An active lifestyle has been identified as a protective factor against cognitive decline[1], where active individuals reduce the risk of cognitive impaired of 38% to 50% in comparison to sedentary individuals[2]. Combination of physical and cognitive training may lead to larger improvements in cognitive and physical outcomes compared to physical or cognitive training alone, and finally to impact on daily functioning[3]. Interactive cognitive-motor training requires individuals to perform both gross motor movements and complex information processing. Repetitive well-timed and directed movement under cognitive load may lead to motor learning and consequently improve motor programs that can be accessed to initiate movement appropriately in real life[4]. Games showed potential as rehabilitative tools among older patients, with several clinical trials indicating that game-based rehabilitation had positive effects on some aspects of physical, psychological, and cognitive functioning. Besides, many VR games for medical therapy were developed and achieved success, like therapy VR games for anxiety, depression or phobias; freeing soldiers from PTSD; pain relief; recovering from brain injuries; better physical activity and faster rehabilitation[5], [6]. Mixed reality technologies harbour the dramatic potential for meaningful scientific application due to their ability to radically shift the way individuals interact with other people, places, objects, and ideas[7]. New interaction methods potentially lead to more efficient, personalized gaming experiences, which is very important for the full impact of cognitive training games.
The main aim of Cognitive training and exercise games in HOLOBALANCE project is to make an environment for empowering and motivating people during their balance physiotherapy. The combination of the cognitive exercise field and the stimulated physical activity is expected to result in an optimal training experience. One of the main aspects of the games is the users’ motivation provided by incorporating key design factors from the entertainment video game world. Also, numerous factors are going to be taken in a count, especially because games combine player’s executive functions with his physical activity in the augmented reality environment.
The games are hosted on the smartphone. The player/patient wears a head-mounted adapter to keep a smartphone at a set location on the head. The head-mounted adapter allows the user to see images generated from the smartphone screen as augmented reality environment in the space in front of the user.
[1] Hertzog C, Kramer AF, Wilson RS, Lindenberger U. Enrichment effects on adult cognitive development: can the functional capacity of older adults be preserved and enhanced? Psychol Sci Public Interest. 2008;9(1):1–65. doi:10.1111/j.1539-6053.2009.01034.x
[2] Küster, Olivia C.; Fissler, Patrick; Laptinskaya, Daria; Thurm, Franka; Scharpf, Andrea; Woll, Alexander; Kolassa, Stephan; Kramer, Arthur F.; Elbert, Thomas; von Arnim, Christine A. F.; Kolassa, Iris-Tatjana. Cognitive change is more positively associated with an active lifestyle than with training interventions in older adults at risk of dementia: a controlled interventional clinical trial BMC Psychiatry. 9/8/2016, Vol. 16, p1-12. 12p. 3 Diagrams, 3 Charts, 2 Graphs. DOI: 10.1186/s12888-016-1018-z
[3] Theill N, Schumacher V, Adelsberger R, Martin M, Jancke L (2013) Effects of simultaneously performed cognitive and physical training in older adults. BMC Neurosci 14: 103. doi: 10.1186/1471-2202-14-103
[4] Brach JS, Van Swearingen JM, Perera S, Wert DM, Studenski S (2013) Motor Learning Versus Standard Walking Exercise in Older Adults with Subclinical Gait Dysfunction: A Randomized Clinical Trial. Journal of the American Geriatrics Society 61: 1879–1886. doi: 10.1111/jgs.12506
[5] http://medicalfuturist.com/top-vr-companies-healthcare/
[6] http://eds.b.ebscohost.com.proxy.kobson.nb.rs:2048/eds/pdfviewer/pdfviewer?vid=1&sid=bb678852-fd33-4702-a580-4c7359c23c42%40sessionmgr120
[7] Leo Kobayashi, Xiao Chi Zhang, Scott A. Collins, Naz Karim, Derek L. Merck, Exploratory Application of Augmented Reality/Mixed Reality Devices for Acute Care Procedure Training, Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 19, January 2018, https://doi.org/10.5811/westjem.2017.10.35026
Also, during the game the player is wearing sensors that measure patient’s physical performances providing critical information needed playing the games.
