Interactive balance training integrating sensor-based visual feedback of movement performance: a pilot study in older adults

Abstract

BackgroundWearable 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.MethodsSenior 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.ResultsAfter 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.ConclusionsResults 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.Trial registrationhttp://www.clinicaltrials.govNCT02043834.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-164) contains supplementary material, which is available to authorized users.

Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

“…The primary aim of the reviewed studies was to evaluate the potential effect of gaming/VR exercise on balance, either alone (9,12,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46), in combination with other physical abilities such as strength or mobility (11,13,(47)(48)(49)(50)(51), or in combination with falls or fear of falling, cognition, quality of life, or user experience (52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62). Seven studies investigated the effect of gaming/VR exercise on gait parameters (63)(64)(65)(66)(67)(68)(69), and six studies examined the effectiveness with regard to different physical functions and associated fall risk (10,(70)(71)(72)…”

“…As can be seen in Table 4, the studies utilizing commercially available exergames targeted a wide variety of physical functions and activities, with balance being the main target of improvement (see Table 4 for references). For the custom-designed games three functions were mainly targeted; balance (9,33,36,38,39,46,54,59,61), walking/stepping (41,51,(62)(63)(64)68), and strength (67, 79). …”

Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

“…Note: The exercises above improve balance in patients with peripheral neuropathy. 24,41 3. In sessions 1-12, perform an ankle reaching task (Figure 1).…”

“…Note: This task is designed to enhance coordination between ankle, knee, and hip joints during weight shifting tasks. 24,41 4. In sessions 2-12, perform an obstacle crossing task with increasing degrees of difficulty.…”

Developing and Validating a New Wireless Wearable Device for Balance Measurement in Sport and Clinical Setting

“…These sensors, with wireless data transfer, have the potential to overcome the major drawbacks of cost, size and limited location of computerized testing, as well as enabling the objective measurement of postural sway and movements during task performance. Wearable sensor technology can accurately measure the postural control (22,23) and may provide a new avenue for motion feedback during balance tests (24). Also, the incorporation of wearable sensors into balance training has been repeatedly suggested in review articles (25,26).…”