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 Researchers asked about 300 adults aged 60 to 90 who had already
experienced at least one prior fall to exercise on a treadmill three
times a week for six weeks, randomly assigning half of them to use
virtual reality systems during the workouts.
When training started, both groups had similar experiences with
falls – the treadmill-only group had an incident rate of 10.7 falls
in the previous six months compared with rate of 11.9 for the
virtual reality group.
Six months after training, however, the incident rate dropped
significantly only in the virtual reality group – to six falls in
six months – while it was little changed for the treadmill-only
group, researchers report in The Lancet.
“Our idea was to use the virtual reality environment to safely train
both the motor or gait aspects that are important to fall risk,
while also implicitly teaching the participants to improve the
cognitive functions that are important for safe ambulation,” said
lead study author Anat Mirelman of Tel Aviv University in Israel.
“The study showed that this type of training is effective in
reducing falls and fall risk in a large diverse population,”
Mirelman added by email. “Thus the findings support the use of motor
cognitive training to enhance health and reduce fall risk in a
growing older population.”
In addition to a history of falls, the participants also had other
risk factors for repeat tumbles such as impaired motor skills or
cognitive function.
Participants were around 73 to 74 years old on average.
About 130 of them had Parkinson’s disease, which can rob people of
motor control, 43 had mild cognitive impairment and 109 had a
history of falls without a clear medical reason.
Researchers asked each participant to move at a comfortable pace
during 45-minute sessions on the treadmill.
Half of the participants also used virtual reality systems
consisting of a motion-capture camera and a computer-generated
simulation projected on to a large screen.
This virtual reality experience was designed to lower the risk of
falls by improving how well participants could navigate obstacles,
multiple pathways and distractions that required a constant
adjustment in the way they stepped on the treadmills.
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Immediately after the six weeks of training, participants in both
groups had improvements in walking speed in usual situations as well
as those with obstacles.
But the virtual reality group generally had a more varied gait while
maneuvering around obstacles, the study found. Obstacle clearance
was also better in the virtual reality group.
While this technology appeared effective, the study didn’t assess
how much it would cost to provide virtual reality treadmill training
to a broad population of older adults at risk for falls.
One limitation of the study is its reliance on self-reported data on
falls before training, which makes it possible that the measurement
of improvements attributed to the training may have been inaccurate,
the authors note.
Even so, the study adds to growing evidence suggesting fall
prevention for the elderly needs to address both motor skills and
cognitive skills necessary to safely navigate an environment that
may not always include perfectly flat, well-lit paths.
Studies in Europe, the U.S. and Australia show that roughly a third
of people aged 65 years or older living outside institutions fall at
least once per year, with half of this number having multiple falls
in this period, writes Stephen Lord, a researcher at the University
of New South Wales in Australia, in an accompanying commentary.
“There have been several pilot studies that have found exergames
involving balance and step training have improved balance reaction
time, stepping performance and cognitive function – known risk
factors for falls,” Lord told Reuters health by email.
“The published study is the first with a sufficiently large sample
to show an effect on falls themselves,” he added.
SOURCE: http://bit.ly/2bdXWAO and http://bit.ly/2b7j1Mx The Lancet,
online August 11, 2016.
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