title: Interactive balance training integrating sensor-based visual feedback of movement performance: a pilot study in older adults.
abstract: BACKGROUND
  Wearable sensor technology can accurately measure body motion and provide incentive feedback during exercising. The aim of this pilot study was to evaluate the effectiveness and user experience of a balance training program in older adults integrating data from wearable sensors into a human-computer interface designed for interactive training.
  
  
  METHODS
  Senior living community residents (mean age 84.6) with confirmed fall risk were randomized to an intervention (IG, n = 17) or control group (CG, n = 16). The IG underwent 4 weeks (twice a week) of balance training including weight shifting and virtual obstacle crossing tasks with visual/auditory real-time joint movement feedback using wearable sensors. The CG received no intervention. Outcome measures included changes in center of mass (CoM) sway, ankle and hip joint sway measured during eyes open (EO) and eyes closed (EC) balance test at baseline and post-intervention. Ankle-hip postural coordination was quantified by a reciprocal compensatory index (RCI). Physical performance was quantified by the Alternate-Step-Test (AST), Timed-up-and-go (TUG), and gait assessment. User experience was measured by a standardized questionnaire.
  
  
  RESULTS
  After the intervention sway of CoM, hip, and ankle were reduced in the IG compared to the CG during both EO and EC condition (p = .007-.042). Improvement was obtained for AST (p = .037), TUG (p = .024), fast gait speed (p = . 010), but not normal gait speed (p = .264). Effect sizes were moderate for all outcomes. RCI did not change significantly. Users expressed a positive training experience including fun, safety, and helpfulness of sensor-feedback.
  
  
  CONCLUSIONS
  Results of this proof-of-concept study suggest that older adults at risk of falling can benefit from the balance training program. Study findings may help to inform future exercise interventions integrating wearable sensors for guided game-based training in home- and community environments. Future studies should evaluate the added value of the proposed sensor-based training paradigm compared to traditional balance training programs and commercial exergames.
  
  
  BACKGROUND
  http://www.clinicaltrials.govNCT02043834.
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. schwenk.michael@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Schwenk
authors.forename: Gurtej S
authors.initials: GS
authors.lastname: Grewal
authors.forename: Bahareh
authors.initials: B
authors.lastname: Honarvar
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schwenk
authors.forename: Jane
authors.initials: J
authors.lastname: Mohler
authors.forename: Dharma S
authors.initials: DS
authors.lastname: Khalsa
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D056228:Feedback, Sensory; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology*; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D014584:User-Computer Interface