一项针对社区居住老年人的个性化居家运动认知训练计划的可行性与有效性：一项实用试点随机对照试验方案

Feasibility and Effectiveness of a Personalized Home-Based Motor-Cognitive Training Program in Community-Dwelling Older Adults: Protocol for a Pragmatic Pilot Randomized Controlled Trial.

作者信息

Seinsche Julia, de Bruin Eling D, Saibene Enrico, Rizzo Francesco, Carpinella Ilaria, Ferrarin Maurizio, Ifanger Sarina, Moza Sotiria, Giannouli Eleftheria

机构信息

Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland.

Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland.

出版信息

JMIR Res Protoc. 2023 Nov 9;12:e49377. doi: 10.2196/49377.

DOI:10.2196/49377

PMID:37943591

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10667977/

Abstract

BACKGROUND

Exergame-based motor-cognitive training in older adults has been associated with improvements in physical, cognitive, and psychological functioning. The novel Cocare system (Dividat GmbH), developed through a user-centered design process, allows motor-cognitive training in a telerehabilitation setting. It includes (1) a stationary stepping platform for supervised exergame training (Dividat Senso; Dividat GmbH), (2) a home-based version (Dividat Senso Flex, which is a rollable pressure-sensitive mat; Dividat GmbH), (3) an assessment system (including motor-cognitive tests), and (4) a rehabilitation cockpit for remote training supervision and management.

OBJECTIVE

The aim of this study is to test the feasibility and effectiveness of this novel training system.

METHODS

A total of 180 older adults from Switzerland, Italy, and Cyprus aged ≥60 years with a prescription for rehabilitation are randomly allocated to an intervention group or a control group. Both groups continue with their usual care, whereas participants in the intervention group additionally perform a 2-week supervised exergame training program at rehabilitation centers, followed by a 10-week home training program under remote supervision. The assessment system is used to indicate the start level of each participant, and, in both intervention periods, standardized progression rules are applied. The measures of feasibility include adherence, attrition, exergame enjoyment, willingness to perform such a training program, and the number and types of help requests. Effectiveness is assessed in terms of cognitive and physical functioning, balance confidence, and quality of life.

RESULTS

Data collection started in February 2023 and is ongoing. Final measurements are expected to be performed in January 2024.

CONCLUSIONS

Owing to the user-centered design approach, the Cocare system is expected to be user-friendly and offers several novel features to cover the whole continuum of care. This pragmatic trial will provide valuable information regarding final necessary adaptations and subsequent implementation efforts.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05751551; https://www.clinicaltrials.gov/study/NCT05751551.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49377.

摘要

背景

针对老年人的基于运动游戏的运动认知训练已被证明与身体、认知和心理功能的改善有关。通过以用户为中心的设计过程开发的新型Cocare系统（Dividat GmbH），允许在远程康复环境中进行运动认知训练。它包括：（1）一个用于监督运动游戏训练的固定式踏步平台（Dividat Senso；Dividat GmbH），（2）一个家庭版（Dividat Senso Flex，这是一个可滚动的压敏垫；Dividat GmbH），（3）一个评估系统（包括运动认知测试），以及（4）一个用于远程训练监督和管理的康复驾驶舱。

目的

本研究的目的是测试这种新型训练系统的可行性和有效性。

方法

共有180名来自瑞士、意大利和塞浦路斯的60岁及以上有康复处方的老年人被随机分配到干预组或对照组。两组都继续接受常规护理，而干预组的参与者还在康复中心进行为期2周的监督运动游戏训练计划，随后在远程监督下进行为期10周的家庭训练计划。评估系统用于指示每个参与者的起始水平，并且在两个干预期内，都应用标准化的进展规则。可行性的衡量指标包括依从性、损耗率、运动游戏的趣味性、执行此类训练计划的意愿以及求助请求的数量和类型。有效性通过认知和身体功能、平衡信心和生活质量来评估。