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Tuan SH, Chang LH, Sun SF, Lin KL, Tsai YJ. Using exergame-based exercise to prevent and postpone the loss of muscle mass, muscle strength, cognition, and functional performance among elders in rural long-term care facilities: A protocol for a randomized controlled trial. Front Med (Lausanne) 2022; 9:1071409. [PMID: 36582297 PMCID: PMC9792490 DOI: 10.3389/fmed.2022.1071409] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Objective Elderly individuals in long-term care facilities (LTCFs) have a higher prevalence of sarcopenia than those in the community. Exercise is the gold standard for preventing and treating sarcopenia. Regarding exercise, multicomponent exercises, including progressive resistance training (PRT), are beneficial. However, developing routine, structured exercise programs for the elderly in LTCFs is difficult because of a shortage of healthcare providers, particularly in rural regions. Exergame-based exercises can increase a player's motivation and reduce staff time for an intervention. Nintendo Switch RingFit Adventure (RFA) is a novel exergame that combines resistance, aerobic, and balance exercises. In this study, we aim to investigate the clinical effectiveness of RFA on muscle and functional performance parameters among the elderly in LTCFs. Methods The EXPPLORE (using EXergame to Prevent and Postpone the LOss of muscle mass, muscle strength, and functional performance in Rural Elders) trial is a single-center randomized controlled trial involving elderly individuals (≥60 years) living in LTCFs in rural southern Taiwan. The participants will be equally randomized to the intervention group (exergame-based exercise plus standard care) or the control group (standard care alone). Both groups will receive standard care except that the intervention group will receive exergame-based exercises at the time previously scheduled for sedentary activities in the LTCFs. The exergame-based exercise will be performed using RFA in the sitting position with a specialized design, including arm fit skills and knee assist mode. Each session of the exercise lasts 30 mins and will be performed two times per week for 12 weeks. The primary outcomes will be the osteoporotic fracture index, appendicular skeletal muscle mass index, dominant handgrip strength, and gait speed. Meanwhile, the secondary outcomes will be the dexterity and agility, muscle strength and thickness, range of motion of the joints of the dominant upper extremity, Kihon checklist, Medical Outcomes Study 36-Item Short-Form Health Survey, and Brain Health Test. Discussion This trial will provide valuable knowledge on whether exergames using RFA can counteract physical decline and improve quality of life and cognition among the elderly in LTCFs. Clinical trial registration [www.ClinicalTrials.gov], identifier [NCT05360667].
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Affiliation(s)
- Sheng-Hui Tuan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,Department of Rehabilitation Medicine, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung City, Taiwan
| | - Ling-Hui Chang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Shu-Fen Sun
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung city, Taiwan,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Ko-Long Lin
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung city, Taiwan,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan,School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yi-Ju Tsai
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,*Correspondence: Yi-Ju Tsai,
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VR exergame interventions among older adults living in long-term care facilities: A systematic review with Meta-analysis. Ann Phys Rehabil Med 2022; 66:101702. [PMID: 36028201 DOI: 10.1016/j.rehab.2022.101702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND To improve the motivation toward exercise in older adults, exergames have shifted from entertainment to rehabilitation. OBJECTIVES To review the training focus of exergames and analyze the effectiveness of exergame training on physical, psychological, or cognitive outcomes among older adults in long-term care facilities (LTCFs). METHODS This review followed the PRISMA guidelines. By searching 7 electronic databases up to April 30, 2022, studies were included if they 1) involved adults ≥65 years old residing in LTCFs, 2) were randomized controlled trials (RCTs) with virtual reality-based exergames as the intervention, 3) compared the effects of exergames to usual care or conventional exercises, and 4) reported physical, psychological, or cognitive outcomes. The Cochrane Risk-of-Bias tool for randomized trials version 2 (RoB 2) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to evaluate the methodological quality of studies and levels of evidence for outcomes. The meta-analysis was conducted with Review Manager 5.4. Results are presented as standardized mean differences (SMDs) and 95% confidence intervals (CIs). RESULTS A total of 12 RCTs were included in the systematic review and meta-analysis. For overall methodological quality, 10 studies showed some concerns and 2 studies showed high risk. Levels of evidence for outcomes were assessed as low (n = 8) and very low (n = 4). The studies involved a total of 482 older adults. Most studies implemented balance exercise as the exergame intervention. Older adults who completed exergame interventions showed improvements in cognitive outcomes (SMD 0.90, 95%CI 0.61-1.19, p<0.001) and in balance self-efficacy (SMD 1.04, 95%CI 0.47-1.61, p<0.001) as compared with those in usual care. They also showed improvements in balance (SMD 0.49, 95%CI 0.20-0.78, p<0.001) as compared with those in conventional exercise programs. Overall, exergames had a positive effect on balance (SMD 0.62, 95%CI 0.29-0.95, p<0.001). CONCLUSION This review revealed that exergames can improve the balance ability of older adults in LTCFs.
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Williams T, Kennedy-Malone L, Thompson J, Monge EC. The effect of an exergame on physical activity among older adults residing in a long-term care facility: A pilot study. Geriatr Nurs 2022; 44:48-53. [DOI: 10.1016/j.gerinurse.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 12/16/2022]
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Gramaglia C, Gattoni E, Marangon D, Concina D, Grossini E, Rinaldi C, Panella M, Zeppegno P. Non-pharmacological Approaches to Depressed Elderly With No or Mild Cognitive Impairment in Long-Term Care Facilities. A Systematic Review of the Literature. Front Public Health 2021; 9:685860. [PMID: 34336772 PMCID: PMC8322575 DOI: 10.3389/fpubh.2021.685860] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Compared to old people who live at home, depressive symptoms are more prevalent in those who live in long-term care facilities (LTCFs). Different kinds of non-pharmacological treatment approaches in LTCFs have been studied, including behavioral and cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy and life review/reminiscence. The aim of the current review was to systematically review non-pharmacological treatments used to treat depressed older adults with no or mild cognitive impairment (as described by a Mini Mental State Examination score > 20) living in LTCFs. Methods: A research was performed on PubMed and Scopus databases. Following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) flowchart, studies selection was made. The quality of each Randomized Controlled Trial was scored using the Jadad scale, Quasi-Experimental Design studies and Non-Experimental studies were scored based on the Newcastle-Ottawa Scale (NOS) Results: The review included 56 full text articles; according to the type of intervention, studies were grouped in the following areas: horticulture/gardening (n = 3), pet therapy (n = 4), physical exercise (n = 9), psychoeducation/rehabilitation (n = 15), psychotherapy (n = 3), reminiscence and story sharing (n = 14), miscellaneous (n = 8). Discussion and Conclusion: Despite mixed or negative findings in some cases, most studies included in this systematic review reported that the non-pharmacological interventions assessed were effective in the management of depressed elderly in the LTCFs context. Regrettably, the limitations and heterogeneity of the studies described above hinder the possibility to generalize and replicate results.
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Affiliation(s)
- Carla Gramaglia
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
- Psychiatry Ward, Maggiore della Carità University Hospital, Novara, Italy
| | - Eleonora Gattoni
- Psychiatry Ward, Maggiore della Carità University Hospital, Novara, Italy
| | - Debora Marangon
- Psychiatry Ward, Maggiore della Carità University Hospital, Novara, Italy
| | - Diego Concina
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Elena Grossini
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Carmela Rinaldi
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Massimiliano Panella
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
- Psychiatry Ward, Maggiore della Carità University Hospital, Novara, Italy
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Abstract
Assisted living (AL) is a well-established alternative to nursing homes, promoting autonomy and choice in a residential environment. This article examines the opportunities that AL affords for older adults and areas for further research to optimize the fit between resident needs and the AL environment. The model of person-environment fit provides an organizing framework for our commentary. The environment of AL emphasizes choice, independence, and privacy. The acuity of health care needs in AL residents has evolved since its inception. Unlike earlier residents, many today live with multiple chronic conditions and need for functional supports. Regulated by states, there is high variability in oversight, staffing, and resources available in AL. Families play an important role in supporting residents, yet expectations for their engagement may not be clear. Descriptive research abounds but there is a need for more sophisticated approaches to understanding how the AL environment can provide optimal supports for older adults, across all states and across income and racial/ethnic groups. There are several methodological challenges to AL research, including the high variability among AL settings and across states, the lack of common data elements, and difficulty accessing representative samples. With the popularity of AL as an option, it will be important to continue to examine how this environment can evolve to meet the changing needs of the resident population, while balancing the elements of autonomy and affordability. [Research in Gerontological Nursing, 14(1), 5-12.].
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Drazich BF, LaFave S, Crane BM, Szanton SL, Carlson MC, Budhathoki C, Taylor JL. Exergames and Depressive Symptoms in Older Adults: A Systematic Review. Games Health J 2020; 9:339-345. [PMID: 32551982 DOI: 10.1089/g4h.2019.0165] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
To synthesize and critique studies that examined the impact of exergames on depressive symptoms in older adults. Articles were retrieved from the databases CINAHL, Embase, PsychINFO, and Medline. Studies were included in the review if they involved a physical activity/videogame intervention and measured outcomes of depressive symptoms in older adults. The search generated 957 articles for consideration, which were narrowed to 17 articles after applying exclusion criteria. In studies that required depressive symptoms as an inclusion criterion, there was an improvement in depressive symptoms in older adults following the exergame intervention. In studies that did not require depressive symptoms as an inclusion criterion, researchers found mixed results. Future older adult exergame research should measure depression as a primary outcome, utilize control groups with random sampling, consist of larger sample sizes, and include people with disabilities.
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Affiliation(s)
| | - Sarah LaFave
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Breanna M Crane
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, Maryland.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.,Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland
| | - Michelle C Carlson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
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Howes SC, Charles DK, Marley J, Pedlow K, McDonough SM. Gaming for Health: Systematic Review and Meta-analysis of the Physical and Cognitive Effects of Active Computer Gaming in Older Adults. Phys Ther 2017; 97:1122-1137. [PMID: 29077911 DOI: 10.1093/ptj/pzx088] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 08/29/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Active computer gaming (ACG) is a method of facilitating physical activity in older people to improve health outcomes. PURPOSE The purpose of this study was to update and extend a systematic review of the evidence for ACG to determine its effects on physical and cognitive health in older adults. DATA SOURCES MEDLINE, EMBASE, CENTRAL in the Cochrane Library, and PsycINFO databases were searched from the date of the previous review (2011) to May 2016. STUDY SELECTION Eligible articles were randomized controlled trials (RCTs) investigating the effect of ACG in adults aged 65 and older. DATA EXTRACTION Thirty-five studies were eligible for inclusion. Two review authors independently conducted data extraction, risk-of-bias assessment, and coding of behavior change techniques. Outcomes of interest were analyzed as continuous data and pooled as standardized mean differences (SMD) and 95% confidence intervals (CI). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the quality of the evidence. DATA SYNTHESIS Behavior change techniques (N = 106) were coded in the included studies (mean = 3.02). Data were pooled for 5 main outcomes of interest. Significant moderate effects in favor of ACG were observed for balance (SMD = 0.52, 95% CI = 0.24 to 0.79; 17 studies; 743 participants), for functional exercise capacity when intervention delivery was >120 minutes per week (SMD = 0.53, 95% CI = 0.15 to 0.90; 5 studies; 116 participants), and for cognitive function (SMD = -0.48, 95% CI = -0.80 to 0.17; 8 studies; 459 participants). There was no significant effect observed for functional mobility or fear of falling. LIMITATIONS The quality of the evidence for all comparisons was graded low or very low. CONCLUSIONS At present there is very little confidence that ACG improves physical and cognitive outcomes in older adults.
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Affiliation(s)
- Sarah C Howes
- S.C. Howes, BSc, Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, Antrim, United Kingdom of Great Britain and Northern Ireland
| | - Darryl K Charles
- D.K. Charles, PhD, Computer Science Research Institute, School of Computing and Information Engineering, Ulster University
| | - Joanne Marley
- J. Marley, PhD, Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, and Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Katy Pedlow
- K. Pedlow, PhD, Brain Injury Matters (NI), Belfast, Northern Ireland
| | - Suzanne M McDonough
- S.M. McDonough, PhD, Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Room 01F118, Jordanstown, United Kingdom; UKCRC Centre of Excellence for Public Health, Belfast, Northern Ireland; and School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Sanchez S, De Boissieu P, Gueyraud C, Armingaud D, Guerrier M, Denormandie P. [Information and communication technology and health of the elderly]. SOINS. GÉRONTOLOGIE 2016; 21:10-14. [PMID: 27664356 DOI: 10.1016/j.sger.2016.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
New technologies offer many advantages, especially in terms of animation in elderly care homes. Consoles and digital tablets used without any medical implication were the subject of a literature review on their impact on the health of the elderly..
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Affiliation(s)
- Stéphane Sanchez
- Institut du Bien vieillir Korian, 32 rue Guersant, 75017 Paris, France; Pôle Information médicale évaluation performance, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France.
| | - Paul De Boissieu
- Pôle Information médicale évaluation performance, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France
| | | | - Didier Armingaud
- Institut du Bien vieillir Korian, 32 rue Guersant, 75017 Paris, France
| | - Marc Guerrier
- Institut du Bien vieillir Korian, 32 rue Guersant, 75017 Paris, France
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Chao YY, Lucke KT, Scherer YK, Montgomery CA. Understanding the Wii Exergames Use: Voices from Assisted Living Residents. Rehabil Nurs 2015; 41:279-88. [DOI: 10.1002/rnj.216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Ying-Yu Chao
- Rutgers, The State University of New Jersey; Newark NJ USA
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Chao YY, Scherer YK, Montgomery CA. Effects of using Nintendo Wii™ exergames in older adults: a review of the literature. J Aging Health 2014; 27:379-402. [PMID: 25245519 DOI: 10.1177/0898264314551171] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this review is to summarize and synthesize the impact of using the Nintendo Wii™ exergames in older adults. METHOD A database search was conducted to identify relevant studies. The search was limited to empirical studies, with particular attention paid to the effects of Wii exergames intervention on cognition, physical function, and psychosocial outcomes in older adults. RESULTS A total of 22 empirical studies met inclusion criteria and were included in this review. Positive effects included improving physical function, decreasing depression, and increasing cognition and quality of life in older adults. Improved socialization and motivation to exercise were also reported. DISCUSSION Using Wii exergames does show promise as an intervention to improve physical function, cognition, and psychosocial outcomes in older adults. Evidence supports that Wii exergames is a safe and feasible tool to encourage older adults to engage in exercise.
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