Interactive Exergaming With Otago Exercise Program on Mobility in Community-Dwelling Older Adults

This cluster-randomized controlled trial investigates the integration of interactive exergaming with the evidence-based Otago Exercise Program (OEP) to enhance mobility among community-dwelling older adults. The study employs comprehensive methodology and rigorous assessment protocols to evaluate intervention effectiveness.

Methodology and Technical Implementation:

Assessment Tools and Measurements:

Primary Outcome Measures:

ICOPE (Integrated Care for Older People) screening tool evaluating six domains: cognition, mobility, nutrition, vision, hearing, and depression

Short Physical Performance Battery (SPPB, ICC=0.81-0.91) measuring:

Balance (side-by-side, semi-tandem, tandem stance) Gait speed (3-meter walk test) Lower extremity strength (5-time sit-to-stand)

Lower extremity muscle strength assessment using MicroFET2 digital dynamometer (accuracy ±1%):

Quadriceps strength Ankle dorsiflexion Hip abduction

Secondary Outcome Measures:

Three-Item Loneliness Scale (T-ILS, Cronbach's α=0.87) Geriatric Depression Scale-5 (GDS-5) Well-being Scale for Older Adults (9 items, Cronbach's α=0.91)

Intervention Protocol Design:

Exercise Program Structure:

12-week intervention period Two 60-minute sessions per week (120 minutes total) Group format (10-25 participants) Led by certified OEP trainers Integration of Nex Playground exergaming system

Session Components:

1. Warm-up (10 minutes):

Head and neck rotations Back stretches Upper body rotation Lower limb stretches 2. Otago Exercise Program (30 minutes):

Knee lifts Ankle movements Knee extensions Standing exercises with support Heel-toe exercises Sit-to-stand practice 3. Interactive Exergaming (20 minutes):

Virtual soccer targeting lower limb strength Fruit Ninja for upper body engagement Alternating activities to prevent fatigue 4. Cool-down (10 minutes):

Stretching exercises Relaxation techniques

Technical Implementation:

Equipment and Setting:

Spacious, well-ventilated rooms Sturdy chairs with armrests Nex Playground gaming system Large display screen/projector Non-slip exercise mats Safety rails/supports

Safety Protocols:

Environmental risk assessment Fall prevention measures Emergency response procedures Continuous monitoring by trained staff Regular equipment maintenance

Quality Control Measures:

Standardization:

Assessor training (ICC \> 0.80 required) Intervention delivery protocols Documentation procedures Data collection methods

Blinding:

Outcome assessors blinded to group allocation Separate staff for intervention and assessment Data coding for anonymity

Monitoring:

Attendance tracking Adverse event documentation Intervention fidelity checks Regular team meetings

Statistical Analysis Framework:

Primary Analysis:

Intention-to-treat principle Generalized Estimating Equations (GEE) Repeated measures analysis Cluster-level adjustments

Data Management:

Coded data entry Regular quality checks Missing data protocols Interim analyses

Methodological Considerations:

Cluster Randomization:

Unit of randomization: community centers Stratification by center size Baseline characteristic balance Intraclass correlation adjustment

• Intrinsic Capacity Score [Срок оценки: baseline (T0), post 12-week intervention (T1), and 3-month follow-up (T2)]
• Loneliness Level [Срок оценки: Measured at baseline (T0), post 12-week intervention (T1), and 3-month follow-up (T2)]
• Depression Symptoms [Срок оценки: Measured at baseline (T0), post 12-week intervention (T1), and 3-month follow-up (T2)]
• Well-being Status [Срок оценки: Measured at baseline (T0), post 12-week intervention (T1), and 3-month follow-up (T2)]