Exergame Balance Training for Patients With Mild Cognitive Impairment

NCT04959383 | Completed

• 1 other identifier: REC/1954 Aruba Saeed
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be a randomized control trial, which will be conducted on older adults with mild cognitive impairment. A specially designed Exergame balance training will be used for cognitive enhancement in patients with MCI. This training will determine the improvement in executive functioning, balance, speech and electrical activity of the brain.

Conditions

Mild Cognitive Impairment

Keywords

Brain Activity; Executive Functions; Exergame balance training; Mild Cognitive Impairment

Outcome Measures

Primary Outcomes (12)

• Stroop test

  Stroop test measure attention, processing speed, cognitive flexibility, and working memory. This test has good specificity (0.85-0.90). Coloured squares (red, green, blue) are presented in rows first (Stroop A), followed by those colour words typed in black ink (Stroop B), followed by incongruent colour words (Stroop C; in which participants will be asked to name the colour of the ink while ignoring the written word). A ratio will be computed to isolate the executive function component of the task. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Trails Test

  Trails test is used to assess selective attention, mental flexibility, visual-spatial skills and motor speed. It requires participants to connect numbered circles in ascending order. Color trails-2, requires individuals to connect numbered circles in consecutive order while also alternating the alphabets of the circle. Reliability and validity are adequate. Higher ratios represent a better executive function. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Digit Span Forward and Backward

  This test measures working memory's number storage capacity. It requires participants to first listen to a list of numbers and repeat them, with the string length increasing to the maximum of their ability. Digit Span Backward, requires repeating a string of numbers in reverse order. Continuing the pattern above to isolate the executive function component, the ratio of the typically smaller sum of correct interference trials on Digit Span Backward, divided by the typically greater sum of correct basic attention trials on Digit Span Forward. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Montreal Cognitive Assessment

  The MoCA was administered at baseline to characterize the sample as either normative aging or "screened as MCI" The MoCA consists of eight different subtests to assess overall cognitive impairment. Scores below 24 out of 30 were used to categorize MCI. This scale has a good reliability with Cronbach's alpha of 0.905. Its sensitivity is 88% and specificity is 98%. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Alzheimer's disease Assessment Scale

  Alzheimer's disease Assessment Scale will be used for Immediate and Delayed Recall Participants shows a list of 11 words on cards and they recall as many as they are able immediately and also after a delay interval. The number of errors/omissions comprises the score, so lower scores are better. It is a reliable tool with Cronbach's alpha of 0.83. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Time Up and Go Test

  The participants rise from sitting, walk 10 feet, turn around and return to the sitting position. The time it takes to complete the task is the score. Lower scores are better. It has a very good validity of 0.857. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Mini Brief Balance Evaluation Systems

  It is a reliable and valid tool. The mini Balance Evaluation Systems Test (BES Test) is a 14-item clinical balance assessment tool, developed to assess balance across six contexts of postural control: mechanical constraints, limits of stability, postural response to the induced loss of balance, sensory orientation, and gait. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Smartphone Gait and Balance Application

  The system consists of the following three components: i) a smartphone that has an embedded accelerometer, ii) a belt to house the phone on the lower back, iii) and a smartphone balance application. There are six different tasks that the subject have to perform with the system, like, normal walking up to 6 meters, walking with head movement, standing with eyes open and close and standing on a compromised surface with eyes open and close. This app. will calculate mediolateral and anterior-posterior sway during each task. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Force Plate

  Force Plate is a reliable and valid tool for balance assessment (ICC=0.8). In the force platform test, the mean velocity of the mediolateral (ML) and anterior-posterior (AP) movement of the COP will be calculated (mm/s) according to the displacement of the COP during each second. The mean moment of velocity (m m2/s) will be calculated as the mean of the areas covered by COP movement during each second of the Force Platform. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Gait Speed Assessment

  Self-selected gait speed (SSGS), fast gait speed (FGS), Cadence are considered to be decreased in patients with MCI. Gait speed will be assessed over 6 meters, and usual- and fast-pace walking mode. The test will be repeated twice with the mean of the two trials will be used for scoring purposes. Participants will be instructed to walk from a standing start at a pace that was normal and comfortable for them or to walk as fast as they could until they reached the end of the marked path. The participants will be asked to stop when their foot contacted the floor at the end of the walking course. Assessment will be done at baseline, after the 4th and 8th week.

  8th weeks

• Electroencephalography

  An electroencephalography scalp electro-voltage activity (sampling frequency: 128Hz, bandpass hardware filter:1-32Hz) will be used. Delta, theta, beta1 and beta2 will be measured in eye open and closed state. Assessment will be done at baseline, after the 4th and 8th week.

  8th week

• Blood Biomarkers

  The blood biomarkers will be assessed. A 5-mL blood sample will be obtained from the patient. The blood samples will be withdrawn for analysis of serum. The blood samples will be centrifuged. Samples will be and stored at - 80 °C for further serum marker assays. Assessment will be done at baseline, after the 4th and 8th week. Blood biomarkers BDNF, IGF-2, VEGF, TNFα, total-tau, amyloid beta-42, a-Synuclein, IL-10, IL1 and IL4 will be measured.

  8th weeks

Secondary Outcomes (1)

• Voice Recording

  8th weeks

Other Outcomes (1)

• MRI of Brain

  8th weeks

Study Arms (4)

Low complexity Exergame balance training group

EXPERIMENTAL

Wobble board based exergame balance training, the game complexity will be low for this group.

Other: Low complexity Exergaming group

Moderate complexity exergame balance training group

EXPERIMENTAL

Wobble board based exergame balance training, game complexity will be moderate for this group.

Other: Moderate complexity Exergaming group

High complexity exergame balance training group

EXPERIMENTAL

Wobble board based exergame balance training, game complexity will be high for this group.

Other: High complexity Exergaming group

Control group

ACTIVE COMPARATOR

Wii fit based Exergame training on a stable surface

Other: Control Group

Interventions

Low complexity Exergaming group OTHER

This group will receive 30 minutes of Exergame Balance Training on Modified wobble board 3 times a week for 8 weeks. Wobble board will be able to rock in all direction with Weight Transfer. Wobble board based exergame balance training group game complexity will be kept low for this group.

Also known as: Group A

Low complexity Exergame balance training group

Moderate complexity Exergaming group OTHER

This group will receive 30 minutes of Exergame Balance Training on Modified wobble board 3 times a week for 8 weeks. Wobble board will be able to rock in all direction with Weight Transfer. Wobble board based exergame balance training group game complexity will be kept moderate for this group.

Also known as: Group B

Moderate complexity exergame balance training group

High complexity Exergaming group OTHER

This group will receive 30 minutes of Exergame Balance Training on Modified wobble board 3 times a week for 8 weeks. Wobble board will be able to rock in all direction with Weight Transfer. Wobble board based exergame balance training group game complexity will be kept high for this group.

Also known as: Group C

High complexity exergame balance training group

Control Group OTHER

This group will receive 30 minutes of Exergame Balance Training on Modified wobble board 3 times a week for 8 weeks. This group will receive exergame balance training on Wii fit. Participants in this group will play Soccer Heading, Ski Slalom, Ski Jump, Table Tilt, Tightrope Walk, Balance Bubble, Penguin Slide and Snowboard Slalom game.

Also known as: Group D

Control group

Eligibility Criteria

• Age: 55 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 55
• MoCA =20-24
• CDR ( dementia rating scale)≤ 1.0
• No unstable disease precluding planned exercise.
• Able to see and hear sufficiently to participate in planned physical and computer-based cognitive training.
• Patients score \>45 on Berg Balance Scale.

You may not qualify if:

• Participation in any cognitive training activity
• Participation in \> 150 min/wk of moderate or greater intensity planned exercise of any kind.
• Non-ambulatory or major mobility disorder.
• Other neurological conditions associated with cognitive impairment such as stroke, Parkinson disease, and head injury
• Any clinically significant psychiatric condition, current drug or alcohol abuse, or laboratory abnormality that would interfere with the ability to participate in the study.
• Individual with any musculoskeletal impairment.
• Unwillingness to participate.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Railway General Hospital

Rawalpindi, 46000, Pakistan

Location

Related Publications (18)

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  PMID: 12215960 BACKGROUND

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• Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA. Exergaming and older adult cognition: a cluster randomized clinical trial. Am J Prev Med. 2012 Feb;42(2):109-19. doi: 10.1016/j.amepre.2011.10.016.

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• Eggenberger P, Wolf M, Schumann M, de Bruin ED. Exergame and Balance Training Modulate Prefrontal Brain Activity during Walking and Enhance Executive Function in Older Adults. Front Aging Neurosci. 2016 Apr 12;8:66. doi: 10.3389/fnagi.2016.00066. eCollection 2016.

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• Saeed A, Amjad I, Niazi IK, Alzahrani A, Shafiq M, Haavik H. Effects of Balance-Based Exergame Training With Variable Difficulty on Balance and Spatiotemporal Gait Outcomes in Adults With Mild Cognitive Impairment: Randomized Controlled Trial. JMIR Serious Games. 2025 Nov 18;13:e74092. doi: 10.2196/74092.

  PMID: 41251404 DERIVED

MeSH Terms

Conditions

Cognitive Dysfunction

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Cognition Disorders; Neurocognitive Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Officials

• Imran Amjad, PhD

  Riphah international university.pakistan

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Assignment

Study Record Dates

• First Submitted: June 26, 2021
• First Posted: July 13, 2021
• Study Start: September 23, 2021
• Primary Completion: December 30, 2022
• Study Completion: December 30, 2022
• Last Updated: May 30, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)