Using shoe-mounted inertial sensors and stepping exergames to assess the motor-cognitive status of older adults: A correlational study

Vânia Guimarães; Inês Sousa; Eling D de Bruin; Joana Pais; Miguel Velhote Correia

doi:10.1177/20552076231167001

Using shoe-mounted inertial sensors and stepping exergames to assess the motor-cognitive status of older adults: A correlational study

Digit Health. 2023 Mar 28:9:20552076231167001. doi: 10.1177/20552076231167001. eCollection 2023 Jan-Dec.

Authors

Vânia Guimarães^{1

2}, Inês Sousa¹, Eling D de Bruin^{3

4

5}, Joana Pais^{6

7

8}, Miguel Velhote Correia^{2

9}

Affiliations

¹ Fraunhofer Portugal AICOS, Porto, Portugal.
² Faculty of Engineering, University of Porto, Porto, Portugal.
³ Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
⁴ Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
⁵ Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland.
⁶ Neuroinova, Lda., Vila Nova de Gaia, Portugal.
⁷ EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
⁸ Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal.
⁹ INESC TEC (Institute for Systems and Computer Engineering, Technology and Science), Porto, Portugal.

Abstract

Objective: Stepping exergames designed to stimulate physical and cognitive skills can provide important information concerning individuals' performance. In this study, we investigated the potential of stepping and gameplay metrics to assess the motor-cognitive status of older adults.

Methods: Stepping and gameplay metrics were recorded in a longitudinal study involving 13 older adults with mobility limitations. Game parameters included games' scores and reaction times. Stepping parameters included length, height, speed, and duration, measured by inertial sensors placed on the shoes while interacting with the exergames. Parameters measured on the first gameplay were correlated against standard cognitive and mobility assessments, including the Montreal Cognitive Assessment (MoCA), gait speed, and the Short Physical Performance Battery. Based on MoCA scores, patients were then stratified into two groups: cognitively impaired and healthy controls. The differences between the two groups were visually inspected, considering their within-game progression over the training period.

Results: Stepping and gameplay metrics had moderate-to-strong correlations with cognitive and mobility performance indicators: faster, longer, and higher steps were associated with better mobility scores; better cognitive games' scores and reaction times, and longer and faster steps were associated with better cognitive performance. The preliminary visual analysis revealed that the group with cognitive impairment required more time to advance to the next difficulty level, also presenting slower reaction times and stepping speeds when compared to the healthy control group.

Conclusion: Stepping exergames may be useful for assessing the cognitive and motor status of older adults, potentially allowing assessments to be more frequent, affordable, and enjoyable. Further research is required to confirm results in the long term using a larger and more diverse sample.

Keywords: Exergames; inertial sensors; motor-cognitive assessment; older adults; serious games; stepping.