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

Michael Schwenk, Gurtej S. Grewal, Bahareh Honarvar, Stefanie Schwenk, Martha J Mohler, Dharma S. Khalsa, Bijan Najafi

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Wearable 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. Methods: Senior 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. Results: After 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. Conclusions: Results 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 registration: http://www.clinicaltrials.gov NCT02043834.

Original languageEnglish (US)
Article number691
JournalJournal of NeuroEngineering and Rehabilitation
Volume11
Issue number1
DOIs
StatePublished - Dec 13 2014

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Sensory Feedback
Exercise Test
Education
Ankle
Hip
Accidental Falls
Body Weights and Measures
Ankle Joint
Hip Joint
Gait
Motivation
Joints
Outcome Assessment (Health Care)
Technology
Safety
Weights and Measures
Control Groups
Walking Speed

Keywords

  • Balance
  • Exercise
  • Exergame
  • Fall risk
  • Interactive
  • Older adults
  • Postural control
  • Wearable sensors

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

Cite this

Interactive balance training integrating sensor-based visual feedback of movement performance : A pilot study in older adults. / Schwenk, Michael; Grewal, Gurtej S.; Honarvar, Bahareh; Schwenk, Stefanie; Mohler, Martha J; Khalsa, Dharma S.; Najafi, Bijan.

In: Journal of NeuroEngineering and Rehabilitation, Vol. 11, No. 1, 691, 13.12.2014.

Research output: Contribution to journalArticle

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AU - Mohler, Martha J

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AU - Najafi, Bijan

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N2 - Background: Wearable 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. Methods: Senior 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. Results: After 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. Conclusions: Results 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 registration: http://www.clinicaltrials.gov NCT02043834.

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