With April marking ‘falls awareness month’, NeuRA’s Stephen Lord and Kim Delbaere discuss how traditional video games like Tetris and Word Scramble are being used to prevent falls.
While we know that balance training can prevent falls in older people, long-term participation in these types of exercise programs can be poor due to the often boring nature of repetitive exercises.
At the falls and balance group at Neuroscience Research Australia (NeuRA), we have recently focussed on finding solutions to help older people do the necessary exercises for them to stay independent. This work has led to the development of novel technology-based solutions. Some examples are the SureStep stepping-based exercise program using a dance mat linked to the home’s television, the Standing Tall home-based exercise program using an Apple iPad app, and the iStoppFalls exercise program using a television. By using these technologies, we hope to provide a more convenient way to inform and guide people towards effective exercises for preventing falls.
As part of this, Daniel Schoene, a PhD student at NeuRA, has conducted a series of studies that show the SureStep technology is a valuable tool for fall risk assessment and an excellent means of improving balance and coordinated stepping. We hope that SureStep will provide people with an exercise program, easily integrated into daily life.
The system is simply installed into homes and can reliably assess stepping ability. It involves low-cost computerised training activities that are enjoyable for older adults and incorporate crucial balance-challenging exercises that involve accurate and appropriately timed stepping. Results from two pilot trials indicate that step training can be safely undertaken at home to improve key physical and mental parameters of fall risk in older people.
One major advantage of combining exercise training and video games is the possibility of increasing their complexity, interest and enjoyment by adding challenging mental tasks. Since conducting these pilot trials, we have developed new step training games modified from engaging video games traditionally played with the hands while seated; Tetris, Pacman, Word Scramble, Jigsaw Puzzle, Bejewelled, Pong and Space Invaders, to name a few.
In collaboration with students from Qantm College, we have also created a balance training game that involves navigating through a Greek village while avoiding obstacles and finding treasures. Our next step is to conduct a randomised controlled trial to determine the effects of a home-based step training program on fall risk in older people.
We will also provide people with unobtrusive, continuous monitoring of their activity levels and balance abilities, using state-of-the-art technologies in collaboration with the technology company Philips. This will enable people to keep track of their progress and to manage their risk of falling. We anticipate this project will conclusively demonstrate that interactive step training has good participation and is effective in preventing falls in the wider community.
Following on from our trial, which we envisage will take three years, we aim to make this new technology generally available for people to use in their homes.
Professor Stephen Lord is an applied physiologist working in the areas of balance assessment and fall and fracture prevention. Dr Kim Delbaere is working with older adults both in a clinical setting and at home. More information on NeuRA here.