Dance-based exergaming to improve physical function in aging and stroke
thesisposted on 01.02.2019, 00:00 by Savitha Subramaniam
Background: Aging and stroke-induced sensori-motor and balance impairments increase postural instability, thus leading to increased fall risk. Thus developing a training paradigm that promotes cardiovascular fitness while addressing postural stability and ambulatory function might be crucial in addressing community based activity profiles among these population groups. Purpose: To examine the effect of a multidimensional, dance-based exergaming training on improving postural stability, walking function, cardiac autonomic modulation and to further assess if these improvements would be carried over to community based activity profiles. Methods: Community dwelling individuals with hemiparethic stroke (N = 15) and healthy older adults (N =15) received dance-based exergaming training for 6 weeks using the commercially available Kinect dance gaming “ Just Dance 2014” for one hour and thirty minutes. Change in balance control was evaluated by the Limits of Stability test (Neurocom Inc.). The post-training changes in self-initiated center of pressure response time (RT), the movement velocity (MV), the maximum excursion (MXE) were examined. Heart rate variability was determined for pre- and post-intervention for 10 minutes in (1) supine. Gait speed and cadence were recorded using an electronic walkway. Changes in PA during community ambulation (one week before and after intervention) were assessed using Omran HJ-321 Tri-Axis Pedometer. To determine if the changes in functional measures assessing mobility (Berg Balance Scale [BERG]), endurance (six-minute walk test [6MWT]), and gait (speed and cadence) correlated with improved community ambulation, the difference in clinical measures and gait performance from pre- to post intervention was linearly regressed with the changes in community ambulation. Results: Post-training the RT was significantly reduced (p<0.05). Similarly, post-training, MV and MXE were significantly higher (p<0.05). Post-training there was a significant improvement in autonomic modulation in the supine position, indicating an improvement in LF, HF and LF/HF (p<0.05). Maximum work load and maximum oxygen uptake increased significantly post-training (p<0.05). The change in number of steps recorded in daily living from pre-to post intervention correlated with the pre-post change scores for functional measures BERG, 6MWT, gait speed, and cadence (p<0.05). Conclusion: The dance-based exergaming provides a benchmark for incorporating long-term adherent PA regimen in aging and stroke population, which along with improving cardiovascular functioning and walking function, improves community based activity profiles.