Exergaming in a Moving Virtual World to Train Vestibular Functions and Gait; a Proof-of-Concept-Study With Older Adults
FRONTIERS IN PHYSIOLOGY
Authors: Swanenburg, Jaap; Wild, Karin; Straumann, Dominik; de Bruin, Eling D.
Abstract
Background: The use of Exergames designed to improve physical and cognitive functioning is relatively new in rehabilitation. Exergaming allows the training of skills, the handling of tools, and procedures; however, often, the potential of these aspects are not assessed before they are adopted in clinical settings. This study aimed at exploring the effects of exergaming on vestibular functions and gait in healthy community dwelling older adults using a proof-of-concept study design registered under ClinicalTrials.gov NCT03160352. Methods: A pre-test-post-test one-group study design comprising 10 older adults (mean age of 73.5 +/- 7.6 years, four males) investigated the feasibility of eight exergaming training sessions (for 160 min) and the effects on dynamic visual acuity (DVA), functional gait assessment (FGA), and extended timed get-up-and-go (ETGUG), The simulator sickness questionnaire (SSG) and the game scores were evaluated for the feasibility of the intervention. Wilcoxon test and Cohen's d (d) were chosen to test for differences and for effect size estimation. Results: Exergaming led to a significantly improved DVA (z = -2.50, p = 0.01, d = 1.35) with improvements in 9 out of 10 participants. In addition, the FGA significantly improved with a large effect size (z = -2.25, p = 0.02, d = 1.17). Specifically, component tasks such as walking with horizontal head turns (p = 0.03), gait with a narrow base of support (p = 0.03), ambulating backward (p = 0.05) significantly improved. The ETGUG component task Gait initiation significantly improved (p = 0.04). No change was found in gait speed and SSG. The game scores of the participants improved continuously during the course of the intervention for every game. Discussion: This proof-of-concept study suggests that the use of exergaming that requires active stepping movements and that contains moving game projection is feasible and facilitates gaze stability during head movements in healthy community dwelling older adults. Aspects of functional gait and gait initiation also improved. Future research aimed at testing this exergaming intervention in patients suffering from vestibular impairments is warranted.
Genetic and chromosomal variation-caused inconsistencies in two parental tests
FORENSIC SCIENCE INTERNATIONAL GENETICS SUPPLEMENT SERIES
Authors: Li, Chen; Li, Yifan; Jia, Li; Chen, Chong; Yan, Shi; Chen, Chuguang; Liu, Yacheng; Ren, He
Abstract
Two special cases were reported where inconsistency between children and the fathers were observed at FGA locus. Regular additional STR tests were performed and no more inconsistency was observed in the first case. Through the following TA cloning and sequencing, the first case turned to be a two-step mutation between child and father. In the second case, however, one more inconsistency was found in the additional WA at D4S2366, which was on Chr. 4 as well. Then, seven randomly selected STR-loci on Chromosome 4 were analyzed, indicating a possible maternal uniparental disomy (UPD) in the child with normal phenotype. This study emphasizes gene or chromosomal variations may mislead parentage test, especially variations like UPD that are relatively unfamiliar to investigators. If all the inconsistent loci are on the same chromosome, investigators should take UPD into consideration, and further tests, like chromosomal-specific STR-typing, should be applied to prevent pseudo-exclusions.