Comparison of Exergaming and Vestibular Training on Gaze Stability, Balance and Gait Performance of Older Adults.
Condition: Older Adults
Study type: Interventional

Summary: 
      Exergames showed beneficial effects than conventional exercises for gaze stability, balance
      and gait improvements in older individuals. Further studies should be conducted to explore
      the benefits of exergames on older adults. This study aims to explore that exergaming has
      more effects on gaze stability, balance and gait performance of older individuals.
    

Detailed description: 
      According to a recent report by 2050, the global adult population between the age 65 and
      above is expected to increase to 28%. A total of 12.13 million people in Pakistan are above
      age of 60, which is expected to raise to 17.53 million by 2025. A high quality of life as
      well as longevity is considered important in older adults.However, characteristics of aging
      include a decrease in muscle strength, balance and decreased vestibular functions can lead to
      falls and compromise good health in older adults.

      Vestibular rehabilitation is an exercised based program intended to alleviate both primary
      and secondary problems caused by vestibular disorders.The main focus of vestibular
      rehabilitation is to use the existing vestibular system for gaze, postural stability and gait
      by use of somatosensory and visual cues. Depending on the vestibular disorders three main
      types of exercises are used. Habituation Gaze stability exercises ,Balance training.
      Habituation exercises are indicated for patients who complain of dizziness during quick head
      movements and when they change position like when they bend over or look up to reach above
      their head. The goal of habituation exercise is to reduce the dizziness through repeated
      exposure to specific movements or visual stimuli that provoke patient's dizziness.

      Gaze stability exercises include eyeball movement, saccadic eye movement, pursuit eye
      movement, vergence eye movement, vestibular-ocular reflex exercise. These exercises improve
      the static balance control thus improves postural control required for vestibular function
      and can be mediated by VSR improvements. These exercises are useful in bilateral vestibular
      hypofunction. Balance training are used to improve standing, bending, reaching and
      performance of dual tasks on even and uneven surfaces. These exercises proved to be effective
      in making individuals do activities of daily livings and prevents the risks of falls.

      Computer based technology is becoming popular in rehabilitation. It stimulates learning in
      real-life environment and provides a 3-dimensional sensory feedback. A computer-generated
      technology allows the user to interact with a virtual world and to make correction during
      performing an exercise task. In particular, previous studies have suggested that new
      technology, such as the Wii Fit Board (WFB) can be used for balance training using virtual
      reality These games have showed repeated good results in vestibular rehabilitation of
      elderly.Virtual reality enables the individual to be physically active and provides a
      pleasant and motivating way of training in these individuals.

      There are literature for the safe and effective use of exergaming in improving gaze
      stability, balance and postural control in older individuals Jaap Swanenburg et al concluded
      that exergaming is effective in improving gaze stability, balance and postural control in
      older adults .Lynne M Taylor showed that active video games proved to be effective in
      improving balance and gait in older individuals .J Hashim concluded that Exergames improved
      dynamic balance in older adults when compared with conventional exercises.
    

Intervention name(s): exergaming training; training - Group II
Intervention type(s): Other; Other
Intervention description(s): HEADING: For 5 mins a day,3 days a week in first 3 weeks (beginner level game) and for 10 mins a day, 3 days a week for 3 weeks. (advanced level game)
TIGHTROPE TENSION: For 5 mins a day,3 days a week in first 3 weeks (beginner level game) and for 10 mins a day, 3 days a week for 3 weeks. (advanced level game)
SNOWBOARD SLALOM: For 5 mins a day,3 days a week in first 3 weeks (beginner level game) and for 10 mins a day, 3 days a week for 3 weeks. (advanced level game)
TABLE TILT: For 5 mins a day,3 days a week in first 3 weeks (beginner level game) and for 10 mins a day, 3 days a week for 3 weeks. (advanced level game); Wobble board for 4 mins a day,3 days a week for first 3 weeks and for 8 mins a day,3 days a week for 3 weeks.
Habituation exercises for 4 mins a day,3 days a week for first 3 weeks and for 8 mins a day,3 days a week for 3 weeks.
Double leg stance with eyes open and eyes closed on firm surface and on foam for 4 mins a day,3 days a week for first 3 weeks and for 8 mins a day,3 days a week for 3 weeks.
Single leg stance with eyes open and eyes open on firm surface and on foam for 4 mins a day,3 days a week for first 3 weeks and for 8 mins a day,3 days a week for 3 weeks.
Tandem walk stance with eyes open and eyes closed on firm surface and on foam for 4 mins a day,3 days a week for first 3 weeks and for 8 mins a day,3 days a week for 3 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other
Keywords: Exergaming; vestibular training; gaze stability; Balance; Gait; older adults