German Clinical Trials Register

Acronym/abbreviation of the study

ExerG – ExerCube goes senior

URL of the study

https://exergetic.de/

Brief summary in lay language

Age-related falls are not uncommon. According to the World Health Organisation (WHO), 28-35% of people over the age of 65 fall at least once a year. Falls can lead to injuries and health limitations that can greatly affect social life and quality of life. Studies have shown that physical and cognitive training considerably improves walking and balance, and consequently reduces the risk of falls. There are several challenges to consider when developing suitable trainings as part of a therapy: The training should be structured in a way that it is easily understandable for the user, adaptable to the person, and motivating. As a training programme content, tasks like daily life activities have been found to be useful. The so-called "ExerG" project wants to realise this novel training measure and develop a first version of a video-game-like exercise programme (exergame) for older adults who are at risk of falling. This type of training is safe, transferable into real life and easily accessible. Users will be involved in the development of the training device, which will allow to respond closely to their needs, preferences and wishes. The project will therefore be divided into several phases, during which users will be interviewed and later test the training device. The ExerG project is funded by “AAL – Active Assistive Living Program Ageing Well in the Digital World”. It is co-financed by the European Commission through the Horizon 2020 Societal Challenge: Health, demographic change, wellbeing. The project consortium consists of scientific and commercial partners from Switzerland, Austria, and Canada. Partners from Switzerland are Sphery Ltd.; Reha Rheinfelden (RHF), and Zurich University of the Arts (ZHdK), Austrian partners are VASCage GmbH and Reha Zentrum Münster (RZM), and the Canadian partner is the HCI Games Group (HCIGG), Communication Arts Department, Stratford School of Interaction Design and Business, University of Waterloo. The first project phase consists of a guided group discussion (focus group study). Here, for example, the needs, preferences, opinions, and experiences of the later so-called "end users" will be asked. There will be three different focus groups. The first group will consist of the end users of the training device: people who are older than 65 years, with or without additional diseases, with a higher risk of falls. The second group will consist of staff from rehabilitation centres such as physiotherapists or sports scientists. The third group will include employees in leading positions at public healthcare payers (for example, health insurance companies), as well as other health care facilities. The group discussion of the first two groups will be a semi-structured interview, with the third group being interviewed individually by telephone for their opinions. The statements of all interviewees will be used to adapt an already existing exergame system of the company Sphery (Switzerland) to the needs of the elderly population. In this way, the users will be directly involved in the development of the new prototype (a first full-scale and functioning test model). In the second phase, the user-friendliness of the training device will be studied. In the final phase, the effectiveness of the exergame training device will be tested.

Brief summary in scientific language

Age-related falls are not uncommon. In the "Global Report on falls prevention in older age" (2007) of the World Health Organisation (WHO) states that about 28-35% of people over 65 years of age fall at least once per year. Falls can have long-term health consequences, involving psychological and social consequences that may subsequently significantly increase costs to health care providers. Systematic reviews show that physical and cognitive training significantly improves walking and postural control and consequently leads to a reduction in falls in older people (with or without disabilities). The development of a rehabilitative tool as a basis for therapeutic exercise training to improve physical and cognitive functions for fall prevention faces a variety of challenges: (1) User-centered focus to personalise training requirements on physical, cognitive and mental levels, (2) motivation to regularly train and exercise, (3) meaningfulness of the training regarding daily life activities and quality of life, (4) ecologically valid training setting allowing an everyday movement-based training, (5) accessibility of the training. The ExerG project aims to address these challenges by developing a prototype for a holistic training procedure using the so-called exergame for older adults ≥65 years at risk of falls. Exergames are computer-based therapeutic exercise games that have the potential to provide older adults at risk of falls with motivating, meaningful, user-centred, environmentally friendly, safe, and accessible training for the cognitive and physical functions. This approach will be applied to rehabilitation and prevention within the ExerG project. The ExerG project is funded by “AAL – Active Assistive Living Program Ageing Well in the Digital World”. It is co-financed by the European Commission through the Horizon 2020 Societal Challenge: Health, demographic change, wellbeing. The project consortium consists of scientific and commercial partners from Switzerland, Austria and Canada. Partners from Switzerland are Sphery Ltd.; Reha Rheinfelden (RHF), and Zurich University of the Arts (ZHdK), Austrian partners are VASCage GmbH and Reha Zentrum Münster (RZM), and the Canadian partner is the HCI Games Group (HCIGG), Communication Arts Department, Stratford School of Interaction Design and Business, University of Waterloo. The goal of the study is to develop and test an exergame device that meets the needs, desires, preferences of the end users. For this purpose, the study is divided into 3 phases: Phase 1- Focus group investigation of selected end users. Phase 2 -Usability testing. Phase 3 -Pilot RCT (randomised controlled trial). The purpose of this focus group investigation is to gain a deeper understanding of the needs, preferences, opinions, fears, and prior experiences of therapeutic exercise games using a computer (exergames). Three end-user groups will be examined. (1) Primary end-user group: people ≥65 years of age with or without comorbid conditions, at increased risk of falls. (2) Secondary end-user group: staff from rehabilitation centres such as physical therapists or sports scientists. (3) Tertiary end-user group: employees in managerial positions at public healthcare payers (for example, health insurance companies), as well as other health care facilities. The primary and secondary end-user groups will be encouraged to participate in guided focus group discussions using semi-structured interviews in their respective groups. Participants of the tertiary end-user group will be asked for their opinions in individual semi-structured telephone interviews. The collected focus group and interview data will be used for the development of the prototype, of which the hardware and software will be based on the existing ExerCube of the company Sphery (CH) and adapted to the needs of the end users. The usability of the ExerG version 1 will be tested in the second phase (usability testing). A pilot RCT will follow based on this in the third phase of the ExerG study.