Development of a Motion-Based Video Game for Postural Training: A Feasibility Study on Older Adults With Adult Degenerative Scoliosis.

Forward sagittal alignment affects physical performance, is associated with pain and impacts the health-related quality of life of the elderly. Interventions that help seniors to improve sagittal balance are needed to inhibit the progression of pain and disability. A motion-sensing video game (active game) is developed in this study to monitor sitting and standing postures in real-time and facilitate the postural learning process by using optical sensors to measure body movement and a video game to provide visual feedback. Ten female subjects (mean age: 60.0 ± 5.2 years old; mean BMI: 21.4 ± 1.9) with adult degenerative scoliosis (mean major Cobb's angle: 38.1° ± 22.7°) participate in a 6-week postural training programme with three one-hour postural training sessions a week. Eleven body alignment measurements of their perceived "ideal" sitting and standing postures are obtained before and after each training session to evaluate the effectiveness of postural learning with the game. The participants learn to sit and stand with increased sagittal alignment with a raised chest and more retracted head position. The forward shift of their head and upper body is significantly reduced after each training session. Although this immediate effect only partially sustained after the 6-week program, the participants learned to adjust their shoulder and pelvis level for a better lateral alignment in standing. The proposed postural training system, which is presented as a gameplay with real-time visual feedback, can effectively help players to improve their postures. This pilot feasibility study explores the development and initial assessment of a motion-based video game designed for postural training in older adults with adult degenerative scoliosis, and demonstrates the usability and benefits of active gameplay in motor training.

Effects of heel height and high-heel experience on foot stability during quiet standing.

BACKGROUND: The use of high-heeled shoes (HHS) introduces instability into the wearer's balance system but how high-heel experience might influence standing balance is less examined in literature. RESEARCH QUESTION: (1) Does foot stability decrease in both the antero-posterior (AP) and medial-lateral (ML) directions with increasing heel height during quiet standing? (2) Does high-heel experience improve the wearer's foot stability during quiet standing in high-heeled conditions? METHODS: Twenty-four young females (12 regular and 12 non-regular HHS wearers) were recruited to perform quiet standing while wearing shoes with heel heights of 1 cm, 5 cm, 8 cm and 10 cm. The effects of heel height on the mean center of pressure (COP), their variability (standard deviations) and mean COP velocities in both the AP and ML directions were analysed by one-way repeated measures ANOVA and Bonferroni post-hoc test. The effects of high-heel experience were analysed through independent samples t-tests. RESULTS: The variability of the COP in both directions increased with heel height, although significance was found only in the ML direction. The COP velocities in both directions were highest for the 1 cm heel, decreased as the heel increased to 8 cm and increased again for the 10 cm heel. Experienced HHS wearers exhibited significantly smaller COP variances (AP) for the 8 cm and 10 cm heels, smaller COP velocities (AP) for all heels, and smaller COP variances (ML) and COP velocities (ML) for the 10 cm heel. SIGNIFICANCE: The use of HHS results in greater stability distortions in both AP and ML directions but high-heel experience improves balance control under high-heeled conditions. Our findings enhance the understanding of how high-heel experience might influence standing balance in different heel height, and highlights the importance of the ML components of the in-foot COP measures in the examination of standing balance in HHS.