Virtual reality exergames for improving physical function, cognition and depression among older nursing home residents: A systematic review and meta-analysis

Wii Fit Exercise's Effects on Muscle Strength and Fear of Falling in Older Adults With Alzheimer Disease: A Randomized Controlled Trial

PURPOSE

This study aimed to investigate how Wii Fit exercises affect muscle strength and fear of falling in older adults with Alzheimer's disease.

METHOD

The study included a total of 32 volunteers with Alzheimer's disease, aged 65-80 years. These participants were divided into two groups: the exercise group and the control group. The exercise group received a 30-min (one session) twice-weekly exercise program for 6 weeks with games selected from different categories, such as balance and aerobic exercises, with the Nintendo Wii virtual reality device. During this period, the control group did not receive any treatment, and routine medical treatments continued. At baseline and 6 weeks later, Mini-Mental State Examination, knee extension muscle strength, Timed Up and Go Test, and Tinetti Fall Efficacy Scale results were recorded in the exercise and control groups.

RESULTS

In intragroup comparison, a statistically significant difference was found in all tests (muscle strength, Timed Up and Go Test, and Tinetti Fall Efficacy Scale) in the exercise group after the exercise program (p < .05), while no significant difference was found in the control group (p > .05). According to the interaction of group and time in the intergroup comparison, there was no difference between the groups (exercise and control group) in muscle strength and Timed Up and Go Test (p > .05), but there was a difference in Tinetti Fall Efficacy Scale (p < .05).

CONCLUSIONS

This randomized controlled trial supports the claim that Wii Fit exercises can reduce the fear of falling in older adults with Alzheimer's disease.

Pei-Wo Drone: a home-based exercise guidance system with a drone for older adults

Active and healthy aging is in great demand in an aging society. Maintaining a high level of physical function is a key aspect of healthy aging. However, many older adults engage in low levels of exercise and physical activity, often due to limited motivation or access to proper guidance. Here, we demonstrate a novel home-based exercise guidance system named Pei-Wo Drone, which assists users perform exercise or physical movements effectively in limited space. By following the drone's trajectory and receiving real-time feedback, users can ensure correct movements and make necessary adjustments. The system provides real-time continuous sound feedback to notify the users if they deviate from the drone's path. The study results indicate that older adult participants (12 females, 3 males; 67.40 ± 5.85 years) successfully followed the drone's movements. In summary, using a drone with real-time feedback to guide physical exercises has the potential to support healthy aging in older adults.

PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke-a randomized, controlled trial

Purpose

Motor-cognitive exergames may be beneficial for addressing both motor and cognitive residual impairments in chronic stroke, however, effective training schedules are yet to be determined. Therefore, this study investigates the effects of a concept-guided, personalized, motor-cognitive exergame training on cognitive functions and gait in chronic stroke survivors.

Methods

In this single-blind, randomized, controlled trial, stroke survivors (at least six-months post-stroke and able to perform step-based exergaming) were allocated either to the intervention (usual care + concept-guided, personalized, motor-cognitive exergame training) or the control group (usual care only). Global cognitive functioning was primarily targeted, while health-related quality of life (HRQoL), cognitive functions, mobility, and gait were evaluated secondarily. Analyses were performed with linear-mixed effect models.

Results

Effects on global cognitive functioning were non-significant, with no differences between responders (participants exhibiting a clinically relevant change) and non-responders (participants exhibiting no clinically relevant change). Among secondary outcomes, the mobility domain of the HRQoL questionnaire, intrinsic visual alertness, cognitive flexibility, working memory, and outdoor walking speed as well as swing width (unaffected side) showed significant interaction effects in favour of the exergame group.

Discussion

Additional exergaming helped maintaining global cognitive functioning and showed encouraging effects in mobility and cognitive outcomes. Responders and non-responders did not differ in adherence, baseline values or age. Enhancing the frequency and intensity of sessions could unlock more substantial benefits. Adopting a blended therapy approach may be key to maximizing positive effects.

Clinical trial registration

clinicaltrials.gov, identifier NCT05524727.

Effect of a home-based physical rehabilitation program via virtual reality on the functional outcomes of frail older adults: a quasi-experimental study

Given the rapid aging of the population in Egypt, efforts to slow down or prevent frailty. Virtual reality technology constitutes a promising rehabilitation strategy, but its effect on frailty in older adults remains inconclusive. A non-equivalent control pre, post, and follow-up test design was used with a sample of 70 prefrail or frail older adults. In 3 urbans affiliated to Dakahlia governorate, tools of data collection; Mini-Cog, Structured Interview Schedule, Survey of Health, Aging and Retirement in Europe of the Frailty Indicator (FI), Short Physical Performance Battery, and Falls Efficacy Scale. For each group, a significant improvement in frailty, physical performance, and falls from each measurement period to immediately after (p < 0.001), and within the 30-days study period while those in the control group were relatively stable over time and sometime worsen. The baseline characteristics and assessment results were similar between groups. We observed significant improvements in the intervention group in terms of frailty criteria, standing balance, gait speed, chair stand, and fear of fall. No improvements were observed in the control group, we anticipate a decrease in frailty index, and increase in standing balance, reinforcing the proven benefits of the exercise in this vulnerable population.

Effects of virtual reality technology on anxiety and depression in older adults with chronic diseases: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Previous research has demonstrated the effectiveness of virtual reality (VR) technology in many application areas. However, there is a clear gap in the literature regarding its effects on depression and anxiety in older adults with chronic diseases.

AIMS

This review aimed to assess the effectiveness of VR interventions for depression and anxiety in older adults with chronic diseases.

METHODS

Seven electronic databases were systematically searched from their inception to April 9, 2024. Two researchers evaluated methodological quality using RoB (version 2.0) and performed meta-analyses using RevMan (version 5.4) and Stata (version 16.0) software.

RESULTS

This review included 19 randomized controlled studies. Meta-analysis revealed that VR significantly improved depression (standard mean difference [SMD] = -0.67, 95% confidence interval [CI] [-0.90, -0.45], p < .00001) and anxiety (SMD = -0.76, 95% CI [-0.95, -0.57], p < .00001) in older adults with chronic diseases, improved their quality of life (SMD = 0.39, 95% CI [0.17, 0.61], p = .0006) and positive emotions (SMD = 5.65, 95% CI [3.61, 7.69], p < .00001), and relieved stress (SMD = -1.08, 95% CI [-1.52, -0.64], p < .00001). However, the difference in self-efficacy was statistically non-significant (SMD = 1.01, 95% CI [-0.48, 2.50], p = .19).

LINKING EVIDENCE TO ACTION

The results of this systematic review provide important evidence for developing interventions to improve the mental health of older adults with chronic diseases.

A Virtual Reality Cognitive Stimulation Program as an Effective Tool Against Residual/Prodromal Depressive Symptoms in Bipolar Disorders

Background: Bipolar disorder (BD) is a severe psychiatric illness characterized by a chronic course and recurrent episodes, including residual depressive symptoms even during euthymic phases. These symptoms, although not meeting criteria for a depressive episode, are linked to relapse risk and impaired social functioning. This study aims to assess whether Virtual Reality Cognitive Remediation Training reduces depressive symptoms below the clinical threshold in individuals with BD. Methods: This post hoc analysis focuses on the secondary outcome (PHQ9) of a randomized-controlled trial. Participants were recruited from the Center of Liaison Psychiatry and Psychosomatics in Italy. The experimental group received Virtual Reality Cognitive Remediation, while the control group received standard treatment Results: Data from 39 individuals in the experimental group and 25 in the control group were analyzed. A greater reduction in PHQ-9 scores (>9) was observed in the experimental group (71.8% to 48.7%) compared to the control group. Significant improvements in total PHQ-9 scores and specific symptoms were noted in the experimental group compared to the control group. Conclusions: The study highlights the significant impact of virtual reality intervention on reducing depressive symptoms in bipolar disorder. This promising outcome underscores the potential preventive role of cognitive stimulation in relapse prevention. The intervention could offer valuable benefits for both treatment and prevention strategies in bipolar disorder.

Impact mechanism of social-related social media use on the job performance of caregivers of older adults

This study investigated the impact mechanism of social-related social media use on the job performance of caregivers of older adults through mental health and analyzed gender differences. A total of 358 valid questionnaires were collected and analyzed using SPSS and Smart PLS. The results showed that mental health plays an important role in the relationship between social-related social media use and job performance. Such social media use can improve psychological well-being and reduce psychological distress by promoting relaxation experience. Psychological well-being has a significant positive impact on job performance. In addition, significant differences exist in the impact path of social-related social media use on psychological distress among different gender groups. The findings of this study can assist nursing homes in assessing the use of social media within their organizations and provide methodological references for enhancing the job performance of caregivers of older adults.