|مجال التميز||تميز دراسي و بحثي|
|عنوان البحث:||Effects of Interactive Videogames on Postural Control and Risk of Fall Outcomes in Frail and Pre-frail Older Adults: A Systematic Review and Meta-Analysis|
|رابط إلى البحث:||https://www.liebertpub.com/doi/10.1089/g4h.2020.0009|
|موجز عن البحث:||
Background: Interactive videogames (IVGs) have been used to reduce risk of falls in the older adult and improve postural control (PC) outcomes.
Objective: To systematically review trials that examine whether IVGs training is effective in improving PC and managing falls in frail and pre-frail older adults.
Data Sources: Four databases were searched, Scopus, Web of science, PubMed, and MEDLINE, from January 2007 to March 2019.
Eligibility Criteria: Frail and pre-frail older adults aged 65+. Interventions were any Nintendo® Wii™ training. The outcome measures were PC and risk of falls as measured by any validated outcome measure.
Studies Appraisal Method: The PEDro (Physiotherapy Evidence Database) scale and Cochrane risk-of-bias tool were used by two independent authors.
Results: Eleven papers were included, involving 388 participants, with a mean age of 79 ± 5.7 years. The mean duration of IVGs sessions was 8.8 ± 3.8 weeks, the mean total number of sessions was 20 ± 11.1 session, and the mean length of training was 44 ± 15.7 minutes.
Meta-Analysis: IVGs achieved better results compared with traditional exercises and control on the Berg Balance Scale (mean difference [MD] 2.80; 95% confidence interval [CI] 1.21 to 4.39; P < 0.001; I2 = 16%), as well as in the short term on Timed Up and Go (MD −1.23; 95% CI −2.37 to −0.09; P = 0.03; I2 = 0%).
Limitation: Definitive judgement could not be made due to the variability in training, training duration and outcomes measurement.
Conclusion: IVGs is a promising modality that has a positive effect on PC but not on the outcome of falls, so it should be prescribed with caution among frail older adults.
Systematic Review Registration: PROSPERO registration number: CRD42019129611.
|عنوان المؤتمر:||PHYSIOTHERAPY UK 2019|
|مكان الإنعقاد:||Birmingham, United Kingdom|
|طبيعة المشاركة:||Poster presentation|
|عنوان المشاركة:||The effect of exergames on balance and falls in frail older adult: a systematic review|
Keywords: exergames, frail elderly, postural balance
Purpose: To systematically review trials that examine whether exergames training is effective in improving balance and falls in frail elderly population.
Methods: Three databases were searched: Scopus, Web of science, PubMed, and MEDLINE. The searches were limited to the period from 2007 to 2019. Frail adults, aged 65 and older, with no specific disorders. Interventions were exergames intervention with the aim of improving balance and falls and were compared to no intervention, traditional exercises, or standard care. The focus was on studies that used Nintendo Wii as a training device because of the wide variety of exergames it provides compare to other devices and it is the common device being used in the last decade in elderly rehabilitation. The outcome measures were balance and falls as measured by any validated outcome measure. The Physiotherapy Evidence Database (PEDro) quality assessment tool and The Cochrane Collaboration tool for assessing risk of bias (CCTARB) were used by two independent authors (HA and MA) to appraise the included studies.
Results: The database search resulted in 1540 articles, of which eleven papers were included. Exergame was compared to no intervention, standard care and traditional exercise. The total number of participants in all the five included studies was 388, with a mean age of 79±5.7 years. 255 were included in the Wii group, while 181 were placed in the control group. A total of 15 games were used in all Wii studies, with number of games per study ranging from 3 to 6 with a mean of 3.7 (SD 1.5). The duration of exergames sessions ranged from3 to 15 weeks with mean of 8.8 (SD 3.8) weeks. The total number of treatments ranged from 6 to 45 with mean of 20 (SD 11.1) session. The length of treatment ranged from 15 to 60 minutes with mean of 44 (SD 15.7) minutes. Four studies were rated as high-quality studies, three were rated as poor quality and the remaining four had fair quality. the effects of exergames on balance and falls could not be pooled for a meta-analysis, due to methodological variability and the different control intervention used across studies.
Conclusion(s): Exergames was found to have positive effect on falls and postural balance among frail elderly. However, definitive judgment could not be obtained due to variation in training, outcomes and methodology. Future studies should focus on designing a standard protocol and include multicomponent exercise rather than just balance exercises.
Implications: Using exergames in elderly rehabilitation is promising and could serve as an alternative for traditional exercise. To achieve optimal outcomes Future studies should focus on designing a standard protocol for exergames and include multicomponent exercise rather than balance exercises only.
Funding acknowledgements: The author(s) received no financial support for the research, authorship, and/or publication of this article.