FRED: Exergame to Prevent Dependence and Functional Deterioration Associated with Ageing. A Pilot Three-Week Randomized Controlled Clinical Trial

Abstract

Introduction: Frailty syndrome and advanced age may decrease the acceptance of illness and quality of life, and worsen patients' existing health conditions, as well as leading to an increase in health care expenses. Purpose: The purpose of this study is to reduce frailty risk via the use of a FRED game which has been expressly designed and put together for the study. Materials and methods: A total of 40 frail volunteers with a score of <10 points in the short physical performance battery (SPPB) took part in a feasibility study in order to validate the FRED game. Following randomisation, the study group (20 subjects) took part in nine sessions of 20 min each over a three-week period. The control group (19 subjects) continued to lead their daily lives in the course of which they had no physical activity scheduled; Results: After three weeks and having taken part in nine physical activity sessions with the FRED game, 60% of subjects from the study group (12/20) obtained a score of ≥10 points at the end of the study, i.e., less risk of evidencing frailty. This result proved to be statistically significant (p < 0.001). The degree of compliance with and adherence to the game was confirmed by 100% attendance of the sessions. Discussion: Our findings support the hypothesis that FRED, an ad hoc designed exergame, significantly reduced the presence and severity of frailty in a sample of sedentary elders, thus potentially modifying their risk profile. Conclusions: The FRED game is a tool that shows a 99% certain improvement in the degree of frailty in frail elderly subjects. The effectiveness of the design of ad hoc games in a certain pathology or population group is therefore evidenced.

Keywords: elderly people; exergame; frailty; kinect; physical activity.

Figure 1

CONSORT flow diagram of the progress through the phases of a parallel randomised trial of two groups (i.e., enrolment, intervention allocation, follow-up, and data analysis). Source: [19,20].

Figure 2

Short physical performance battery (SPPB) flowchart. Source: [27].

Figure 3

Presentation of participants who meet inclusion criteria according to ranges of age, gender and Barthel score.

Figure 4

Screen images for when effort is rated, together with screen images for the breathing exercises.

Figure 5

Images of the game in Scenario 1.

Figure 6

Images of the game in Scenario 2.

Figure 7

Images of the game in Scenario 3.

Figure 8

Images of the game in Scenario 4.

Figure 9

Images of the game in Scenario 6.

Figure 10

Images from the game in Scenario 7.

Figure 11

Statistical description of the short physical performance battery (SPPB) results in the first and third weeks of the study.

Figure 12

Score obtained using the SPPB in weeks 1 and 3.

Figure 13

Frailty percentage and number of subjects in control group and study group at the end of week 3.

Figure 14

SPPB score evolution.

Figure 15

Distribution of SPPB score obtained according to age and gender.

Figure 16

Daily response percentages by the study group to the questions: “Do you like the game?” and “Do you find it motivating for the purpose of improving your physical condition?”