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

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 rehabilitation

• The 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

Acknowledgements

The authors thank Jan Vanwezer, the residents, and staff at long-term care facility de Wingerd, and the master students from the KU Leuven Department of Rehabilitation Sciences for their participation and hospitality in the data collection process. The authors thank the developers of the VITAAL solution for providing the device and additional support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The original contributions presented in the study are included in the article. Further requests can be directed to the corresponding author.

Additional information

Funding

This work was performed in the context of the project VITAAL AAL-2017-066, funded under the AAL Joint Program and co-funded by the European Commission and the National Funding Authorities of Portugal, Switzerland, and Belgium.