Games-based biofeedback training and the attentional demands of balance in older adults.

BACKGROUND AND AIMS Programs designed to improve balance in older adults may function by improving general fitness (strength, endurance, range of motion) and also changing the attentional demands of postural control. Research in previously sedentary older adults cannot differentiate between changes in balance ability resulting from improved fitness or reduced attentional demands. A training program of games-based balance biofeedback was given to nine older adults with previous exercise experience. METHODS Training consisted of sixteen sessions (twice weekly for eight weeks) of 30 minutes each. Postural sway (force plate measurement), attentional demands (dual task paradigm), the Community Balance and Mobility Scale (CB&M), and the six minute walk test were measured in pre, post and retention tests. RESULTS Participants in the training group significantly decreased their reaction time from pre to post testing in a dual task paradigm compared to a control group. The training group also significantly increased their scores on the CB&M scale compared to control participants. The decreased reaction times and increased CB&M scores observed in the training group were maintained through a two week retention period. Changes in reaction time were significantly correlated with changes in CB&M score. Six minute walk distance increased significantly in both groups and did not appear to result directly from the training program. CONCLUSIONS Gamesbased balance biofeedback training using a range of training postures can significantly improve functional balance in exercise trained older adults by reducing the attentional demands of postural control.