Using motion-based technology to measure movement confidence among people with dementia and mild cognitive impairment

BACKGROUND: Movement confidence is defined as "a person's feeling or sense of adequacy in a movement situation." It is proposed that those who are 'movement confident' are more likely to partake in movement situations (e.g., exercise) and enjoy doing so. However, the concept and measurement of movement confidence has not been explored among people with dementia and MCI, who can benefit from participating in activities involving physical movement, such as exercise. 

METHOD: Participants with dementia and MCI (n=28; 53.6% female) were recruited from four community-based adult day programs to participate in a 10-week Xbox Kinect bowling intervention to see whether the intervention impacted their balance, movement confidence, and cognition. As part of the data collection procedure, video recordings were taken during the first, middle, and final week of the intervention and coded using video analysis software, to measure movement confidence. Count and percentage data were examined, and the coding scheme used to create a categorical measure of movement confidence. Count, percentage, and categorical data were analyzed descriptively and also compared across the study using a series of related-samples Wilcoxon signed rank tests. 

RESULT: Among those who completed the study, movement confidence was high at the start and did not significantly decline over time (Z-score=-0.359, p=0.719), suggesting a potential maintenance effect of the intervention. Various behaviours signifying movement confidence during the motion-based activity, such as hip shifting, knee bending, change in base of support, and willingness to move were captured using both the movement confidence coding scheme and categorial measure. The coding scheme, categorical measure, and implications will be further described. 

CONCLUSION: This study is the first to examine the complex construct of movement confidence among people with dementia and MCI, paving the way for future investigations. This study is also the first to create an observational, categorical measure of movement confidence which could potentially be used by clinicians (e.g., physiotherapists) to quickly score the movement confidence of people with dementia and MCI in various movement situations.