The effects of a short-term exergame balance training on postural control and balance recovery reactions of older adults

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 previous studies 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.

To establish if a short period of exergame balance training will affect
postural control and/or balance recovery reactions in older adults.

Before-after design to study within-subject effects in postural control and
balance recovery reactions in response to a short-term exergame training.

The intervention group receives a short-term exergame training (virtual ice
skating). The control group will play a conventional *fun* game (Angry Birds)
on the iPad. Both groups will perform three pre- and post-tests, which consist
of a balance perturbation test, a target-directed weight-shifting test and a
one leg balancing test.

The burden of playing the exergame and performing the pre- and post-tests is
moderate and not higher than regular activities in daily life. Playing the
exergame by older adults is approved in a previous study (METC nr. 2014/204)
and found to be safe during a six-week exergame intervention in the home
environment of older adults. All three pre- and post-tests are performed and
approved in previous studies (METC nr. 2013/271). Participants will rest
between tests and can take extra rest whenever requested. Time between trials
of the pre- and post-tests will be enough to let the participants recover and
prepare for upcoming trials. Participants are wearing a harness during all
trials of the balance perturbation test and an assistant remains at the side of
the subjects at all times to prevent falling. During the experiments a
certified CAREN operator and two persons to lead the test will be present at
all times.Therefore the risk associated with participation can be considered
negligible and the burden can be considered minimal.