A New Approach to Improve Cognition, Muscle Strength, and Postural Balance in Community-Dwelling Elderly with a 3-D Virtual Reality Kayak Program.

Aging is usually accompanied with deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity. Recently, intervention methods with virtual reality have been introduced, providing an enjoyable therapy for elderly. The aim of this study was to investigate whether a 3-D virtual reality kayak program could improve the cognitive function, muscle strength, and balance of community-dwelling elderly. Importantly, kayaking involves most of the upper body musculature and needs the balance control. Seventy-two participants were randomly allocated into the kayak program group (n = 36) and the control group (n = 36). The two groups were well matched with respect to general characteristics at baseline. The participants in both groups performed a conventional exercise program for 30 min, and then the 3-D virtual reality kayak program was performed in the kayak program group for 20 min, two times a week for 6 weeks. Cognitive function was measured using the Montreal Cognitive Assessment. Muscle strength was measured using the arm curl and handgrip strength tests. Standing and sitting balance was measured using the Good Balance system. The post-test was performed in the same manner as the pre-test; the overall outcomes such as cognitive function (p < 0.05), muscle strength (p < 0.05), and balance (standing and sitting balance, p < 0.05) were significantly improved in kayak program group compared to the control group. We propose that the 3-D virtual reality kayak program is a promising intervention method for improving the cognitive function, muscle strength, and balance of elderly.

[1]  Mariana Asmar Alencar,et al.  Força de preensão palmar em idosos com demência: estudo da confiabilidade , 2012 .

[2]  P. Abizanda,et al.  Validity and usefulness of hand-held dynamometry for measuring muscle strength in community-dwelling older persons. , 2012, Archives of gerontology and geriatrics.

[3]  Winifred Schultz-Krohn,et al.  Pedretti's Occupational Therapy: Practice Skills for Physical Dysfunction , 2012 .

[4]  J. Kloubec.  Pilates for Improvement of Muscle Endurance, Flexibility, Balance, and Posture , 2010, Journal of strength and conditioning research.

[5]  F. Shaw.  Falls in cognitive impairment and dementia. , 2002, Clinics in geriatric medicine.

[6]  J. M. D. Dias,et al.  Handgrip strength in elderly with dementia: study of reliability. , 2012, Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil)).

[7]  K. Markides,et al.  Handgrip strength and cognitive decline in older Mexican Americans. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  T. Vahlberg,et al.  Effects of risk-based multifactorial fall prevention on postural balance in the community-dwelling aged: a randomized controlled trial. , 2009, Archives of gerontology and geriatrics.

[9]  Albert Gollhofer,et al.  Effects of Core Instability Strength Training on Trunk Muscle Strength, Spinal Mobility, Dynamic Balance and Functional Mobility in Older Adults , 2012, Gerontology.

[10]  Heidi Sveistrup,et al.  Feasibility, Motivation, and Selective Motor Control: Virtual Reality Compared to Conventional Home Exercise in Children with Cerebral Palsy , 2006, Cyberpsychology Behav. Soc. Netw..

[11]  A. Rizzo,et al.  The application of virtual reality technology in rehabilitation. , 2001 .

[12]  A. Thorstensson,et al.  Dynamic trunk stability is improved in paraplegics following kayak ergometer training , 2007, Scandinavian journal of medicine & science in sports.

[13]  S. Shahar,et al.  Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions , 2014, Clinical interventions in aging.

[14]  F. Horak.  Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? , 2006, Age and ageing.

[15]  Roland Holm,et al.  Virtual Reality Training As A Method For Interactive And Experience-based Learning , 2008 .

[16]  David Machin,et al.  Sample Size Tables for Clinical Studies , 1997 .

[17]  Claire Ballinger,et al.  Exercise for improving balance in older people. , 2011, The Cochrane database of systematic reviews.

[18]  James S Goodwin,et al.  The interaction of cognitive and emotional status on subsequent physical functioning in older mexican americans: findings from the Hispanic established population for the epidemiologic study of the elderly. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[19]  C. Wang,et al.  Grip strength in older adults: test-retest reliability and cutoff for subjective weakness of using the hands in heavy tasks. , 2010, Archives of physical medicine and rehabilitation.

[20]  H. Christensen,et al.  Apolipoprotein E ε4 and later-life decline in cognitive function and grip strength. , 2012, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[21]  Sandra Freitas,et al.  Montreal Cognitive Assessment: Validation Study for Mild Cognitive Impairment and Alzheimer Disease , 2013, Alzheimer disease and associated disorders.

[22]  Physical Aspects of Healthy Aging: Assessments of Three Measures of Balance for Studies in Middle-Aged and Older Adults , 2011, Current gerontology and geriatrics research.

[23]  L. Rubenstein.  Falls in older people: epidemiology, risk factors and strategies for prevention. , 2006, Age and ageing.

[24]  S. Jarrot,et al.  Cognitive impairment and effects on upper body strength of adults with dementia. , 2008, Journal of aging and physical activity.

[25]  Mahmood Saghaei,et al.  Random allocation software for parallel group randomized trials , 2004, BMC medical research methodology.

[26]  Misuzu Watanabe,et al.  Handgrip strength as a predictor of higher-level competence decline among community-dwelling Japanese elderly in an urban area during a 4-year follow-up. , 2013, Archives of gerontology and geriatrics.

[27]  T. Masud,et al.  Epidemiology of falls. , 2001, Age and ageing.

[28]  W.-M. Hsieh,et al.  Virtual reality system based on Kinect for the elderly in fall prevention. , 2014, Technology and health care : official journal of the European Society for Engineering and Medicine.

[29]  D. Rand,et al.  The Sony PlayStation II EyeToy: Low-Cost Virtual Reality for Use in Rehabilitation , 2008, Journal of neurologic physical therapy : JNPT.

[30]  Wojtek Chodzko-Zajko,et al.  Reliability and Validity of the Fullerton Functional Fitness Test: An Independent Replication Study , 1999 .

[31]  Kenneth J. Ottenbacher,et al.  Virtual Reality in the Assessment of Selected Cognitive Function After Brain Injury , 2001, American journal of physical medicine & rehabilitation.

[32]  Juliana Maria Gazzola,et al.  Fatores associados ao equilíbrio funcional em idosos com disfunção vestibular crônica , 2006 .

[33]  M. Jeon,et al.  Comparison of body composition, handgrip strength, functional capacity, and physical activity in elderly Koreans and Korean immigrants. , 2009, Research in gerontological nursing.

[34]  J. Timsit,et al.  Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay , 2000, Critical care medicine.

[35]  M. Choe,et al.  Prevalence and predictors of geriatric depression in community-dwelling elderly. , 2009, Asian nursing research.

[36]  Sitting balance and effects of kayak training in paraplegics. , 2004, Journal of rehabilitation medicine.

[37]  J. Williamson,et al.  Associations of gait speed and other measures of physical function with cognition in a healthy cohort of elderly persons. , 2007, The journals of gerontology. Series A, Biological sciences and medical sciences.

[38]  M. Perracini,et al.  Functional balance associated factors in the elderly with chronic vestibular disorder , 2006, Brazilian journal of otorhinolaryngology.

[39]  Duk L. Na,et al.  Brief Screening for Mild Cognitive Impairment in Elderly Outpatient Clinic: Validation of the Korean Version of the Montreal Cognitive Assessment , 2008, Journal of geriatric psychiatry and neurology.

[40]  Upinderpal Singh,et al.  Age related changes in postural stability. , 2007, Indian journal of physiology and pharmacology.

[41]  D. An,et al.  Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly , 2014, Journal of physical therapy science.