing width