Exer-game Balance Training on Dementia

Study Overview
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Brief Summary
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Age-related cognitive impairment is a wide phenomenon. Mild cognitive impairment is a transitional stage between Dementia and normal cognition.Mild cognitive impairment (MCI) is a syndrome that has been recognized in older adults and it has become a topic of a major focus on clinical care and research. In people with this condition, there are cognitive deficits and these have adverse effects on activities of daily living . These patients cannot recognize their impairment. Mild cognitive impairment is a risk factor for dementia.

Detailed Description
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The clinical features of MCI are memory impairment along with language or speech impairments, executive functions, and visuospatial impairments. In regard to clinical features of Mild cognitive impairment (MCI), there are motor problems as patients have difficulty in doing complex motor tasks like doing pegboard assembly and also in fine and gross motor skills performance like they have difficulty in maintaining balance and body weight. Major factors contributing to mild cognitive impairment or major causes are medical conditions like hepatic or renal failure, depression, sleep disturbances, psychological problems,s and medicine side effects. impaired attention and concentration can lead to impaired memory and a decline in cognitive function. As literature supports the evidence of the effectiveness of Exergaming in adults with neurocognitive disorders.As Exer-gaming training program improved their lower extremity functioning, cognitive function, and reduced depression, neuropsychiatric symptoms too. Recent studies on the treatment of Exergaming and its effect on the quality of life in dementia approach the standing balance Exer-gaming being effective and has increased attention, concentration, memory, and reaction time and has improved physical, cognitive, emotional, social function and quality of life and decreased the level of frailty in dementia patients. Recent literature on Exergaming has successfully improved cognition, balance,gait, and verbal memory in MCI patients and reduced fall risk in older adults of age >55 years

Official Title
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Effects of Exergame Balance Training on Dementia-Related Quality of Life and Self-Efficacy in Patients With Mild Cognitive Impairment

Conditions
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Mild Cognitive Impairment

Intervention / Treatment
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* Other: Exergaming low intensity group
* Other: Exergaming moderate intensity group
* Other: Exergaming high intensity group
* Other: control group exergaming


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals >55 years of age. Patients meeting mild cognitive impairment (MCI), The Montreal Cognitive Assessment (MoCA) 20-24. clinical dementia rating scale (CDR) ≤ 1.0 No unstable disease precluding the planned exercise Able to see and hear sufficiently to participate in planned physical and computer-based cognitive training Exclusion Criteria: Non-ambulatory or major mobility disorder; Other neurological conditions associated with cognitive impairment such as stroke, Parkinson disease, and head injury Any clinically significant psychiatric condition, current drug or alcohol abuse, that would interfere with the ability to participate in the study Severe visual impairment Unwillingness to participate

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: low intensity group<br>Will receive wobble board based Exergame balance training, game intensity will be low for this group (Size of goal will be kept large) | Other: Exergaming low intensity group<br>* wobble board-based Exergame balance training, the game intensity will be low for this group (Size of goal will be kept small for 3 times a week, 30 minutes per day for 8 weeks.<br>|
| Experimental: moderate intensity group<br>Will receive wobble board based Exergame balance training, game intensity will be low for this group (Size of goal will be kept large) | Other: Exergaming moderate intensity group<br>* Wobble board-based Exer- game balance training, the game intensity will be moderate for this group (size of goal will be kept medium).for 3 times a week, 30 minutes per day for 8 weeks.<br>|
| Experimental: high intensity group<br>Will receive wobble board-based Exergame balance training, game intensity will be high for this group (Size of goal will be kept small). | Other: Exergaming high intensity group<br>* Wobble board-based Exer- game balance training, the game intensity will be moderate for this group (size of goal will be kept high).for 3 times a week, 30 minutes per day for 8 weeks.<br>|
| Active Comparator: control group<br>Will receive Exer-game balance training with Wii Fit balance games | Other: control group exergaming<br>* Exer games training with soccer heading and penguin slide games(Wii Fitt balance games) for 3 times a week, 30 minutes per day for 8 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| DEMENTIA QUALITY OF LIFE QUESTIONAIRRE (DEMQOL) | it has 29 statements with five scales and each scale score is measured by taking mean of the individual items. Every item have a 5-point scale response format on enjoyment (not at all, a lot) and frequency (never, very often). | week 8 | 
| General Self Efficacy scale | This tool tells human behavior and coping outcomes. It's very useful with studying behaviour of people who are living with any illness. This scale have 10-items and possible responses are not at all ,all true1=hardly true, 2=moderately true,3= exactly true,4=total score between 10 and 40 | week 8 | 
| 2 Minute Walk test (2MWT) | is a reliable and valid tool for accessing balance in older adults. Instructions given to the participants are that you have to walk at your comfortable zone. The assessor will be half a meter behind the participant to ensure his/her safety. No encouragement or feedback is given during the whole test. Two practice trials and one final trial for record are performed. The participants are given at least 10 min rest between trials. The distance covered in the 2 min is recorded as the 2MWT | week 8 |