Physical and Cognitive Stimulation Using an Exergame in Subjects with Normal Aging, Mild and Moderate Cognitive Impairment

Article type: Research Article

Authors: Ben-Sadoun, Grégory^{a; b; *} | Sacco, Guillaume^{a; b; c; d} | Manera, Valeria^{a; b; i} | Bourgeois, Jérémy^{a; b; i} | König, Alexandra^{a; b; e; i} | Foulon, Pierre^f | Fosty, Baptiste^g | Bremond, François^{a; g} | d’Arripe-Longueville, Fabienne^h | Robert, Philippe^{a; b; i}

Affiliations: [a] EA 7276 CoBTeK –Cognition Behaviour Technology, University of Nice Sophia-Antipolis, Claude Pompidou Institute, Edmond and Lily Safra center, Nice, France | [b] Centre Mémoire de Ressources et de Recherche (CMRR) –Teaching Hospital of Nice, Claude Pompidou Institute, Edmond et Lily Safra Center, Nice, France | [c] Department of Geriatrics, Rehabilitation Unit, University Hospital of Nice, Cimiez Hospital, Nice, France | [d] Centre d’Innovation et d’Usages en Santé (CIU-S), Cimiez Hospital, Teaching Hospital of Nice, France | [e] School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, Netherlands | [f] Group GENIOUS Serious Games, Montpellier, France | [g] INRIA, STARS, Sophia-Antipolis, Sophia-Antipolis, France | [h] Laboratory of Human Motricity Sport and Health (LAHMESS, EA 6312), Nice Sophia Antipolis University, Nice, France | [i] Association Innovation Alzheimer, Claude Pompidou Institute, Nice, France

Correspondence: [*] Correspondence to: Grégory Ben-Sadoun, EA 7276 CoBTeK–Cognition Behaviour Technology, University of Nice Sophia-Antipolis, Claude Pompidou Institute, Edmond and Lily Safra center, Nice, France. Tel.: +33 6 51 09 16 00; E-mail: bensadoun.gregory@hotmail.fr.

Abstract: Background: The use of Serious exerGames (SeG) as enriched environments (EE), which promotes cognitive simulation with physical activity in a positive emotional context, has been proposed to represent a powerful method to slow down the decline due to neurodegenerative diseases (ND), such as Alzheimer’s disease (AD). However, so far, no SeG targeting EE has been tested in ND subjects. Objective: This study aimed at evaluating the usability and short-term training effects of X-Torp, an action SeG designed for elderly ND subjects with mild cognitive impairment (MCI) and AD. Methods: X-Torp is a SeG played using the Microsoft® Kinect™. 10 ND subjects and 8 healthy elderly controls (HEC) were enrolled in a 1-month program with three training sessions per week. Usability was evaluated through game time, game performance, the aerobic intensity level reached, perceived emotions, and perceived usability. Results: All participants successfully completed the training program. ND subjects played less and had a lower game performance compared to HEC. During the sessions, ND subjects maintained a light intensity of aerobic activity, while HEC maintained a moderate intensity. Both groups experienced only positive emotions, and reported a ‘moderate’ to ‘high’ perceived competence, a ‘moderate’ game difficulty, and a ‘high’ interest in the game. Conclusion: Usability results suggest that X-Torp represents a usable EE for healthy subjects and persons with MCI and AD. However, in order to reach moderate or high intensity of aerobic activity, X-Torp control modes should be adapted to become more physically stimulating.

Keywords: Aerobic activity, Alzheimer’s disease, cognition, enriched environment, mild cognitive impairment, sep serious game

DOI: 10.3233/JAD-160268

Journal: Journal of Alzheimer's Disease, vol. 53, no. 4, pp. 1299-1314, 2016