title: A randomized controlled pilot study of home-based step training in older people using videogame technology.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention).
  
  
  METHODS
  Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia.
  
  
  METHODS
  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.
  
  
  METHODS
  CSRT, the Physiological Profile Assessment (PPA), neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12611001081909.
authors.affiliation: Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schoene
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Connie
authors.initials: C
authors.lastname: Severino
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Davies
authors.forename: Stuart T
authors.initials: ST
authors.lastname: Smith
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003072:Cognition Disorders / Q000150:complications; D005081:Exercise Therapy / Q000379:methods*; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D010349:Patient Compliance; D010865:Pilot Projects; D004856:Postural Balance; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D016896:Treatment Outcome; D018910:Video Games