Virtual Reality And Task Oriented Circuit Training Among Elderly Population
Condition: Elderly
Study type: Interventional

Summary: 
      There is a paucity of literature in studying the comparative effects of Virtual Reality and
      Circuit training in elderly population for fall prevention. This study will also analyze the
      effects of the comparative intervention on Gait, Balance and Cognition. This will also deduce
      the impact of Virtual reality and Circuit training on Quality of Life QOL.
    

Detailed description: 
      As the individual ages, numerous physical and functional alterations occur especially
      frailty, disturbed body balance, physical and cognitive declines, impaired gait hence leading
      to falls among the elderly population. Fall is defined as an event in which an individual
      unintentionally loses balance and inadvertently coming to rest on ground or lower surface.
      While Balance is the ability to maintain the center of mass on the base of support (BOS)
      without causing a fall. According to WHO survey, falls are the second leading cause of
      accidental or unintentional injury deaths worldwide. Approximately 40% of older adults
      >65years fall at least once a year and 10-20% of these falls results in hospitalizations
      which leads to poor Quality of Life. Women are more prone for age specific fall rates as
      compared to men. Cognition is referred to as "The mental action or process of acquiring
      knowledge and understanding through thought, experience, and the senses". Optimum cognitive
      levels are important for successful aging and any deficits should be monitored. Altered
      cognition affects the Activities of Daily living (ADL), causes disabilities and directly
      impacts the Quality of Life. A study by Ray et al, deduced that Cognitive training
      significantly increased the Gait speed and improved the Timed up and go test values, hence
      Cognitive training slows degradation of balance and improves gait while distracted, rendering
      it a promising approach to falls prevention.

      United States Preventive Service Task Force (USPSTF), evaluated that risk of falls increases
      with age and include multiple factors: Balance and gait deficits, cognitive impairments,
      medications, frailty, fear of falling, vision and environmental hazard. USPSTF recommends
      multifactorial interventions to address the balance and fall related issues among elderly.
      These protocols include improving Balance and gait, improving cognition, environmental
      alterations, balanced diet and nutrition along with appropriate medications. Adequate
      exercises helps to improve general body conditioning to overcome the deteriorating effects of
      aging hence, better Quality of life QOL. Previously it has been reported that a number of
      specific approaches are useful in improving balance, gait and cognition as compared to
      general conventional therapies: they include Virtual Reality, Goal oriented training,
      Task-oriented training, Kinect training and Visual feedback, Motivational interventions with
      active participations and Focused repetitive training.

      As the technological advancement has occurred in recent years, "Virtual Reality" is being
      incorporated in the PT management sessions to minimize the limitations in the existing
      interventions and hence improving the deficits. VR training refers to interactive
      stimulations enabling the user to experience the virtual environment similar to reality by
      incorporating computer hardware and software. In comparison to home-based exercise plans, VR
      training enhances motivation by introducing practical gaming element. A Study conducted by on
      elderly 60-85yrs and they assessed the effects of Wifiit VR games and found that the scores
      of body Center of pressure-COP movement area (Romberg test) with eyes open and eyes closed
      improved among experimental group individuals after 8 weeks of trials hence improved Balance.
      Likewise as reported , VR game exercises improves balance and gait in elderly over 65 yrs of
      age - increases the step length while average Sway time and Time up and go test TUG both
      decreased towards normal as compared to conventional Ball exercises.

      Task oriented Circuit training CT is a series of systematically devised protocol, which
      embodies multiple endurance and strength training parameters with moderate and high
      intensities and sufficient repetitions of functional tasks. As reported that Circuit training
      improves the partial O2 concentration, Respiratory rate-RR, HR hence overall cardiac
      endurance and physical functioning. CT also helps in maintenance of functional Quality of
      life. Several studies have reported that Virtual Reality and Task-oriented circuit training
      also assists in motor and balance recovery among the stroke and CP. As documented by Lee et
      al,(13) they compared the effects of VR against CT among the stroke patients and concluded
      that static balance and Functional reach test outcomes were higher in VR group as compared to
      CT group hence making Virtual Reality more feasible for balance training. A study concluded
      that on older adults and deduced that VR training causes improvement in hip muscle strength
      of the extensors, flexors, adductors, and abductors after 8 weeks along with greater ground
      reaction force on the backward stepping test (with eyes opened and closed) and the crossover
      stepping test( with eyes open and closed).
    

Intervention name(s): Virtual reality training group; Circuit Training group
Intervention type(s): Other; Other
Intervention description(s): This group will receive video based games; They will receive Task-oriented Circuit training exercise program
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other