Virtual Reality Training With Three-Dimensional Video Games Improves Postural Balance and Lower Extremity Strength in Community-Dwelling Older Adults

in Journal of Aging and Physical Activity

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Yongwoo Lee
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Wonjae Choi
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Kyeongjin Lee
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Changho Song
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Seungwon Lee
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Avatar-based three-dimensional technology is a new approach to improve physical function in older adults. The aim of this study was to use three-dimensional video gaming technology in virtual reality training to improve postural balance and lower extremity strength in a population of community-dwelling older adults. The experimental group participated in the virtual reality training program for 60 min, twice a week, for 6 weeks. Both experimental and control groups were given three times for falls prevention education at the first, third, and fifth weeks. The experimental group showed significant improvements not only in static and dynamic postural balance but also lower extremity strength (p < .05). Furthermore, the experimental group was improved to overall parameters compared with the control group (p < .05). Therefore, three-dimensional video gaming technology might be beneficial for improving postural balance and lower extremity strength in community-dwelling older adults.

Y. Lee, Song, and S. Lee are with the Department of Physical Therapy, Sahmyook University, Seoul, Republic of Korea. Choi is with the Department of Physical Therapy, The Graduate School of Sahmyook University, Seoul, Republic of Korea. K. Lee is with the Department of Physical Therapy, Kyungdong University, Gangwon, Republic of Korea.

Address author correspondence to Seungwon Lee at swlee@syu.ac.kr.
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  • Agmon, M., Perry, C.K., Phelan, E., Demiris, G., & Nguyen, H.Q. (2011). A pilot study of Wii Fit exergames to improve balance in older adults. Journal of Geriatric Physical Therapy, 34(4), 161167. PubMed doi:10.1519/JPT.0b013e3182191d98

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Allison, L.K., Painter, J.A., Emory, A., Whitehurst, P., & Raby, A. (2013). Participation restriction, not fear of falling, predicts actual balance and mobility abilities in rural community-dwelling older adults. Journal of Geriatric Physical Therapy, 36(1), 1323. PubMed doi:10.1519/JPT.0b013e3182493d20

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Altermann, C.D., Martins, A.S., Carpes, F.P., & Mello-Carpes, P.B. (2014). Influence of mental practice and movement observation on motor memory, cognitive function and motor performance in the elderly. Brazilian Journal of Physical Therapy, 18(2), 201209. PubMed doi:10.1590/S1413-35552012005000150

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Anguera, J.A., Boccanfuso, J., Rintoul, J.L., Al-Hashimi, O., Faraji, F., Janowich, J., … Gazzaley, A. (2013). Video game training enhances cognitive control in older adults. Nature, 501(7465), 97101. PubMed doi:10.1038/nature12486

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aoyama, M., Suzuki, Y., Onishi, J., & Kuzuya, M. (2011). Physical and functional factors in activities of daily living that predict falls in community-dwelling older women. Geriatrics and Gerontology International, 11(3), 348357. PubMed doi:10.1111/j.1447-0594.2010.00685.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Balzer, K., Bremer, M., Schramm, S., Luhmann, D., & Raspe, H. (2012). Falls prevention for the elderly. GMS Health Technol Assess, 8, Doc01. doi:10.3205/hta000099

    • Search Google Scholar
    • Export Citation
  • Carter, N.D., Kannus, P., & Khan, K.M. (2001). Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports Medicine, 31(6), 427438. PubMed doi:10.2165/00007256-200131060-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Choi, W., Lee, G., & Lee, S. (2014). Effect of the cognitive-motor dual-task using auditory cue on balance of surviviors with chronic stroke: a pilot study. Clinical Rehabilitation, 13, 18. PubMed doi:10.1177/0269215514556093

    • Search Google Scholar
    • Export Citation
  • de Bruin, E.D., Schoene, D., Pichierri, G., & Smith, S.T. (2010). Use of virtual reality technique for the training of motor control in the elderly. Some theoretical considerations. Zeitschrift für Gerontologie und Geriatrie, 43(4), 229234. PubMed doi:10.1007/s00391-010-0124-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dias, R.C., Freire, M.T., Santos, E.G., Vieira, R.A., Dias, J.M., & Perracini, M.R. (2011). Characteristics associated with activity restriction induced by fear of falling in community-dwelling elderly. Rev Bras Fisioter, 15(5), 406413. PubMed doi:10.1590/S1413-35552011000500011

    • Search Google Scholar
    • Export Citation
  • Duque, G., Boersma, D., Loza-Diaz, G., Hassan, S., Suarez, H., Geisinger, D., … Demontiero, O. (2013). Effects of balance training using a virtual-reality system in older fallers. Clinical Interventions in Aging, 8, 257263. PubMed doi:10.2147/CIA.S41453

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gelbard, R., Inaba, K., Okoye, O.T., Morrell, M., Saadi, Z., Lam, L., … Demetriades, D. (2014). Falls in the elderly: a modern look at an old problem. The American Journal of Surgery, 208(2), 249253. PubMed doi:10.1016/j.amjsurg.2013.12.034

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Goldie, P.A., Evans, O.M., & Bach, T.M. (1992). Steadiness in one-legged stance: development of a reliable force-platform testing procedure. Archives of Physical Medicine and Rehabilitation, 73(4), 348354. PubMed doi:10.1016/0003-9993(92)90008-K

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Graves, L.E., Ridgers, N.D., Williams, K., Stratton, G., Atkinson, G., & Cable, N.T. (2010). The physiological cost and enjoyment of Wii Fit in adolescents, young adults, and older adults. Journal of Physical Activity and Health, 7(3), 393401. PubMed doi:10.1123/jpah.7.3.393

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hagedorn, D.K., & Holm, E. (2010). Effects of traditional physical training and visual computer feedback training in frail elderly patients. A randomized intervention study. European Journal of Physical and Rehabilitation Medicine, 46(2), 159168. PubMed

    • Search Google Scholar
    • Export Citation
  • Iwamoto, J., Suzuki, H., Tanaka, K., Kumakubo, T., Hirabayashi, H., Miyazaki, Y., … Matsumoto, H. (2009). Preventative effect of exercise against falls in the elderly: a randomized controlled trial. Osteoporosis International, 20(7), 12331240. PubMed doi:10.1007/s00198-008-0794-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kang, S. (2012). A study on crosstalk about three-dimensional LCD TV. (Master's thesis), Hanyang University, Seoul.

  • Kovacs, E., Prokai, L., Meszaros, L., & Gondos, T. (2013). Adapted physical activity is beneficial on balance, functional mobility, quality of life and fall risk in community-dwelling older women: a randomized single-blinded controlled trial. European Journal of Physical and Rehabilitation Medicine, 49(3), 301310. 23486300

    • Search Google Scholar
    • Export Citation
  • Lajoie, Y., & Gallagher, S.P. (2004). Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. Archives of Gerontology and Geriatrics, 38(1), 1126. PubMed doi:10.1016/S0167-4943(03)00082-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lord, S.R., Murray, S.M., Chapman, K., Munro, B., & Tiedemann, A. (2002). Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 57(8), 539543. PubMed doi:10.1093/gerona/57.8.M539

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marston, H.R., & Smith, S.T. (2012). Interactive videogame technologies to support independence in the elderly: a narrative review. Games for Health: Research, Development, and Clinical Applications, 1(2), 139152. PubMed doi:10.1089/g4h.2011.0008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Martin-Moreno, J., Ruiz-Fernandez, D., Soriano-Paya, A., & Jesus Berenguer-Miralles, V. (2008). Monitoring 3D movements for the rehabilitation of joints in physiotherapy. Proceedings of the 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 48364839. doi:10.1109/iembs.2008.4650296

    • Search Google Scholar
    • Export Citation
  • Mura, G., Cossu, G., Migliaccio, G.M., Atzori, C., Nardi, A.E., Machado, S., & Carta, M.G. (2014). Quality of life, cortisol blood levels and exercise in older adults: results of a randomized controlled trial. Clinical Practice and Epidemiology in Mental Health, 10, 6772. PubMed doi:10.2174/1745017901410010067

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nitz, J.C., Kuys, S., Isles, R., & Fu, S. (2010). Is the Wii Fit a new-generation tool for improving balance, health and well-being? A pilot study. Climacteric, 13(5), 487491. PubMed doi:10.3109/13697130903395193

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Paez, D.G., Aparicio, F., de Buenaga, M., & Padron, V. (2012). Personalized health care system with virtual reality rehabilitation and appropriate information for seniors. Sensors (Basel), 12(5), 55025516. PubMed doi:10.3390/s120505502

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Press, Y., Grinshpun, Y., Berzak, A., Friger, M., & Clarfield, A.M. (2007). The effect of co-morbidity on the rehabilitation process in elderly patients after hip fracture. Archives of Gerontology and Geriatrics, 45(3), 281294. PubMed doi:10.1016/j.archger.2007.01.059

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosenberg, D., Depp, C.A., Vahia, I.V., Reichstadt, J., Palmer, B.W., Kerr, J., … Jeste, D.V. (2010). Exergames for subsyndromal depression in older adults: a pilot study of a novel intervention. American Journal of Geriatric Psychiatry, 18(3), 221226. PubMed doi:10.1097/JGP.0b013e3181c534b5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rubenstein, L.Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention [Review]. Age Ageing, 35(Suppl 2), ii37ii41. doi:10.1093/ageing/afl084

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rydwik, E., Frandin, K., & Akner, G. (2004). Effects of physical training on physical performance in institutionalised elderly patients (70+) with multiple diagnoses. Age Ageing, 33(1), 1323. PubMed doi:10.1093/ageing/afh001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Salminen, M., Vahlberg, T., Sihvonen, S., Sjosten, N., Piirtola, M., Isoaho, R., … Kivela, S.L. (2009). Effects of risk-based multifactorial fall prevention on postural balance in the community-dwelling aged: a randomized controlled trial. Archives of Gerontology and Geriatrics, 48(1), 2227. PubMed doi:10.1016/j.archger.2007.09.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Saposnik, G., Teasell, R., Mamdani, M., Hall, J., McIlroy, W., Cheung, D., … Bayley, M. (2010). Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle. Stroke, 41(7), 14771484. PubMed doi:10.1161/STROKEAHA.110.584979

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Seo, J.G. (2009). A study on the urban growth with information, aging, centralized society. Korean Public Administration Quarterly, 21(2), 521539.

    • Search Google Scholar
    • Export Citation
  • Singh, D.K., Rajaratnam, B.S., Palaniswamy, V., Pearson, H., Raman, V.P., & Bong, P.S. (2012). Participating in a virtual reality balance exercise program can reduce risk and fear of falls. Maturitas, 73(3), 239243. PubMed doi:10.1016/j.maturitas.2012.07.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Teixeira, L.E., Silva, K.N., Imoto, A.M., Teixeira, T.J., Kayo, A.H., Montenegro-Rodrigues, R., … Trevisani, V.F. (2010). Progressive load training for the quadriceps muscle associated with proprioception exercises for the prevention of falls in postmenopausal women with osteoporosis: a randomized controlled trial. Osteoporosis International, 21(4), 589596. PubMed doi:10.1007/s00198-009-1002-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tiedemann, A., Shimada, H., Sherrington, C., Murray, S., & Lord, S. (2008). The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing, 37(4), 430435. PubMed doi:10.1093/ageing/afn100

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tucker, M.G., Kavanagh, J.J., Morrison, S., & Barrett, R.S. (2009). Voluntary sway and rapid orthogonal transitions of voluntary sway in young adults, and low and high fall-risk older adults. Clinical Biomechanics (Bristol, Avon), 24(8), 597605. PubMed doi:10.1016/j.clinbiomech.2009.06.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Whitney, S.L., Wrisley, D.M., Marchetti, G.F., Gee, M.A., Redfern, M.S., & Furman, J.M. (2005). Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand test. Physical Therapy, 85(10), 10341045. PubMed doi:10.1093/ptj/85.10.1034

    • Search Google Scholar
    • Export Citation
  • Williams, B., Doherty, N.L., Bender, A., Mattox, H., & Tibbs, J.R. (2011). The effect of nintendo wii on balance: a pilot study supporting the use of the wii in occupational therapy for the well elderly. Occupational Therapy in Health Care, 25(2–3), 131139. PubMed doi:10.3109/07380577.2011.560627

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wolf, S.L., Barnhart, H.X., Kutner, N.G., McNeely, E., Coogler, C., & Xu, T. (1996). Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT group. Frailty and injuries: cooperative studies of intervention techniques. Journal of the American Geriatrics Society, 44(5), 489497. PubMed doi:10.1111/j.1532-5415.1996.tb01432.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Young, W., Ferguson, S., Brault, S., & Craig, C. (2011). Assessing and training standing balance in older adults: a novel approach using the ‘Nintendo Wii’ balance board. Gait Posture, 33(2), 303305. PubMed doi:10.1016/j.gaitpost.2010.10.089

    • Crossref
    • Search Google Scholar
    • Export Citation
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