title: Effects of an interactive computer game exercise regimen on balance impairment in frail community-dwelling older adults: a randomized controlled trial.
abstract: BACKGROUND
  Due to the many problems associated with reduced balance and mobility, providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills.
  
  
  OBJECTIVE
  The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging, interactive video game paradigm. The intervention focused on performing targeted dynamic tasks, which included reactive balance controls and environmental interaction.
  
  
  METHODS
  This study was a randomized controlled trial.
  
  
  METHODS
  The study was conducted in a geriatric day hospital.
  
  
  METHODS
  Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study.
  
  
  METHODS
  Participants were randomly assigned to either a control group or an experimental group. The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital. The experimental group received a program of dynamic balance exercises coupled with video game play, using a center-of-pressure position signal as the computer mouse. The tasks were performed while standing on a fixed floor surface, with progression to a compliant sponge pad. Each group received 16 sessions, scheduled 2 per week, with each session lasting 45 minutes.
  
  
  METHODS
  Data for the following measures were obtained before and after treatment: Berg Balance Scale, Timed "Up & Go" Test, Activities-specific Balance Confidence Scale, modified Clinical Test of Sensory Interaction and Balance, and spatiotemporal gait variables assessed in an instrumented carpet system test.
  
  
  RESULTS
  Findings demonstrated significant improvements in posttreatment balance performance scores for both groups, and change scores were significantly greater in the experimental group compared with the control group. No significant treatment effect was observed in either group for the Timed "Up & Go" Test or spatiotemporal gait variables.
  
  
  CONCLUSIONS
  The sample size was small, and there were group differences at baseline in some performance measures.
  
  
  CONCLUSIONS
  Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise. This coupling, in turn, resulted in a greater improvement in dynamic standing balance control compared with the typical exercise program. However, there was no transfer of effect to gait function.
authors.affiliation: Department of Physical Therapy, School of Medical Rehabilitation, University of Manitoba, R106-771 McDermot Ave, Winnipeg, Manitoba, Canada R3E 0T6. ptsturm@cc.umanitoba.ca
authors.forename: Tony
authors.initials: T
authors.lastname: Szturm
authors.forename: Aimee L
authors.initials: AL
authors.lastname: Betker
authors.forename: Zahra
authors.initials: Z
authors.lastname: Moussavi
authors.forename: Ankur
authors.initials: A
authors.lastname: Desai
authors.forename: Valerie
authors.initials: V
authors.lastname: Goodman
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D004856:Postural Balance; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018910:Video Games