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Major Risk for Older Adults As many as 70% of older people with forms of mild cognitive impairment fall at least once a year. Injuries can be severe even from minor falls, but even without injury, the subsequent fear of falling often leads to avoidance of going outside which creates social isolation and weakened muscles creating greater fall risk. Accordingly fall risk is a major health concern in aging populations.
Current interventions for falls in older adults typically focus on improving muscle strength, balance, and gait, often with the use of treadmills. However, Dr. Anat Mirelman, lead study author of new research into fall risk, stated, "Older people's ability to negotiate obstacles can be impaired because of age-related decline in cognitive abilities like motor planning, divided attention, executive control, and judgement."
In the largest study of its kind, Dr.Mirelman’s team researched fall incidence across 5 countries over 2 years following an intervention experiment. In this study the researchers chose to combine treadmill exercise with virtual reality where participants had to avoid virtual obstacles coming towards them, with the aim of combining both physical and cognitive aspects of training. They also had another group performing just treadmill exercise. Both groups had some history of falls. The researchers then tracked all fall incidences over the next six months.
The average reduction for exercise interventions had been previously found to be 17%, which was similar in the treadmill only group. However, the 142 participants in the VR treadmill group of had a dramatic 42% reduction in falls. The results are particularly significant because of the longevity of the prevention effects, as Dr. Mirelman summarized, "We found that virtual reality plus treadmill training helped to reduce fall frequency and fall risk for at least six months after training."
The implications are also far reaching because of the feasibility of this type of intervention, as Professor Stephen R. Lord at Neuroscience Research Australia independently commented, “These findings have important implications for clinical practice…treadmill training with a VR component could be administered in community gyms and rehabilitation clinics, and since the intervention is relatively short term in nature, throughput of many people would be possible.”
The research also correlates with preliminary NeuroTracker studies showing that cognitive load is a critical factor in motor-skill coordination, showing that even the puck handling skills NHL pros diminishes when placed near their attentional threshold, and that combined physical and cognitive training improved capabilities in both areas with Olympic athletes.
These kinds of findings may pave the way to a new understanding of how cognitive intervention is key for maintaining physical safety into old age.
Study name:
Dr Anat Mirelman, PhD et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial.
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