title: A systematic review and meta-analysis of outcome measures to assess postural control in older adults who undertake exergaming.
abstract: Exergaming has been shown to be an effective tool to improve postural control (PC) in older community-dwelling individuals. The outcome measures (OMs) used to assess PC are varied and this could limit the estimation of the effectiveness of the intervention. This systematic review and meta-analysis aims to explore the OMs currently used to assess PC in exergaming interventions, for healthy elderly individuals aged over 60 years. The literature search was conducted across five databases (CINAHL, EMBASE, PubMed, ISI, SPORTdiscus and Science Direct) using a range of search terms and combinations relating to exergaming, balance, exercise, falls and elderly. Quality assessment was conducted using the PEDro Scale and a custom-made quality assessment tool. Eleven trials were included in the meta-analysis, with a mean (SD) PEDro score of 5.36 (1.57). Primary and secondary OMs showed small effects in favour of alternative training modes, although these effects were statistically insignificant for all primary OMs. Tertiary OMs could not be included in the meta-analysis due to varying output parameters from different instruments. Heterogeneity remained high across trials and no studies performed long-term follow-up. Exergaming is a potential alternative to PC training, although still in its infancy. Strong and well-designed RCTs are needed, targeting specific populations aged over 60 years. Variability in instrumented OMs prevents generalisation of results. Technological improvements may provide data not currently available from clinical and laboratory-based methods, and may allow PC to be assessed more realistically and specifically in relation to a population's activities of daily living, though this remains a new area of research.
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Science, University of Northumbria, Newcastle Upon Tyne, UK. Electronic address: robin.a.tahmosybayat@northumbria.ac.uk.
authors.forename: Robin
authors.initials: R
authors.lastname: Tahmosybayat
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Science, University of Northumbria, Newcastle Upon Tyne, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Baker
authors.affiliation: Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Godfrey
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Science, University of Northumbria, Newcastle Upon Tyne, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Caplan
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Science, University of Northumbria, Newcastle Upon Tyne, UK; Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Barry
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D006299:Health Services for the Aged; D006801:Humans; D053580:Muscle Strength / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology*; D055070:Resistance Training / Q000379:methods*; D018910:Video Games
keywords: Balance; Community-dwelling; Elderly; Exergaming; Falls; Meta-analysis; Outcome measures; Postural control