The United States is a rapidly aging nation. Older adults have higher rates of falls than any other age group. One in four older adults fall each year. Many of these falls are associated with sedentary lifestyles and decreased muscular strength effecting balance and gait performance. Physical activity (exercise) can reduce the risk of falls among older adults, yet adherence remains low. Exergames can increase adherence to interventions that promote health and physical activity. Social engagement can increase self-efficacy and motivation to exercise. By design, the Bingocize® health promotion mobile application (app) increases social engagement, while providing a multi-factorial fall prevention intervention. The purpose of this investigation was to evaluate the efficacy of the app to improve gait in community-dwelling older adults (N=38; mean age 72.42 years +12.58). Participants were clustered and randomly assigned to (a) experimental (n=20; using app with bingo game, health education and exercise) or (b) control (n=18; using app with bingo game, health education without exercise) condition. Each group completed a tenweek intervention that consisted of two- 45-60 minute sessions per week. Pre and post gait analysis, at self-selected (SS) and fast-walking speeds, measured using the GAITRite® Electronic Walkway (GWS). Gait analysis included parameters of velocity, cadence, step time, step length and width, and single and double support time. A mixedmodel ANOVA (p < .05) was used for statistical analysis. There were no main effects observed. Significant interactions (group x time) were observed at fast speed and SS speed compared to the control group. Significant interactions were observed at fast speed included velocity (λ = .886, F (1, 36) = 4.61, p = .039, 𝜼𝒑 𝟐 = .114); and step length (λ = .864, F (1, 36) = 5.64, p = .023, 𝜼𝒑 𝟐 = .136); and were observed at SS speed for single support time (λ = .887, F (1, 36) = 4.59, p = .039, 𝜼𝒑 𝟐 = .113). Post hoc analyses using paired and independent samples t-tests were conducted on gait variables with observed significant interactions. The independent samples t-test for Single Support Time (SS) post was significant (t (36) = 2.454, p = .019, two-tailed). None of the remaining post hoc analyses were significant. There was a meaningful detectable change (MDC) in mean velocity (>5 cm/s) over time, for both SS and fast walking speeds, within the experimental condition. MDC in gait speed ranges from 5 cm/s (small) to 10 cm/s (large). As for clinical significance, this should be considered a small, yet meaningful detectable change. It is the conclusion of the investigators, that the app, with the exercise intervention, can effectively produce a meaningful change in gait speed (5 cm/s), which has the potential for reducing the risk of falls in older adults. This investigation was funded by The Retirement Research Foundation.
| Identifer | oai:union.ndltd.org:WKU/oai:digitalcommons.wku.edu:theses-2951 |
| Date | 01 April 2017 |
| Creators | Falls, Dustin Glenn |
| Publisher | TopSCHOLAR® |
| Source Sets | Western Kentucky University Theses |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Masters Theses & Specialist Projects |
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