Improving movement confidence of people with dementia using gaming

Background: People living with dementia face increased risk of falls due to balance impairment and falling-related psychological factors, such as fear of falling and lack of confidence. Improving movement confidence could improve balance and impact fall risk. This study set out to examine movement confidence of people living with dementia while playing a digital bowling game. 

Method: Sixty-six people (34F/32M) with dementia (mean MoCA 12.7/30), completed a formal balance measure (mini-BEST or Sharpened Romberg) before and after participating in a 20-session (2x per week) digital bowling game. Samples of video recordings of the bowling sessions were analysed by two raters, using a coding scheme developed to examine movement confidence. 

Result: Formal balance measures confirmed that the majority of participants were substantially impaired in several domains, including reactive postural control (mini-BEST) and balance with eyes open (Sharpened Romberg). By contrast movement confidence during game play started at a high level in several domains such as optimal walking and fluency of motion and remained high throughout. 

Conclusion: Movement confidence can be observed when people with dementia are playing a physical game and contrasts with their performance on formal measures. This may be due to game playing focusing attention onto the game activity, whereas formal assessment focuses on completing the specific movements under assessment. The results highlight the potential of exergames to improve movement confidence and target balance to reduce fall risk of people living with dementia.