Comparison of exergames versus conventional exercises on the cognitive skills of older adults: a systematic review with meta-analysis.

PURPOSE: To compare the effects of exergames versus conventional physical training on the cognitive skills of older adults. MATERIALS AND METHODS: Scientific studies published in PubMed, Web of Science, and Cochrane Library databases were searched. Individual studies were assessed using the Cochrane Risk-of-bias tool for randomized trials (RoB 2). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE Pro). The cognitive outcomes were Trail Making Test (TMT)-A, TMT-B, Stroop Word-Color test, Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). RESULTS: We identified 256 studies, in which 13 studies were included in the systematic review and 11 in the meta-analysis. The majority of the exergame interventions were based on the Xbox 360's Kinect, followed by the Impact Dance Platform, Nintendo Wii, and the Bike Labyrinth. We observed heterogeneity in the conventional exercise group and in the duration of training, which ranged from 12 to 52 sessions. There was no statistically significant difference between groups in TMT-A (p=0.083), TMT-B (p=0.122), and Stroop (p=0.191). There were differences in favor of exergames in MMSE (raw mean difference=-1.58, 95% CI: -2.87 to -0.28, p<0.001) and MoCA (raw mean difference=-1.22, 95% CI: -2.24 to -0.20, p=0.019). CONCLUSIONS: Despite statistical differences in MMSE and MoCA, these results should be interpreted with caution due to methodological heterogeneity. Some studies reported possible neurophysiological benefits induced by exergames, which should be explored in future investigations.

Intervenção por realidade virtual e exercício físico em idosos / Intervention for virtual reality and physical exercise in elderly / La intervención de la realidad virtual y el ejercicio físico en los ancianos

Objetivo: Comparar nos idosos a evolução do equilíbrio, cognição e marcha durante a prática de exercício físico com a realidade virtual. Métodos: 31 participantes de ambos os sexos, foram divididos nos grupos: 1. Realidade Virtual (RV); 2. Exercício Físico (EF) e 3. Realidade Virtual e Exercício Físico (RVEF), realizaram procedimentos com um quebra-cabeça virtual (grupos RV) e/ou exercício físico de caminhada (grupos EF), durante 5 meses. Resultados: Na atenção todos os grupos aumentaram o escore médio após o período de intervenção. Na memória as diferenças estatisticamente significativas ocorreram nos grupos RV e RVEF. No equilíbrio todos os grupos aumentaram o escore após o período de intervenção. Na marcha o grupo RVEF obteve melhor resultado. Conclusões: As intervenções por RV e EF mostraram-se eficazes para a melhora do equilíbrio, marcha, atenção e memória. Portanto, conclui-se que a intervenção por RV associada ao EF melhora o desempenho físico funcional em idosos.

Objective: To compare in the elderly, the evolution of balance, cognition and walking during physical exercise with virtual reality. Methods: 31 participants of both sexes divided into groups: 1. Virtual Reality (VR); 2. Physical Exercise (PE) and 3. Virtual Reality and Physical Exercise (VRPE), performed procedures with a virtual puzzle (VR groups) or walking physical exercise (PE groups), during five months. Results: In the attention test, all groups increased the mean score after the intervention period; In the memory test, statistically significant differences occurred in the VR and VRPE groups; In the balance test, all groups increased the score after the intervention period, and in the gait test, the VRPE group obtained better results. Conclusions: The interventions by VR and PE were effective in improving balance, gait, attention and memory. Therefore, we conclude that VR intervention associated with PE improves functional physical performance in the elderly.

Objetivo: Comparar la evolución del equilibrio, la cognición y la marcha durante el ejercicio físico con la realidad virtual del ancianos. Métodos: 31 participantes de ambos sexos fueron divididos en grupos: 1. Realidad Virtual (RV) con un rompecabezas virtual; 2. Ejercicio Físico (EF) caminando; y 3. Realidad Virtual y Ejercicio Físico (RVEF). La intervención ha durado cinco meses. Resultados: En la atención todos aumentaron la puntuación media después del período de intervención. En la memoria, las diferencias estadísticamente significativas ocurrieron en los grupos RV y RVEF. En equilibrio, todos aumentaron la puntuación después del período de intervención. En la marcha el grupo RVEF obtuvo mejores resultados. Conclusiones: Las intervenciones de RV y EF fueron efectivas para mejorar el equilibrio, la marcha, la atención y la memoria. Se concluye que la intervención de la RV asociada a la EF mejora el rendimiento físico y funcional en los ancianos.