Can Entertaining Action-video Games Enhance Dynamic Visual Function and Improve Balance? A Randomized Controlled Trial.

Study Overview
=================
Brief Summary
-----------------
This project is aimed to find out whether action video games can enhance dynamic visual function and improve balance function in the community-dwelling older adults. It is also aimed to examine the relationship between dynamic visions and balance functions.

Detailed Description
-----------------
Balance control is an important component even in a very simple daily task like walking. However, as we age, our physical and visual function would gradually deteriorate even in the absence of health or eye problems. Improving elderly balance control through different training is one way to prevent falls. In our project, we investigate the use of action video games, which is easy-to-find and entertaining, as a visual function trainer to improve balance of older adults. We hypothesize that the training would show an improvement in both balance and dynamic vision. Our primary hypothesis is that postural sway in static and dynamic balance measures will improve after action video-game intervention. For secondary outcome measures, we hypothesize that the training will improve dynamic visual function (as measured by dynamic visual acuity and dynamic contrast sensitivity), and visual attention measures (as measured by useful field of view, multiple object tracking and spatial attention).

Official Title
-----------------
Can Entertaining Action-video Games Enhance Dynamic Visual Functions and Improve Balance? A Randomized Controlled Trial.

Conditions
-----------------
Vision, Balance and Falls in Older Adults

Intervention / Treatment
-----------------
* Behavioral: Slow-paced action video game
* Behavioral: Fast-paced action video game
* Behavioral: Control


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Ability to understand and speak Cantonese No formal training or regular practice of balance function (e.g. Tai-chi) Little and preferably no video-game experience Best corrected distance acuity of 0.2 logMAR or better Exclusion Criteria: Any diagnosed ocular diseases and ocular-motor abnormalities Suffering form severe medical problems or self reported neurological or cognitive disorders Suffering from physical impairments or physical limitations restricting them from training Having self reported vestibular or cerebellar dysfunction, history of vertigo or severe hearing loss Suffering from crippling arthritis, or a recent fracture of lower limb Planned major surgery during the trial

Ages Eligible for Study
-----------------
Minimum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Control Group<br>Receive leisure activities (e.g. reading, web-surfing, playing chess/ Mahjong) Twenty hours (2-3 sessions per week, 1.5 hours per session) | Behavioral: Control<br>* 20 hours leisure activities<br>|
| Active Comparator: Intervention Group 1<br>Receive slow motion Nintendo Wii video games Twenty hours ( 2-3 sessions per week, 1.5 hours per session) | Behavioral: Slow-paced action video game<br>* 20 hours slow-paced action video games<br>|
| Active Comparator: Intervention Group 2<br>Receive fast motion Nintendo Wii video games (e.g. shooting game) Twenty hours ( 2-3 sessions per week, 1.5 hours per session) | Behavioral: Fast-paced action video game<br>* 20 hours fast-paced action video games<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Static and dynamic postural sway on forced platform | Static Balance - postural sway when standing on firm or foam surface. Dynamic Balance: Limits of stability (LOS) Sequential weight shifting test (SWS) | Change from baseline at week 8 and change from baseline at week 16 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Grating visual acuity at different moving speeds | Dynamic visual function measure - Grating visual acuity is measured with different moving speeds | Change from baseline at week 8 and change from baseline at week 16 | 
| Useful Field of View (UFOV) | One of the visual attention measures - Useful Field of View (UFOV) | Change from baseline at week 8 and change from baseline at week 16 | 
| Multiple tracking objects (MOT) | One of the visual attention measures - Multiple tracking objects (MOT) | Change from baseline at week 8 and change from baseline at week 16 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
balance, visual function, community-dwelling older adults, action video-game