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VR exergame interventions among older adults living in long-term care facilities: A systematic review with Meta-analysis - 06/05/23

Doi : 10.1016/j.rehab.2022.101702 
Po-Jung Chen a, Hui-Fen Hsu a, Kuei-Min Chen a, b, , Frank Belcastro c
a Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, Taiwan 80708 
b Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan 
c Department of Education and Psychology, University of Dubuque; 2000 University Ave., Dubuque, Iowa 52001, USA 

Corresponding author at: College of Nursing, Kaohsiung Medical University; 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, Taiwan.College of NursingKaohsiung Medical University100 Shih-Chuan 1st Rd., Sanmin DistrictKaohsiungTaiwan

Abstract

Background

To improve the motivation toward exercise in older adults, exergames have shifted from entertainment to rehabilitation.

Objectives

To review the training focus of exergames and analyze the effectiveness of exergame training on physical, psychological, or cognitive outcomes among older adults in long-term care facilities (LTCFs).

Methods

This review followed the PRISMA guidelines. By searching 7 electronic databases up to April 30, 2022, studies were included if they 1) involved adults ≥65 years old residing in LTCFs, 2) were randomized controlled trials (RCTs) with virtual reality-based exergames as the intervention, 3) compared the effects of exergames to usual care or conventional exercises, and 4) reported physical, psychological, or cognitive outcomes. The Cochrane Risk-of-Bias tool for randomized trials version 2 (RoB 2) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to evaluate the methodological quality of studies and levels of evidence for outcomes. The meta-analysis was conducted with Review Manager 5.4. Results are presented as standardized mean differences (SMDs) and 95% confidence intervals (CIs).

Results

A total of 12 RCTs were included in the systematic review and meta-analysis. For overall methodological quality, 10 studies showed some concerns and 2 studies showed high risk. Levels of evidence for outcomes were assessed as low (n = 8) and very low (n = 4). The studies involved a total of 482 older adults. Most studies implemented balance exercise as the exergame intervention. Older adults who completed exergame interventions showed improvements in cognitive outcomes (SMD 0.90, 95%CI 0.61–1.19, p<0.001) and in balance self-efficacy (SMD 1.04, 95%CI 0.47–1.61, p<0.001) as compared with those in usual care. They also showed improvements in balance (SMD 0.49, 95%CI 0.20–0.78, p<0.001) as compared with those in conventional exercise programs. Overall, exergames had a positive effect on balance (SMD 0.62, 95%CI 0.29–0.95, p<0.001).

Conclusion

This review revealed that exergames can improve the balance ability of older adults in LTCFs.

Le texte complet de cet article est disponible en PDF.

Keywords : Exergame, Long-term care facilities, Meta-analysis, Older adults, Systematic review

Abbreviations : LTCFs, PRISMA, SMD


Plan


 Systematic Review Registration: PROSPERO (CRD42021241923)


© 2022  Elsevier Masson SAS. Tous droits réservés.
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Vol 66 - N° 3

Article 101702- avril 2023 Retour au numéro
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