Application of Interactive Video Games as Rehabilitation Tools to Improve Postural Control and Risk of Falls in Prefrail Older Adults

Alhasan, Hammad; Wheeler, Patrick C.; Fong, Daniel Tik-Pui

doi:10.34133/2021/9841342

Cited by 8 publications

(13 citation statements)

References 77 publications

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“…Most previous studies asked participants to maintain a quiet stance in a steady state. Alhasan et al [19,25] indicated that most falls among older adults were due to poor movement control when faced with perturbation. This system challenged the subjects to reach their stability limit as far as possible.…”

Section: Discussionmentioning

confidence: 99%

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Interactive Game-Based Platform System for Assessing and Improving Posture Control in the Elderly

Sun,

Kao,

Kao

et al. 2023

Bioengineering

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Inadequate response to balance perturbations lead to posture instability in the elderly. The fall risks are increased by a reduced capacity to control the center of pressure (COP) displacement within the safety limit of the supporting base. This study developed an interactive evaluation and training platform. The system incorporated a computerized program with instantaneous force plate evaluation. Ten young subjects underwent a baseline evaluation and twenty-nine community-dwelling elderly received pre- and post-intervention testing. The ability to reach the stability limit was assessed by measuring the maximum voluntary excursion of the COP in anterior–posterior and medial–lateral directions. Functional mobility tests including Berg Balance Scale, Timed-Up-and-Go and functional reach were used as functional outcomes. The experimental group (n = 15) received a 40 min intervention three times a week for six weeks. The interactive game-based training focused on multi-directional weight shifting by tracing a COPcontrolled target to challenge an individual’s stability limit. The control group (n = 14) maintained daily activities as usual. The young group revealed a superior COP displacement through active ankle control than the elderly, especially in the anterior–posterior direction. The experimental group improved their COP displacement control more in the medial–lateral direction due to the predominant side-to-side gameplay movement. The functional outcome measures were also significantly improved after training. Using the COPcontrolled game-based program, the stability limit was challenged to facilitate dynamic posture control by an incremental increase in self-initiated perturbations. The platform system could assist in transferring the immediate training effects into daily functional mobility in the elderly.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies recommended the use of computer assistive technology or the introduction of a game element to improve the subjects' motivation for exercise participation. Some researchers indicated that the interactive gameplay would lead to more improvements in the dynamic balance control compared with a generic program [18,19].…”

Section: Introductionmentioning

confidence: 99%

Interactive Game-Based Platform System for Assessing and Improving Posture Control in the Elderly

Sun,

Kao,

Kao

et al. 2023

Bioengineering

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“…Thinking about rehabilitation approaches, robot-assisted devices such as the Tymo system (Tyromotion, Austria) have advantages over traditional physiotherapy (e.g., stretching and muscle strengthening) for impacting gait. These devices enable the task-oriented design of exercises and adjustment of the intensity of exercises [ 49 , 146 – 148 ].…”

Section: Progress Of Electrophysiological Couplings In Physiology And...mentioning

confidence: 99%

Cross-Frequency Coupling and Intelligent Neuromodulation

et al. 2023

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Cross-frequency coupling (CFC) reflects (nonlinear) interactions between signals of different frequencies. Evidence from both patient and healthy participant studies suggests that CFC plays an essential role in neuronal computation, interregional interaction, and disease pathophysiology. The present review discusses methodological advances and challenges in the computation of CFC with particular emphasis on potential solutions to spurious coupling, inferring intrinsic rhythms in a targeted frequency band, and causal interferences. We specifically focus on the literature exploring CFC in the context of cognition/memory tasks, sleep, and neurological disorders, such as Alzheimer's disease, epilepsy, and Parkinson's disease. Furthermore, we highlight the implication of CFC in the context and for the optimization of invasive and noninvasive neuromodulation and rehabilitation. Mainly, CFC could support advancing the understanding of the neurophysiology of cognition and motor control, serve as a biomarker for disease symptoms, and leverage the optimization of therapeutic interventions, e.g., closed-loop brain stimulation. Despite the evident advantages of CFC as an investigative and translational tool in neuroscience, further methodological improvements are required to facilitate practical and correct use in cyborg and bionic systems in the field.

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“…However, whether these findings are useful in neurofeedback training or predicting gait require further validation. Also, whether these findings prevail in the combined use of cues, such as interactive video games is unknown (Alhasan et al, 2022).…”

Section: Limitations To This Studymentioning

confidence: 99%

Frequency Nesting Interactions in the Subthalamic Nucleus Correlate With the Step Phases for Parkinson’s Disease

et al. 2022

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Gait disturbance in Parkinson’s disease (PD) can be ameliorated by sound stimulation. Given that excessive β synchronization in basal ganglia is linked to motor impairment in PD, whether the frequency nesting interactions are associated with the gait problem is far from clear. To this end, the masking phase-amplitude coupling (PAC) method was proposed to overcome the trade-off between intrinsic nonlinearity/non-stationarity and demand for predetermined frequencies, normally extracted by the filter. In this study, we analyzed LFPs recorded from 13 patients (one female) with PD during stepping with bilateral deep brain electrodes implanted in the subthalamic nucleus (STN). We found that not only high-frequency oscillation (100–300 Hz) was modulated by β (13–30 Hz) but also β and γ amplitude were modulated by their low-frequency components in δ/θ/α and δ/θ/α/β bands. These PAC values were suppressed by sound stimulation, along with an improvement in gait. We also showed that gait-related high-β (Hβ) modulation in the STN was sensitive to auditory cues, and Hβ gait-phase modulation increased with a metronome. Meanwhile, phase-locking values (PLVs) across all frequencies were significantly suppressed around contralateral heel strikes, manifesting the contralateral step as a critical gait phase in gait initiation for PD. Only the PLVs around contralateral steps were sensitive to auditory cues. Our results support masking PAC as an effective method in exploring frequency nesting interactions in LFPs and reveal the linkages between sound stimulation and couplings related to gait phases in the STN. These findings raise the possibility that nesting interactions in the STN work as feasible biomarkers in alleviating gait disorders.

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Application of Interactive Video Games as Rehabilitation Tools to Improve Postural Control and Risk of Falls in Prefrail Older Adults

Cited by 8 publications

References 77 publications

Interactive Game-Based Platform System for Assessing and Improving Posture Control in the Elderly

Interactive Game-Based Platform System for Assessing and Improving Posture Control in the Elderly

Cross-Frequency Coupling and Intelligent Neuromodulation

Frequency Nesting Interactions in the Subthalamic Nucleus Correlate With the Step Phases for Parkinson’s Disease

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