ARTICLE

PRESENTATION
Title: The Effect of Information Technology Convergence Gamification
Training in Community-Dwelling Older People: A Multicenter,
Randomized Controlled Trial

Authors: Eun-Lee Lee BA, Myung-Jun Shin PhD

Journal: Journal of the American Medical Directors Association

Impact factor: 7.82

Year: 2021
Aims
To confirm the safety and efficacy of information technology (IT)
convergence gamification exercise equipment for older adults.
Materials and methods
Study design: Randomised control trial

Study population: Community dwelling elderly population

Inclusion and exclusion criteria

The selection criteria were adults aged 60-85 years. Patients with severe untreated
medical disease or other reasons for which the examiner considered them unsuitable
for clinical study participation were excluded.

Sample size: Total of 40 participants were selected from the experimental group
(n=20) and control group (n=20) condidering the 10% dropout rate and dispersion
size.
Randomisation
This study was a multicenter randomized controlled trial. The selected participants
were randomly assigned according to the recruitment order, and the random
assignment table was prepared using a random number table in Excel. The random
assignment resulted in group 1 (conventional exercise group) consisting of 9 men
and 11 women and group 2 (IT convergence exercise) consisting of 7 men and 13
women.
Interventions
Group1 (control group): Conventional exercise was conducted 3 times/wk for 30
minutes per session for 8 weeks (a total of 24 times). Exercises were performed
following preproduced exercise videos. The exercise program consisted of upper
limb and trunk stretching, chest mobility exercises, lower extremity stretching and
muscle-strengthening exercises, balance training (one leg standing with a chair
holding), squats, quadriceps strengthening exercises (sitting on chair and holding on
the knee extension), and upper extremity training using elastic therabands (biceps,
deltoid, and upper trapezius).
Group 2 (Experimental): IT convergence exercises were performed using
Balpro110 designed for older adults. The training game content involved matching
pictures (training to pair the same picture cards after showing the card arrangement
for a certain period time, balance training of the lower extremities using 9
scaffolds), solving quizzes (lower extremity training to hold the suggested position
for a certain period of time after solving the quiz), obstacle running (lower
extremity training to avoid running obstacles), and fruit picking (exercise that
detects upper extremity movements by taking specified fruits and putting them in
the box below) in consideration of the exercise program of the conventional
exercise group.
Functional Assessment
The exercise program was conducted for 8 weeks in both groups 3 times a week, and
vital signs were assessed and adverse events were monitored during the exercises.
Functional assessment was conducted before training and after 8 weeks of training,
and the functional assessment was reconducted after a 4-week rest at the end of the
training.

Functional assessment was performed using the FTSST, Berg Balance Scale (BBS),
Timed Up-and-Go (TUG) test, 10-m Walking Test (10MWT), Chair Sit and Reach
(CSR) test, and the Korean version of the Falls Efficacy Scale International (KFES-I)
Statistical analysis
For group comparisons, Fisher exact test was performed for categorical variables,
independent 2-sample t tests were used for continuous variables if normality was
satisfied, and Wilcoxon rank sum tests were used if normality was not satisfied. A
comparison before and after treatment in each group was analyzed through the
paired t test. In post hoc analyses, a multiple comparison was performed using the
Bonferroni method to set a significance level <0.017.
Results

.
Conclusion
IT convergence gamification exercise equipment such as balpro110 has exercise
effects similar to existing conventional exercise methods, and also has advantages
as an alternative to exercise for older adults in the next generation, including
accessibility, interest, and data recording. It is expected that future research will
reveal the benefits of IT convergence gamification devices if further studies are
conducted to identify the effects associated with cognitive functions.
Strengths and limitations
Strengths

• It is a multi-centre study.

• They have explained the research progress in detail.

• The study has been performed under the supervision of experienced professionals.

• There are no drop-outs.

Limitations

• They could have taken pathological cases in the elderly population along with the

community dwelling elderly population.

• Availabilty and maintenance of the equipment

• Follow up could be of a longer duration

• More details could have been given regarding the inclusion and exclusion criteria
of the subjects.

• Should have evaluated other components such as adherence to the program as well.
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