A randomized controlled pilot study of home-based step training in older people using videogame technology.
A randomized controlled pilot study of home-based step training in older people using videogame technology.
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DOI：
10.1371/journal.pone.0057734
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Smith ST
中科院分区：
文献类型：
--
作者：
Schoene D;Lord SR;Delbaere K;Severino C;Davies TA;Smith ST
行走障碍与老年人身体和认知能力下降以及跌倒风险增加有关。运动干预可以降低跌倒风险，但坚持度往往很低。一种新的包括台阶训练的运动游戏可能为老年人预防跌倒提供一种愉快的运动选择。评估无监督的、基于家庭的踏垫训练的可行性和安全性，并确定这种干预对老年人踏步表现和相关跌倒风险的有效性。单盲双臂随机对照试验，比较踏垫训练与对照组（无干预）。居住在澳大利亚悉尼退休村独立生活单元的37名老年人。干预组（IG）的参与者被提供了一个与电视相连的电脑化的踏步板系统，他们可以随心所欲地玩踏步游戏（建议每周2-3次，每次15-20分钟），持续8周。此外，IG参与者被要求每周完成一次选择步进反应时间（CSRT）任务。在基线和8周随访时对CSRT、生理特征评估（PPA）、神经心理和功能活动能力进行评估。32名参与者完成了研究（86.5%）。IG参与者平均每周玩2.75次游戏，无不良事件报告。与对照组相比，IG组显著提高了CSRT （F31,1 = 18.203, p< 0.001）、PPA综合评分（F31,1 = 12.706, p = 0.001）、体位摇摆（F31,1 = 4.226, p = 0.049）和对比敏感度（F31,1 = 4.415, p = 0.044） PPA子成分评分。此外，通过计时up和go测试/语言流畅性任务评估，IG的双任务能力显著提高（F31,1 = 4.226, p = 0.049）。踏垫训练可以在家中安全地进行，以改善无重大认知和身体障碍的老年人跌倒风险的身体和认知参数。澳大利亚新西兰临床试验注册中心ACTRN12611001081909。
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 ACTRN12611001081909.