Clinical trial NCT04959383: Exergame Balance Training for Patients With Mild Cognitive Impairment
Official title: Exergame Balance Training for Pre Frontal Brain Activity and Executive Functioning in Patients With Mild Cognitive Impairment
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Mild Cognitive Impairment
Keywords: Brain Activity
Executive Functions
Exergame balance training
Mild Cognitive Impairment
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2021-07-13
Enrollment: 90
Sex: ALL
Minimum age (years): 55
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Assignment
Primary purpose: TREATMENT

Brief summary: This study will be a randomized control trial, which will be conducted on older adults with mild cognitive impairment. A specially designed Exergame balance training will be used for cognitive enhancement in patients with MCI. This training will determine the improvement in executive functioning, balance, speech and electrical activity of the brain.

Detailed description: From last few years the line of research for cognitive enhancement has been shifted towards balance training as balance training is considered to directly stimulate the neuronal activity as compare to aerobic training. The previous finding also proposed that in aerobic training it is the intensity of training that improves the neuroplasticity and cognition but it is the neuro-cognitive demands and complexity of the task in balance training that affects the relationship between exercise and cognition in balance training. There is a need to determine the effect of the level of complexity of balance training on neural activity and executive functioning. Exergame augmented balance training is expected to have a better physical and cognitive outcome as compared to traditional balance training.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 55
* MoCA =20-24
* CDR ( dementia rating scale)≤ 1.0
* No unstable disease precluding planned exercise.
* Able to see and hear sufficiently to participate in planned physical and computer-based cognitive training.
* Patients score \>45 on Berg Balance Scale.

Exclusion Criteria:

* Participation in any cognitive training activity
* Participation in \> 150 min/wk of moderate or greater intensity planned exercise of any kind.
* 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, or laboratory abnormality that would interfere with the ability to participate in the study.
* Individual with any musculoskeletal impairment.
* Unwillingness to participate.

Primary outcomes:
measure: Stroop test
timeFrame: 8th weeks
measure: Trails Test
timeFrame: 8th weeks
measure: Digit Span Forward and Backward
timeFrame: 8th weeks
measure: Montreal Cognitive Assessment
timeFrame: 8th weeks
measure: Alzheimer's disease Assessment Scale
timeFrame: 8th weeks
measure: Time Up and Go Test
timeFrame: 8th weeks
measure: Mini Brief Balance Evaluation Systems
timeFrame: 8th weeks
measure: Smartphone Gait and Balance Application
timeFrame: 8th weeks
measure: Force Plate
timeFrame: 8th weeks
measure: Gait Speed Assessment
timeFrame: 8th weeks
measure: Electroencephalography
timeFrame: 8th week
measure: Blood Biomarkers
timeFrame: 8th weeks
Secondary outcomes:
measure: Voice Recording
timeFrame: 8th weeks
Other outcomes:
measure: MRI of Brain
timeFrame: 8th weeks
Locations:
city: Rawalpindi
country: Pakistan
facility: Railway General Hospital
Study officials:
affiliation: Riphah international university.pakistan
name: Imran Amjad, PhD
role: STUDY_CHAIR
References:
citation: Fjell AM, Walhovd KB. Structural brain changes in aging: courses, causes and cognitive consequences. Rev Neurosci. 2010;21(3):187-221. doi: 10.1515/revneuro.2010.21.3.187.
citation: Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, Ritchie K, Rossor M, Thal L, Winblad B. Current concepts in mild cognitive impairment. Arch Neurol. 2001 Dec;58(12):1985-92. doi: 10.1001/archneur.58.12.1985.
citation: Hanninen T, Hallikainen M, Tuomainen S, Vanhanen M, Soininen H. Prevalence of mild cognitive impairment: a population-based study in elderly subjects. Acta Neurol Scand. 2002 Sep;106(3):148-54. doi: 10.1034/j.1600-0404.2002.01225.x.
citation: Angevaren M, Aufdemkampe G, Verhaar HJ, Aleman A, Vanhees L. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005381. doi: 10.1002/14651858.CD005381.pub2.
citation: Ludyga S, Gerber M, Brand S, Holsboer-Trachsler E, Puhse U. Acute effects of moderate aerobic exercise on specific aspects of executive function in different age and fitness groups: A meta-analysis. Psychophysiology. 2016 Nov;53(11):1611-1626. doi: 10.1111/psyp.12736. Epub 2016 Aug 24.
citation: Saraulli D, Costanzi M, Mastrorilli V, Farioli-Vecchioli S. The Long Run: Neuroprotective Effects of Physical Exercise on Adult Neurogenesis from Youth to Old Age. Curr Neuropharmacol. 2017;15(4):519-533. doi: 10.2174/1570159X14666160412150223.
citation: Christie BR, Eadie BD, Kannangara TS, Robillard JM, Shin J, Titterness AK. Exercising our brains: how physical activity impacts synaptic plasticity in the dentate gyrus. Neuromolecular Med. 2008;10(2):47-58. doi: 10.1007/s12017-008-8033-2. Epub 2008 Jun 6.
citation: Fabre C, Chamari K, Mucci P, Masse-Biron J, Prefaut C. Improvement of cognitive function by mental and/or individualized aerobic training in healthy elderly subjects. Int J Sports Med. 2002 Aug;23(6):415-21. doi: 10.1055/s-2002-33735.
citation: Barnes DE, Santos-Modesitt W, Poelke G, Kramer AF, Castro C, Middleton LE, Yaffe K. The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults. JAMA Intern Med. 2013 May 13;173(9):797-804. doi: 10.1001/jamainternmed.2013.189.
citation: Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA. Exergaming and older adult cognition: a cluster randomized clinical trial. Am J Prev Med. 2012 Feb;42(2):109-19. doi: 10.1016/j.amepre.2011.10.016.
citation: Hosseini SM, Kramer JH, Kesler SR. Neural correlates of cognitive intervention in persons at risk of developing Alzheimer's disease. Front Aging Neurosci. 2014 Aug 26;6:231. doi: 10.3389/fnagi.2014.00231. eCollection 2014.
citation: Shubert TE, McCulloch K, Hartman M, Giuliani CA. The effect of an exercise-based balance intervention on physical and cognitive performance for older adults: a pilot study. J Geriatr Phys Ther. 2010 Oct-Dec;33(4):157-64.
citation: Ries JD, Hutson J, Maralit LA, Brown MB. Group Balance Training Specifically Designed for Individuals With Alzheimer Disease: Impact on Berg Balance Scale, Timed Up and Go, Gait Speed, and Mini-Mental Status Examination. J Geriatr Phys Ther. 2015 Oct-Dec;38(4):183-93. doi: 10.1519/JPT.0000000000000030.
citation: Rogge AK, Roder B, Zech A, Nagel V, Hollander K, Braumann KM, Hotting K. Balance training improves memory and spatial cognition in healthy adults. Sci Rep. 2017 Jul 18;7(1):5661. doi: 10.1038/s41598-017-06071-9.
citation: Greblo Jurakic Z, Krizanic V, Sarabon N, Markovic G. Effects of feedback-based balance and core resistance training vs. Pilates training on cognitive functions in older women with mild cognitive impairment: a pilot randomized controlled trial. Aging Clin Exp Res. 2017 Dec;29(6):1295-1298. doi: 10.1007/s40520-017-0740-9. Epub 2017 Mar 1.
citation: Eggenberger P, Wolf M, Schumann M, de Bruin ED. Exergame and Balance Training Modulate Prefrontal Brain Activity during Walking and Enhance Executive Function in Older Adults. Front Aging Neurosci. 2016 Apr 12;8:66. doi: 10.3389/fnagi.2016.00066. eCollection 2016.
citation: Schattin A, Arner R, Gennaro F, de Bruin ED. Adaptations of Prefrontal Brain Activity, Executive Functions, and Gait in Healthy Elderly Following Exergame and Balance Training: A Randomized-Controlled Study. Front Aging Neurosci. 2016 Nov 23;8:278. doi: 10.3389/fnagi.2016.00278. eCollection 2016.