Time course of changes in motor-cognitive exergame performances during task-specific training in patients with dementia: identification and predictors of early training response.
Christian Werner, Rebekka Rosner, Stefanie Wiloth and 3 others
PMID 30409202WHAT IT FOUND
In mild-to-moderate dementia, exergame balance training improved completion time within 3 weeks.
Gains were largest early, then plateaued; more complex tasks still improved over the full 10 weeks. Patients with poorer baseline task, visuospatial, and dual-task scores responded fastest.
Key findings
01Performance improved significantly on every exergame task after the first seven training sessions.
02Four of six tasks did not change significantly between sessions 7 and 14, but all tasks improved from session 7 to post-intervention, with the largest gains on the most complex tasks.
03Early response was predicted by poorer baseline exergame performance, lower visuospatial constructional praxis, and poorer dual-task performance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a secondary analysis of only the intervention group, and the control group was assessed only before and after training, so the time course cannot be compared with placebo. The sample was small, and the more complex tasks had even fewer participants, with 13 completing level 5. Participants could walk at least 10 m without a walking aid and had mild-to-moderate dementia, so results do not apply to severe dementia or patients who cannot walk without aids. The early-response analysis used 52 participants and was exploratory, so the predictor model may be imprecise. Transfer outcomes such as balance and cognitive functioning were not analyzed in this study.
Declared interests
Funding is named as Dietmar Hopp Stiftung, Robert Bosch Stiftung, and the Network of Aging Research at the Heidelberg University. The supplied text does not list author conflict-of-interest disclosures.
The easy way to misread this
Do not conclude that this training reduces falls or improves global cognition. The study measured only completion time on the exergame tasks, did not test transfer to balance or cognition, and did not compare mid-training changes with the placebo group.