The purpose of the present study was to assess the potential of exergame training based on physically simulated sport play as a mode of physical activity that could have cognitive benefits for older adults. If exergame play has the cognitive benefits of conventional physical activity and also has the intrinsic attractiveness of video games, then it might be a very effective way to induce desirable lifestyle changes in older adults. To examine this issue, the authors developed an active video game training program using a pretest-training-posttest design comparing an experimental group (24 ϫ 1 hr of training) with a control group without treatment. Participants completed a battery of neuropsychological tests, assessing executive control, visuospatial functions, and processing speed, to measure the cognitive impact of the program. They were also given a battery of functional fitness tests to measure the physical impact of the program. The trainees improved significantly in measures of game performance. They also improved significantly more than the control participants in measures of physical function and cognitive measures of executive control and processing speed, but not on visuospatial measures. It was encouraging to observe that, engagement in physically simulated sport games yielded benefits to cognitive and physical skills that are directly involved in functional abilities older adults need in everyday living (e.g., Hultsch, Hertzog, Small, & Dixon, 1999).
The purposes of this present research were, in the first study, to determine whether age impacts a measure of postural control (the braking force in walking) and, in a second study, to determine whether exergame training in physically-simulated sport activity would show transfer, increasing the braking force in walking and also improving balance assessed by clinical measures, functional fitness, and health-related quality of life in older adults. For the second study, the authors developed an active video game training program (using the Wii system) with a pretest-training-posttest design comparing an experimental group (24 1-hr sessions of training) with a control group. Participants completed a battery comprising balance (braking force in short and normal step conditions), functional fitness (Senior Fitness Test), and health-related quality of life (SF-36). Results show that 12 weeks of video game-based exercise program training improved the braking force in the normal step condition, along with the functional fitness of lower limb strength, cardiovascular endurance, and motor agility, as measured by the Senior Fitness Test. Only the global mental dimension of the SF-36 was sensitive to exergame practice. Exergames appear to be an effective way to train postural control in older adults. Because of the multimodal nature of the activity, exergames provide an effective tool for remediation of age-related problems.
Planning held before emergency management of a critical situation might be an invaluable asset for optimising team preparation. The purpose of this study was to investigate whether a brief planning discussion improved team performance in a simulated critical care situation. Forty-four pairs of trainees in anaesthesia and intensive care were randomly allocated to either an intervention or control group before participating in a standardised simulated scenario. Twelve different scenarios were utilised. Groups were stratified by postgraduate year and simulated scenario, and a facilitator was embedded in the scenario. In the intervention group, the pairs had an oral briefing followed by a 4-min planning discussion before starting the simulation. The primary end-point was clinical performance, as rated by two independent blinded assessors on a score of 0-100 using video records and pre-established scenario-specific checklists. Crisis resource management and stress response (cognitive appraisal ratio) were also assessed. Two pairs were excluded for technical reasons. Clinical performance scores were higher in the intervention group; mean (SD) 51 (9) points vs. 46 (9) in the control group, p = 0.039. The planning discussion was also associated with higher crisis resource management scores and lower cognitive appraisal ratios, reflecting a positive response. A 4-min planning discussion before a simulated critical care situation improved clinical team performance and cognitive appraisal ratios. Team planning should be integrated into medical education and clinical practice.
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