Virtual reality balance training for elderly: Similar skiing games elicit different challenges in balance training

Vries, A.W. de; Faber, Gert S.; Jonkers, Ilse; Dieën, Jaap H. van; Verschueren, Sabine

doi:10.1016/j.gaitpost.2017.10.006

Cited by 54 publications

(41 citation statements)

References 27 publications

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“…The remaining two were off-the-shelf games: Adventure, Kinect Adventures (Ubisoft, Rennes, France) and Kinski, Kinect sports season 2 (Microsoft Studios, Redmond, WA, US). Adventure and Kinski were included in this study because they showed to be the games that previously had most induced muscle activity and weight shifts [22,24].…”

Section: Gamesmentioning

confidence: 99%

“…Based on the recommendations for balance and strength training, obtained from the literature [2,6,18,27] and our previous work in training using exergames [22,24,25], several concepts to be addressed in exergames balance training applications were proposed. In Fig.…”

Section: Gamesmentioning

confidence: 99%

“…To quantify their challenge, weight shifts were expressed relative to the FLOS. In the FLOS test, participants receive visual feedback on their COM and are instructed to move their COM as far as possible into eight directions [22]. This test represents the individual, functional limits of stability, as opposed to theoretical limits of stability based on anthropometry.…”

Section: Weight Shiftsmentioning

confidence: 99%

“…A study that analysed the challenge of balance provided by off-the-shelf games showed that balance is challenged to a varying extent, but that ample room for improvements is left. Moreover, it was found that adaptation to or learning the game, as trials advanced, resulted in a decreasing challenge in some games [22,23]. From the analysis of muscle activity in seven off-the shelf games, it was concluded that overall muscle activation was low and that longer periods of muscle activation were scarce [24].…”

Section: Introductionmentioning

confidence: 99%

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Does a novel exergame challenge balance and activate muscles more than existing off-the-shelf exergames?

Willaert

Vries

Tavernier

et al. 2020

J NeuroEngineering Rehabil

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Background: Novel balance-targeting exergames controlled with off-the-shelf hardware, were developed based on current recommendations for balance training in healthy older adults and documented shortcomings of existing games. The aim of this study was to explore the feasibility of these novel exergames as training tool for elderly and, more specifically whether these games can elicit more challenging weight shifts and higher levels of muscle activity compared to existing off-the-shelf exergames. Furthermore, the motivational pull in these new games was studied. Methods: Sixteen healthy older adults were recruited to play the novel games and two reference games that were found to be the most challenging ones in terms of weight shifts or muscle activity in previous studies. Weight shifts were expressed relative to participants' Functional Limits of Stability (FLOS). Muscular challenge of the games was quantified by dividing the signal into 200 ms blocks and determining the average muscle activity within these blocks. The muscle activity was normalized to maximal voluntary contractions (MVC) to categorize the blocks in zones of < 40, 40-60, 60-80 and > 80% MVC. Subsequently, the number of blocks per intensity level and the number of consecutive blocks above 40% were determined. Motivation to play the games was assessed using the Intrinsic Motivation Inventory (IMI) and scores between the games were analyzed using Generalized Estimated Equations (GEE). Results: The novel exergames successfully elicited center of mass (COM) displacements with medians of around 80% of FLOS or higher for all directions. Furthermore, the COM displacements in the novel games were larger for each direction than in the reference games, although for one game the sideward left direction reached significance only at the third trial. Compared to the existing games, longer blocks of muscle activation above 40% MVC were found, but overall intensity remained low. IMI scores were high on all subscales, indicating that older adults experienced the games as motivating. Conclusion: We conclude that affordable hardware can be used to create challenging and enjoyable balance training programs using exergames. The exergames that were successful in eliciting challenging weight shifts and muscle activity should now be further studied in longitudinal randomized controlled interventions, to assess effects on balance, muscle strength and eventually fall risk in healthy older adults.

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Section: Gamesmentioning

confidence: 99%

Section: Gamesmentioning

confidence: 99%

Section: Weight Shiftsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does a novel exergame challenge balance and activate muscles more than existing off-the-shelf exergames?

Willaert

Vries

Tavernier

et al. 2020

J NeuroEngineering Rehabil

Self Cite

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“…Rehabilitation using VR appeals to elderly patients because it gives them the possibility to diversify treatment by introducing alternative forms of activity. However, there is still a demand for more randomized clinical studies that would confirm the efficacy of this form of activity, especially in patients suffering from the frailty syndrome, who are the largest group of beneficiaries of this type of rehabilitation [27,28].…”

Section: Virtual Reality In Rehabilitationmentioning

confidence: 99%

Virtual reality in medicine: a brief overview and future research directions

Mazurek¹,

Kiper²,

Cieślik³

et al. 2019

Hum Mov.

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Virtual reality (VR), also called phantomatics, is an image of artificial reality created entirely in three-dimensional graphics with the use of information technology. VR makes it possible to experience the imaginary world as if it was real, where sensory data are delivered to the brain through a specialized system. The purpose of virtual medicine is to minimize direct contact and impact on human body during treatment. Taking into consideration the increasing accessibility of high quality electronic devices, their immense computing powers, and the continuously developing Internet infrastructure, the advancement in this area is only a matter of time. Therefore, the aim of the study was to identify the applications of VR in medicine, focusing on the areas of psychiatry and rehabilitation and considering guidelines for future research.

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