title: Video and computer-based interactive exercises are safe and improve task-specific balance in geriatric and neurological rehabilitation: a randomised trial.
abstract: OBJECTIVE
  Does adding video/computer-based interactive exercises to inpatient geriatric and neurological rehabilitation improve mobility outcomes? Is it feasible and safe?
  
  
  METHODS
  Randomised trial.
  
  
  METHODS
  Fifty-eight rehabilitation inpatients.
  
  
  METHODS
  Physiotherapist-prescribed, tailored, video/computer-based interactive exercises for 1 hour on weekdays, mainly involving stepping and weight-shifting exercises.
  
  
  METHODS
  The primary outcome was the Short Physical Performance Battery (0 to 3) at 2 weeks. Secondary outcomes were: Maximal Balance Range (mm); Step Test (step count); Rivermead Mobility Index (0 to 15); activity levels; Activity Measure for Post Acute Care Basic Mobility (18 to 72) and Daily Activity (15 to 60); Falls Efficacy Scale (10 to 40), ED5D utility score (0 to 1); Reintegration to Normal Living Index (0 to 100); System Usability Scale (0 to 100) and Physical Activity Enjoyment Scale (0 to 126). Safety was determined from adverse events during intervention.
  
  
  RESULTS
  At 2 weeks the between-group difference in the primary outcome (0.1, 95% CI -0.2 to 0.3) was not statistically significant. The intervention group performed significantly better than usual care for Maximal Balance Range (38mm difference after baseline adjustment, 95% CI 6 to 69). Other secondary outcomes were not statistically significant. Fifty-eight (55%) of the eligible patients agreed to participate, 25/29 (86%) completed the intervention and 10 (39%) attended > 70% of sessions, with a mean of 5.6 sessions (SD 3.3) attended and overall average duration of 4.5hours (SD 3.1). Average scores were 62 (SD 21) for the System Usability Scale and 62 (SD 8) for the Physical Activity Enjoyment Scale. There were no adverse events.
  
  
  CONCLUSIONS
  The addition of video/computer-based interactive exercises to usual rehabilitation is a safe and feasible way to increase exercise dose, but is not suitable for all. Adding the exercises to usual rehabilitation resulted in task-specific improvements in balance but not overall mobility.
  
  
  BACKGROUND
  ACTRN12613000610730.
authors.affiliation: Department of Rehabilitation, Aged and Extended Care, Flinders University.
authors.forename: Maayken
authors.initials: M
authors.lastname: van den Berg
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Department of Rehabilitation, Aged and Extended Care, Flinders University.
authors.forename: Maggie
authors.initials: M
authors.lastname: Killington
authors.affiliation: Faculty of Arts and Business, University of the Sunshine Coast, Sippy Downs.
authors.forename: Stuart
authors.initials: S
authors.lastname: Smith
authors.affiliation: Faculty of Design, Architecture and Building, University of Technology, Sydney, Australia.
authors.forename: Bert
authors.initials: B
authors.lastname: Bongers
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney.
authors.forename: Leanne
authors.initials: L
authors.lastname: Hassett
authors.affiliation: Department of Rehabilitation, Aged and Extended Care, Flinders University.
authors.forename: Maria
authors.initials: M
authors.lastname: Crotty
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D000066530:Neurological Rehabilitation / Q000379:methods*; D004856:Postural Balance / Q000502:physiology; D012047:Rehabilitation Centers; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D018910:Video Games
keywords: Exercise; Feasibility studies; Randomised controlled trial; Rehabilitation; Technology