Immersive virtual reality exergames to promote well-being of community-dwelling older adults: a mixed-methods pilot study protocol (Preprint)

BACKGROUND Despite the proven benefits of exercise in older adults, challenges such as access and motivation can deter older adults’ engagement. Interactive virtual reality games that are combined with exercise (VR exergames) are a plausible strategy to encourage physical activity among this population. However, there has been little research regarding the feasibility, acceptability, and potential benefits of deploying at-home VR exergames among community-dwelling older adults. OBJECTIVE The objectives of this pilot study are to i) estimate the feasibility, usability, and acceptability of a co-designed VR exergame in community-dwelling older adults; ii) examine the feasibility of the intervention and assessment protocols to use them in a future large-scale trial; and iii) provide pilot data on outcomes of interest including physical activity, exercise self-efficacy, mood, cognition, perception, and gameplay metrics. METHODS The pilot study will be a remote, 6-week intervention study consisting of an experimental and a control group. A sample of at least 12 community-dwelling older adults (with no or mild cognitive impairment) will be recruited for each group. Both participant groups will follow the same study procedures and assessment methods. However, participants in the experimental group will engage with a co-designed VR exergame (Seas The Day) three times/week for approximately 20 minutes, using the Oculus Quest 2 VR headset. Those recruited for the control study will not have exposure to the exergame and instead they will read thrice/week for approximately 20 minutes over the 6-week period. A mixed-methods evaluation will be used. Changes in physical activity, exercise self-efficacy, mood, cognition, and perception will be analyzed pre- and post-acute as well as pre- and post-6 weeks between the experimental (exergaming) and control (reading) groups. Qualitative data from post-intervention focus groups/interviews, as well as informal notes and reports from all participants, will be analyzed to assess the feasibility of the study protocol. Qualitative data from the experimental group will also be analyzed to assess the feasibility, usability, and acceptability of at-home VR exergame and explore perceived facilitators and barriers of uptaking VR systems among community-dwelling older adults. RESULTS The screening and recruitment process for the experimental group started in May 2021 and the data collection process will be ongoing until September 2021. Recruitment process for the control group has not started, however, data collection will be complete by December 2021. CONCLUSIONS This pilot study with an experimental and control group will provide important information on the feasibility, acceptability, and usability of a custom-made VR exergaming intervention to promote older adults’ well-being. Findings from this study will be useful to inform the methodology, design, study procedures, and assessment protocol for future large-scale trials of VR exergames with older adults as well as deepening the understanding of remote deployment and at-home use of VR for older adults exercise.

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“Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189514 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9514

Author(s):

Shefaly Shorey ◽

Ee Heok Kua ◽

Wilson Tam ◽

Valerie Chan ◽

Yong Shian Goh ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Pilot Study ◽

Intervention Group ◽

Well Being ◽

Small Sample ◽

Community Dwelling ◽

Control Group ◽

Community Dwelling Older Adults

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.

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Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136682 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6682

Author(s):

Hilde Bremseth Bårdstu ◽

Vidar Andersen ◽

Marius Steiro Fimland ◽

Lene Aasdahl ◽

Hilde Lohne-Seiler ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Resistance Training ◽

Home Care ◽

Community Dwelling ◽

Activity Level ◽

Group Differences ◽

Control Group ◽

Cluster Randomized ◽

Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

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The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17144966 ◽

2020 ◽

Vol 17 (14) ◽

pp. 4966

Author(s):

Ziyan Li ◽

Mimi Tse ◽

Angel Tang

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Controlled Trial ◽

The Elderly ◽

Management Program ◽

Community Dwelling ◽

Control Group ◽

Pain Management Program ◽

Community Dwelling Older Adults ◽

Experimental Group

Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.

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AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.603 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S169-S169

Author(s):

Junxin Li ◽

Sarah Szanton ◽

Minhui Liu ◽

Nada Lukkahatai ◽

Junxin Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Quality ◽

Behavioral Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Tnf Α ◽

Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

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An mHealth-Facilitated Personalized Intervention for Physical Activity and Sleep in Community-Dwelling Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0463 ◽

2021 ◽

pp. 1-10

Author(s):

Junxin Li ◽

Sarah L. Szanton ◽

Miranda V. McPhillips ◽

Nada Lukkahatai ◽

Grace W. Pien ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Financial Incentives ◽

Pilot Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Subjective Sleep Quality ◽

Community Dwelling Older Adults ◽

Personalized Intervention

This randomized controlled pilot trial tested the preliminary effect of a 24-week mHealth-facilitated, personalized intervention on physical activity (PA) and sleep in 21 community-dwelling older adults. The intervention included a personalized exercise prescription, training, goal setting, and financial incentives. mHealth strategies, including self-monitoring, motivational messages, activity reminders, and phone coaching, were used to facilitate PA participation. PA and sleep were measured using actigraphy and questionnaires at baseline and 8-, 16-, and 24-week visits. Participants in the intervention group had lower objective PA levels at 24 weeks than at 8 and 16 weeks, although levels of PA remained higher than at baseline. Compared with the control group, the intervention increased PA at 8, 16, and 24 weeks; improved subjective sleep quality at 16 and 24 weeks; and increased actigraphy-measured sleep duration and sleep efficiency at 24 weeks. mHealth PA interventions may benefit PA and sleep in older adults. Strategies for maintaining long-term PA behavioral changes are needed.

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Effects of Semi-Immersive Virtual Reality-Based Cognitive Training Combined with Locomotor Activity on Cognitive Function and Gait Ability in Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare9070814 ◽

2021 ◽

Vol 9 (7) ◽

pp. 814

Author(s):

Na-Kyoung Hwang ◽

Jong-Bae Choi ◽

Dae-Kil Choi ◽

Jae-Min Park ◽

Chang-Wan Hong ◽

...

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Cognitive Function ◽

Locomotor Activity ◽

Cognitive Training ◽

Community Dwelling ◽

Control Group ◽

Immersive Virtual Reality ◽

Community Dwelling Older Adults ◽

Experimental Group

This study aimed to investigate the effects of semi-immersive virtual reality-based cognitive training (VRCT) combined with locomotor activity on cognitive function, balance, and gait ability in older adults. Eighteen community-dwelling older adults participated in this study. Subjects who met the selection criteria were assigned to an experimental group (n = 9) and a control group (n = 9). The experimental group received VRCT combined with locomotor activity for 30 min a day, three times a week, for 6 weeks. The control group received tabletop activity-based cognitive training for the same amount of time. Before and after the training, the Korean Mini-Mental State Examination (K-MMSE), Trail Making Test (TMT; A and B), and Digit Span Test (DST; forward and backward) were used to evaluate cognitive function; and the Timed Up and Go (TUG) test and 10-m Walking Test (10MWT) were used to evaluate the improvement in the balance and gait ability parameters. After the intervention, the experimental group showed a significantly greater improvement in the TMT-A (p = 0.045) and DST-backward (p = 0.012) scores compared with the control group. Regarding the gait ability variable, the experimental group showed a significant improvement in the 10MWT test (p = 0.001). This study confirmed that semi-immersive VRCT combined with locomotor activity is useful for improving cognitive function and gait ability in older adults. Therefore, VRCT combined with locomotor activity can be used as a simultaneous intervention for cognitive rehabilitation and functional capacity improvement in older adults.

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Promoting self-transcendence and well-being in community-dwelling older adults: A pilot study of a psychoeducational intervention

Geriatric Nursing ◽

10.1016/j.gerinurse.2015.06.007 ◽

2015 ◽

Vol 36 (6) ◽

pp. 431-437 ◽

Cited By ~ 5

Author(s):

Valerie Lander McCarthy ◽

Jiying Ling ◽

Sharon Bowland ◽

Lynne A. Hall ◽

Jennifer Connelly

Keyword(s):

Older Adults ◽

Pilot Study ◽

Well Being ◽

Community Dwelling ◽

Psychoeducational Intervention ◽

Self Transcendence ◽

Community Dwelling Older Adults

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Exploring the Effects of Arts Intervention Groups on Well-Being Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.093 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 29-29

Author(s):

Emily Ihara ◽

Kathryn McNeil ◽

Adriana Lopez-Piper ◽

Maxine Eber ◽

Catherine Tompkins ◽

...

Keyword(s):

Older Adults ◽

Focus Groups ◽

Controlled Trial ◽

Subjective Evaluation ◽

Well Being ◽

Community Dwelling ◽

Social Connections ◽

Control Group ◽

Social Conversation ◽

Community Dwelling Older Adults

Abstract Engaging in the arts reportedly improves well-being, but research is limited on the specific effects for community-dwelling older adults. The purpose of this randomized controlled trial was to examine how taking part in different arts interventions (dance & music), affects older adults’ overall well-being compared to a social conversation control group. Sixty-four participants (mean = 71 years old) participated twice weekly in a 10-week intervention that included ballroom dancing (n=23), ukulele playing (n=17), and social conversation (n=24). At the conclusion, three focus groups were held to assess participants’ experiences and subjective evaluation of the interventions’ impact. Twenty-two out of the sixty-four participants (dance= 8, ukulele = 6, social conversation = 8) took part in focus groups. Transcripts of the recorded focus groups were independently coded and compared. Common themes were agreed-upon by two researchers. Focus groups revealed positive outcomes for participants in all three groups. Several themes emerged across the intervention groups compared to the control group, including participants feeling challenged as they crossed their comfort zones, reporting increased confidence, enhanced social connections, and a sense of accomplishment when learning new skills. Community-dwelling older adults reported improved health-related outcomes after taking part in arts and social conversation sessions. Implementation of community-engaged arts intervention programs for older adults in the future may examine motivators which attract participants, foster positive social connections during sessions, and use participant-empowering pedagogical adaptations to retain participants. These factors can increase the efficacy of arts-engaged programs and help improve well-being in older adults.

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The Mediating Effects of Resilience, Morale, and Sense of Coherence Between Physical Activity and Perceived Physical/Mental Health Among Japanese Community-Dwelling Older Adults: A Cross-Sectional Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2017-0265 ◽

2018 ◽

Vol 26 (4) ◽

pp. 544-552 ◽

Cited By ~ 5

Author(s):

Hiroko Kukihara ◽

Niwako Yamawaki ◽

Michiyo Ando ◽

Yoshiko Tamura ◽

Kumi Arita ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Older Adults ◽

Sense Of Coherence ◽

Short Form ◽

Well Being ◽

Community Dwelling ◽

Mediating Effects ◽

Community Dwelling Older Adults ◽

The Relationship

The aim of this study was to examine the mediating effects of resilience, morale, and sense of coherence on the relationship between physical activity and respondents’ perceived physical/mental health and depression among community-dwelling older adults in Japan. The study included 369 participants with an average age of 74 years from Kasuishimohara District in Fukuoka Prefecture, Japan. They completed a survey that included the Resilience Scale, the Sense of Coherence Scale, the Medical Outcomes Short Form 8, the Philadelphia Geriatric Center Morale Scale, the Geriatric Depression Scale (Short Form), and a demographic questionnaire. The results of the path mediation analyses revealed that resilience and morale fully mediated the relationship between physical activity and perceived physical/mental health and depression. However, sense of coherence was not a significant mediator. Some intervention programs are suggested to maximize the effects of physical activity on one’s well-being. At-risk populations who need such programs are also discussed.

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Effects of Exercise Training Combined with Increased Physical Activity to Prevent Chronic Pain in Community-Dwelling Older Adults: A Preliminary Randomized Controlled Trial

Pain Research and Management ◽

10.1155/2018/2132039 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Tatsuya Hirase ◽

Hideki Kataoka ◽

Shigeru Inokuchi ◽

Jiro Nakano ◽

Junya Sakamoto ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Exercise Training ◽

Controlled Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Randomized Controlled ◽

Community Dwelling Older Adults

Objective. With the aim of developing a chronic pain prevention program, this randomized controlled trial examined whether exercise training combined with increased physical activity more effectively improves pain and physical activity than exercise training alone in community-dwelling older adults without chronic pain. Methods. We randomized 76 older adults without chronic pain into an intervention group n=38 involving exercise training combined with increased physical activity and a control group n=38 involving exercise training alone. The exercise training comprised weekly 60-min sessions for 12 weeks. The program to increase physical activity required participants to record their daily step counts using pedometers. Pain intensity, total number of pain sites, and physical activity were assessed before and 12 weeks after the intervention. Results. A time-by-group interaction was found for physical activity, with the intervention group showing significant improvement p<0.05. The intervention group also showed greater improvement in pain intensity and total number of pain sites at 12 weeks after intervention than the control group p<0.05. Conclusions. In older adults without chronic pain, exercise training combined with increased physical activity improves key outcome indicators more effectively than exercise training alone. “This trial is registered with UMIN000018503.”

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