Comparative Effects Of Exergaming And Otago Exercise On Anticipatory Postural Control And Sensory Integration In Older Adults

NCT07308353 | Active Not Recruiting

• 1 other identifier: FUI/CTR/2025/14
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

This study explores whether non-immersive, interactive Exergaming using Xbox Kinect can go beyond conventional exercise by actively training the brain and body to react faster, balance smarter, and move more confidently. Through dynamic games like Reflex Ridge and 20,000 Leaks, we aim to stimulate internal perturbations and real-time Sensory Integration, something Otago doesn't directly target. In this randomized controlled trial, 36 older adults (aged 55+) will be assigned to either the Exergaming or Otago group. Both groups will receive 6 weeks of supervised balance training (3x/week, 30 mins/session). Primary outcomes include Sensory Integration, measured using modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and Anticipatory postural control assessed through Limits of Stability (LOS) test. Timed up and Go (TUG) will capture functional mobility, which will serve as the secondary outcome in this study. Both mCTSIB and LOS will be administered using the Postural Stability System of Biodex, a reliable and valid computerized platform designed to objectively quantify postural control under varying sensory conditions. With evidence-based outcome tools and rigorous analysis, this project doesn't just aim to compare two programs, it's about challenging tradition, modernizing rehab, and making balance training smarter, safer, and more engaging for the elders we serve. This research could be a leap forward in community-based fall prevention and a step toward a more responsive, personalized future in Neurological Rehabilitation.

Conditions

Exercise Therapy; Frail Elderly; Healthy Aging; Mobility Limitation; Muscle Strength; Postural Balance; Proprioception; Exergaming

Keywords

Exergaming; Exercise Therapy; Frail Elderly; Healthy Aging; Mobility limitation; Muscle Strength; Postural Balance; Proprioception

Outcome Measures

Primary Outcomes (3)

• Anticipatory Postural Control

  It will be assessed using the Limits of Stability test of Postural Stability System (Biodex Balance System). The LOS test measures anticipatory postural control by evaluating the participant's ability to voluntarily shift their center of gravity (COG) toward multiple targets without losing balance. Participants will be instructed to shift their weight toward 8 targets displayed on a screen, using ankle and trunk strategies while standing on a stable platform. Overall LOS Score and Time to complete test will be recorded. Higher values of Overall Directional control indicate better anticipatory balance. Whereas shorter Time to Complete Test reflects quicker anticipatory responses.

  6 weeks

• Sensory Integration

  The mCTSIB will be used to assess sensory integration.This test includes the four conditions: Eyes Open on Firm Surface, Eyes Closed on Firm Surface, Eyes Open, Foam Surface and Eyes Closed, Foam Surface. Each condition will be tested for 30 seconds, and the system will automatically calculate an overall composite sway score. Higher Sway Index shows lower sensory integration

  6 weeks

• Functional Mobility

  The Timed Up and Go (TUG) test will be used to measure functional mobility before and after the intervention. Time to complete (in seconds) will be recorded using a stopwatch. Score ≤13.5 seconds is considered normal for community-dwelling older adults. Score \>13.5 seconds indicates reduced functional mobility

  6 weeks

Study Arms (2)

Otago Exercise Program

ACTIVE COMPARATOR

Strengthening exercises 1. Knee extensor (front knee strength) 2. Knee flexor (Back knee strength) 3. Hip abductor (side hip strength) 4. Ankle plantarflexors (calf raises) 5. Ankle dorsiflexors (toe raises) Balance retraining exercises 1\. Knee bends 2. Backwards walking 3. Walking and turning around 4. Sideways walking 5. Tandem stance (Heel toe stand) 6. Tandem walk (heel toe walk) 7. One leg stand 8. Heel walking 9. Toe walk 10. Heel toe walking backwards 11. sit to stand 12. Stair walking Levels: LEVEL A 10 repetitions Hold support LEVEL B 10 repetitions, no support or 10 repetitions, hold support, repeat LEVEL C 10 repetitions No support, repeat LEVEL D 3 x 10 repetitions No support

Procedure: Otago Exercise Program

Exergaming

EXPERIMENTAL

Games Included: 20,000 Leaks - multi-directional reaching, internal perturbations Reflex Ridge - anticipatory jumping, ducking, trunk-limb coordination River Rush - dynamic weight shifting, lateral stepping Rally Ball - anticipatory posture control, bilateral upper limb coordination Levels: Basic, Intermediate and Advance

Procedure: Exergaming

Interventions

Otago Exercise Program PROCEDURE

It will consist of 5 Strengthening Exercises, 12 Progressive Balance Exercises and Walking Training (as tolerated). Protocol will include 3 sessions per week 30 minutes per session for total of 6 weeks Strength exercises will be progressed by increasing repetitions, weight, or duration. Balance tasks will be made challenging by reducing upper limb support, altering base of support, or eyes closing. Progression will be adjusted weekly based on performance and comfort. All sessions will be delivered under physiotherapist supervision using the official OEP manual.

Otago Exercise Program

Exergaming PROCEDURE

This intervention involves non-immersive exergaming using the Xbox Kinect system. Games Included are 20,000 Leaks, Reflex Ridge, River Rush and Rally Ball. Games will be played 3 times per week for 30 minutes for total of 6 weeks. Three difficulty levels include Basic, Intermediate and Advance. Progression based on participant performance, game scores (gold/silver pins, stars), and therapist observation. For first three weeks 2/3 Game Plays and last three weeks there will be 4/5 game plays. Sessions will be supervised one-on-one by a physiotherapist. Participant performance, fatigue, and safety will be monitored throughout the session.

Exergaming

Eligibility Criteria

• Age: 55 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 55 years
• Both Genders
• Ambulatory, community-dwelling
• Able to stand unassisted \>1 min
• TUG ≤ 13.5 s
• Able to understand and follow command

You may not qualify if:

• Diagnosed vestibular and neurological conditions affecting balance
• Orthopedic Conditions i.e., Recent fractures or surgeries, cervical spine issues or severe OA
• Severe visual or auditory deficits
• Use of Assistive device
• Currently enrolled in any other balance or exercise program

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, 44000, Pakistan

Location

MeSH Terms

Conditions

Mobility Limitation

Interventions

Exergaming

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 15, 2025
• First Posted: December 29, 2025
• Study Start: November 18, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: December 29, 2025

Record last verified: 2025-12

Locations

PA (1)