The feasibility of a stepping exergame prototype for older adults with major neurocognitive disorder residing in a long-term care facility: a mixed methods pilot study

Nathalie Swinnen; Eling D de Bruin; Vânia Guimarães; Chantal Dumoulin; Jacqueline De Jong; Riekje Akkerman; Mathieu Vandenbulcke; Brendon Stubbs; Davy Vancampfort

doi:10.1080/09638288.2023.2182916

The feasibility of a stepping exergame prototype for older adults with major neurocognitive disorder residing in a long-term care facility: a mixed methods pilot study

Disabil Rehabil. 2023 Feb 23:1-15. doi: 10.1080/09638288.2023.2182916. Online ahead of print.

Authors

Nathalie Swinnen¹, Eling D de Bruin^{2

3}, Vânia Guimarães⁴, Chantal Dumoulin^{5

6}, Jacqueline De Jong⁷, Riekje Akkerman⁸, Mathieu Vandenbulcke^{9

10}, Brendon Stubbs^{11

12}, Davy Vancampfort^{1

10}

Affiliations

¹ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
² Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.
³ Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
⁴ Fraunhofer Portugal Research Center for Assistive Information and Communication Solutions, Porto, Portugal.
⁵ Faculty of Medicine, University of Montreal, Québec, Canada.
⁶ Montreal Geriatric University Institute, Québec, Canada.
⁷ Physio SPArtos, Interlaken, Switzerland.
⁸ Long-term care facility De Wingerd, Leuven, Belgium.
⁹ Department of Neurosciences, KU Leuven, Leuven, Belgium.
¹⁰ University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium.
¹¹ South London and Maudsley NHS Foundation Trust, London, UK.
¹² Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.

PMID: 36824039
DOI: 10.1080/09638288.2023.2182916

Abstract

Purpose: To explore the feasibility of an exergame prototype in residential individuals with major neurocognitive disorder (MNCD).

Materials and methods: Participants were randomly assigned to a 12-week stepping exergame training or traditional exercise (active control group). Semi-structured interviews were conducted after six and 12 weeks of exergaming. Qualitative data were thematically analysed using NVivo 12. The Short Physical Performance Battery, one minute sit-to-stand test, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, and Dementia Quality of Life were assessed at baseline and post intervention using a Quade's ANCOVA.

Results: Seven older adults with MNCD in the exergame and 11 in the active control group completed the study [mean age = 83.2 ± 6.5 years; 94.4% female; SPPB score = 7.3 ± 2.4]. Results indicated that the VITAAL exergame prototype was experienced as enjoyable and beneficial. The post-MMSE score was higher (η²=.02, p = 0.01, F = 8.1) following exergaming versus traditional exercise.

Conclusions: The findings suggest that the exergame prototype is accepted by individuals with MNCD residing in a long-term care facility when they are able to participate and under the condition that they are extensively guided. The preliminary efficacy results revealed higher post-MMSE scores after exergaming versus traditional exercise. Future trials should confirm or refute these findings.

Trial registration: The trial was registered in ClinicalTrials.gov (Identifier: NCT04436315)Implications for rehabilitationThe VITAAL exergame prototype is accepted by individuals with MNCD residing in a long-term care facility who are able to participate.Supervision of exergaming by health professionals is essential for successful implementation.The VITAAL exergame prototype might maintain cognitive levels in major neurocognitive disorder longer than walking combined with standardised squatting and stepping exercises.

Keywords: Cognition; dementia; exercise; long-term care; physical activity; qualitative research; serious game.

Associated data

ClinicalTrials.gov/NCT04436315