Exergaming Experience of Older People With Chronic Musculoskeletal Pain

NCT04029285 | Completed

• 1 other identifier: ExergamingOldPeople
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Chronic musculoskeletal pain is debilitating and can lower the quality of life in older people. Therapeutic benefits have been reported from exergaming used as an intervention for rehabilitation or alternative to exercise. This study investigated the effects of exergaming in comparison with those of standard exercise on pain, postural control, technology acceptance and flow experience in older people with musculoskeletal pain.

Conditions

Musculoskeletal Pain; Musculoskeletal Pain Disorder

Keywords

Exergaming; Exercise Therapy; Musculoskeletal Pain; Aged, Aged 80 and Over; Postural Balance; Flow state experience; Technology acceptance; Heart Rate

Outcome Measures

Primary Outcomes (15)

• Change in score, on each cluster included in the Multi Affect and Pain Survey (MAPS) questionnaire (Clark, 2002).

  MAPS comprises three superclusters reflecting three major aspects of pain: somatosensory, emotional and well-being. 1. somatosensory supercluster contains 17 clusters with 57 descriptors of painful sensory qualities 2. emotional supercluster has 8 clusters with 26 descriptors of negative emotional qualities 3. well-being supercluster has 5 clusters with 18 descriptors of positive affect, and health. Descriptors are presented as statements and participants rate how closely each comes to describing how they feel on a six point scale (from 0 (Not at all) to 5 (Very much so)). Descriptor scores are summed to give Cluster scores. An increased score in somatosensory and emotional clusters reflects a worsening, in well-being it reflects an improvement.

  Change in MAPS Cluster Score, from baseline to six weeks

• Change in Pain intensity (within previous 30 days) rating

  Participants rated the intensity of their pain (within previous 30 days) on a 0-10 scale where 10 is the WORST POSSIBLE PAIN. An increased score represents greater pain.

  Change in Pain intensity (within previous 30 days) rating, from baseline to six weeks

• Change in Pain intensity (at present time) rating

  Participants rated the intensity of their pain (within previous 30 days) on a 0-10 scale where 10 is the WORST POSSIBLE PAIN. An increased score represents greater pain.

  Change in Pain intensity (within previous 30 days) rating, from baseline to six weeks

• Change in rate of change of centre of pressure (mm.s-1) location - eyes open.

  Centre of pressure velocity (mm.s-1) is the rate at which the centre point of force (measured on a Kistler™ Force Plate) moves, as the participant stands on the force plate with their eyes open. It is quantified in mm.s-1 and an increase represents faster movements and hence more rapid corrections of balance are required to maintain equilibrium and hence postural control has worsened.

  Change in centre of pressure velocity (mm.s-1) (eyes open), from baseline to six weeks

• Change in standard deviation of centre of pressure (mm) location measurements in the anterio-posterior direction - eyes open.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes open. The location of the CoP changes in the anterio-posterior direction (forwards to backwards) if the person sways forward and backward. The variability in the magnitude of sway is reflected in the Standard Deviation of this measure. It is quantified in mm and an increased variation in movement means that more varied corrections of balance are required to maintain equilibrium and hence postural control has worsened.

  Change in standard deviation of centre of pressure (mm) location measurements in the anterio-posterior direction (eyes open), from baseline to six weeks

• Change in range of centre of pressure (mm) location measurements in the anterior-posterior direction - eyes open.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes open. The location of the CoP changes in the anterio-posterior direction (forwards to backwards) if the person sways forward and backward. The extent of maximal and minimal magnitude of sway is reflected in the Range of this measure. It is quantified in mm and an increase represents larger movements occurred and so correspondingly larger corrections of balance are required, to maintain equilibrium and hence postural control has worsened.

  Change in range of centre of pressure (mm) location measurements in the anterior-posterior direction (eyes open), from baseline to six weeks

• Change in standard deviation of centre of pressure (mm) location measurements in the medio-lateral direction - eyes open.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes open. The location of the CoP changes in the medio-lateral direction (side-to-side) if the person sways from side to side. The variability in the magnitude of sway is reflected in the Standard Deviation of this measure. It is quantified in mm and an increased variation in movement means that more varied corrections of balance are required to maintain equilibrium and hence postural control has worsened.

  Change in standard deviation of centre of pressure (mm) location measurements in the medio-lateral direction (eyes open), from baseline to six weeks

• Change in range of centre of pressure (mm) location measurements in the medio-lateral direction - eyes open.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes open. The location of the CoP changes in the medio-lateral direction (side-to-side) if the person sways from side to side. The extent of maximal and minimal magnitude of sway is reflected in the Range of this measure. It is quantified in mm and an increase represents larger movements occurred and so correspondingly larger corrections of balance are required, to maintain equilibrium and hence postural control has worsened.

  Change in range of centre of pressure (mm) location measurements in the medio-lateral direction (eyes open), from baseline to six weeks

• Change in rate of change of centre of pressure (mm.s-1) location - eyes closed.

  Centre of pressure velocity (mm.s-1) is the rate at which the centre point of force (measured on a Kistler™ Force Plate) moves, as the participant stands on the force plate with their eyes closed. It is quantified in mm.s-1 and an increase represents faster movements and hence more rapid corrections of balance are required to maintain equilibrium and hence postural control has worsened.

  Change in rate of change of centre of pressure (mm.s-1) location (eyes closed), from baseline to six weeks

• Change in standard deviation of centre of pressure (mm) location measurements in the anterio-posterior direction - eyes closed.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes closed. The location of the CoP changes in the anterio-posterior direction (forwards to backwards) if the person sways forward and backward. The variability in the magnitude of sway is reflected in the Standard Deviation of this measure. It is quantified in mm and an increased variation in movement means that more varied corrections of balance are required to maintain equilibrium and hence postural control has worsened.

  Change in standard deviation of centre of pressure (mm) location measurements in the anterio-posterior direction (eyes closed), from baseline to six weeks

• Change in range of centre of pressure (mm) location measurements in the anterior-posterior direction - eyes closed.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes closed. The location of the CoP changes in the anterio-posterior direction (forwards to backwards) if the person sways forward and backward. The extent of maximal and minimal magnitude of sway is reflected in the Range of this measure. It is quantified in mm and an increase represents larger movements occurred and so correspondingly larger corrections of balance are required, to maintain equilibrium and hence postural control has worsened.

  Change in range of centre of pressure (mm) location measurements in the anterior-posterior direction(eyes closed), from baseline to six weeks

• Change in standard deviation of centre of pressure (mm) location measurements in the medio-lateral direction - eyes closed.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes closed. The location of the CoP changes in the medio-lateral direction (side-to-side) if the person sways from side to side. The variability in the magnitude of sway is reflected in the Standard Deviation of this measure. It is quantified in mm and an increased variation in movement means that more varied corrections of balance are required to maintain equilibrium and hence postural control has worsened.

  Change in standard deviation of centre of pressure (mm) location measurements in the medio-lateral direction (eyes closed), from baseline to six weeks

• Change in range of centre of pressure (mm) location measurements in the medio-lateral direction - eyes closed.

  Centre of pressure (CoP) is the centre point of force (measured on a Kistler™ Force Plate) as the participant stands on the force plate with their eyes closed. The location of the CoP changes in the medio-lateral direction (side-to-side) if the person sways from side to side. The extent of maximal and minimal magnitude of sway is reflected in the Range of this measure. It is quantified in mm and an increase represents larger movements occurred and so correspondingly larger corrections of balance are required, to maintain equilibrium and hence postural control has worsened.

  Change in range of centre of pressure (mm) location measurements in the medio-lateral direction(eyes closed), from baseline to six weeks

• Change in score on each domain included in the Technology Acceptance: United Theory of Acceptance and Use of Technology (UTAUT) questionnaire (Venkatesh, 2003).

  The UTAUT comprises statements rated on a 7-point Likert scale, 1 strongly disagree to 7 strongly agree, grouped into six domains. 1. performance expectancy, the belief that using a system will help improve performance, 2. effort expectancy, how easy it is to use the technology 3. social influence, how much the user believes others think they should use the technology 4. facilitation conditions, how much the user believes they should use the technology, 5. self-efficacy, how capable the user feel to use the technology 6. behavioural intention, intention to use the technology again. Statement ratings are summed to give Domain scores. An increased score in any Domain reflects an increase in acceptance (positive outcome in respect of technology usage).

  Change in score on each domain included in the Technology Acceptance: United Theory of Acceptance and Use of Technology (UTAUT) questionnaire, from baseline to six weeks

• Change in score on each sub-scale included in the Flow State Scale (FSS) (Jackson and Marsh, 1996).

  FSS comprises 36 questions rated on a 5-point Likert scale 1 strongly disagree to 5 strongly agree, grouped into nine subscales. 1. autotelic experience, the intrinsically rewarding experience doing a task 2. clear goals, clearly confident of action 3. challenge-skill-balance, balance between skills and challenge 4. concentration at task, complete control on performing a task 5. control, at full focus at the task 6. unambiguous feedback, feedback on performing a task 7. action-awareness-merging, immediate, direct and clear observations whilst performing a task 8. transformation of time, sense of time speeds or slows, becomes irrelevant or out of one's awareness 9. loss of self consciousness, sense of not being concerned with oneself while engaged in a task Question ratings are summed to give subscale score. An increased score in any subscale reflects an increase in the experience of Flow State (a positive outcome in respect of experience of any activity).

  Change in score on each sub-scale included in the Flow State Scale questionnaire, from baseline to six weeks

Study Arms (2)

Traditional Gym Based exercise - Control

OTHER

Twice weekly sessions of TGB exercise for six weeks.

Other: Exergaming

Exergaming

EXPERIMENTAL

Twice weekly sessions of exergames for six weeks.

Other: Exergaming

Interventions

Exergaming OTHER

The exergaming group played six IREX® exergames. Those in the TGB group performed exercises that were matched to the IREX® exergames for: movement patterns required, physiological demands, sequence, duration and mode of exercise by adopting open and closed kinetic chain movements, in the same range and loading, across both groups. Each IREX® exergame was played for two minutes and was repeated three times within a session. TGB exercise was conducted in sets of two minutes duration, repeated three times within a session. In both groups participants were given rest periods of 10 to 30 seconds, or longer, if required, between exergames or TGB exercise sets.

Exergaming; Traditional Gym Based exercise - Control

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• male or female
• aged 65 years or over
• able to walk unassisted (i.e. did not use, or require, any walking aids) for at least 0.5 of a mile
• having musculoskeletal pain in two or more joints, of more than 12 weeks duration

You may not qualify if:

• diagnosis (or suspicion) of any systemic conditions that may cause pain in two or more joints
• of more than 12 weeks duration (such as cancer, rheumatic or neurological disease or condition)
• self-report of current (or history) of any condition or injury which would contra- indicate participation in the exercises under study
• inability (or any doubt of ability) to give informed consent
• inability to read and write English

Sponsors & Collaborators

• Teesside University: lead

Study Sites (1)

Teesside University, School of Health and Social Care

Middlesbrough, Cleveland, TS1 3BA, United Kingdom

Location

Related Publications (4)

• Clark CW, Yang JC, Tsui SL, Ng KF, Clark SB. Unidimensional pain rating scales: a multidimensional affect and pain survey (MAPS) analysis of what they really measure. Pain. 2002 Aug;98(3):241-247. doi: 10.1016/S0304-3959(01)00474-2.

  PMID: 12127025 BACKGROUND

• Jackson SA. Toward a conceptual understanding of the flow experience in elite athletes. Res Q Exerc Sport. 1996 Mar;67(1):76-90. doi: 10.1080/02701367.1996.10607928.

  PMID: 8735997 BACKGROUND

• Shamliyan TA, Wang SY, Olson-Kellogg B, Kane RL. Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Nov. Report No.: 12(13)-EHC115-EF. Available from http://www.ncbi.nlm.nih.gov/books/NBK114568/

  PMID: 23213666 BACKGROUND

• Ditchburn JL, van Schaik P, Dixon J, MacSween A, Martin D. The effects of exergaming on pain, postural control, technology acceptance and flow experience in older people with chronic musculoskeletal pain: a randomised controlled trial. BMC Sports Sci Med Rehabil. 2020 Oct 9;12:63. doi: 10.1186/s13102-020-00211-x. eCollection 2020.

  PMID: 33062284 DERIVED

MeSH Terms

Conditions

Musculoskeletal Pain; Collagen Diseases

Interventions

Exergaming

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Connective Tissue Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Alasdair MacSween

  Teesside University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Lecturer (Research Governance)

Model Details: Participants were assigned to either the control group (TGB) or the experimental group (exergaming) in parallel for the duration of the study.

Study Record Dates

• First Submitted: July 18, 2019
• First Posted: July 23, 2019
• Study Start: September 20, 2010
• Primary Completion: March 31, 2011
• Study Completion: September 16, 2011
• Last Updated: July 23, 2019

Record last verified: 2019-07

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)