Revising virtual reality programs to support healthy ageing and quality of life of the elderly

The main aim of the study is to assess the influence of physical activity on the changes of postural behavior and biochemical markers level playing role in neurodegenerative diseases in older adults. The same number of active and no active participants will be randomly allocated to one of five groups to constitute homogeneous groups. 1 Group VR1: 8 training sessions of balance-based training in augmented reality (VB-Clinic) 2 Group VR2: 8 training sessions of treadmill training in augmented reality 3 Group VR3: 8 training sessions of balance-based VR training (in HMD system - helmet mounted display) 4 Group Active Control: 8 training sessions with conventional home workout (exercise book) 5 Group Passive Control: 4 weeks without any intervention In each training group (excluding passive control group) session will last 30min with moderate intensity (60-75%HRmax)/ 2 sessions per week. Before pre-tests all included participants will be assessed according to their physical activity level by means of ActiGraph GT1M M during 7 consecutive days and assigned as ‘active’ or ‘no active’. All pre-tests will be performed before the intervention begins for two days and all post-tests will be performed after finishing the intervention period, also for two days. TRAINING PROTOCOL After pre-testing, subjects will participate in 8 sessions of balance training using virtual/augmented reality or conventional home workout. In each training group session will last 30min with moderate intensity (60-75%HRmax)/ 2 sessions per week. Group VR1: Augmented reality balance training: During each training session, the test subjects will practice maintaining standing posture, dynamic weight transfer, standing on one leg, pivoting in different directions, trunk rotation, and stepping. Games will be tailored to the individual capabilities of the test subject by changing the parameters of the game. The training will be conducted using Virtual Balance Clinic. This VR system included two integrated devices, a 3D measurement system based on time-of-flight cameras (Kinect sensor system) and a custom made force platform (from previous project “VB-Clinic” project no. STRATEGMED3/306011/1/NCBR/2017.) 2. Group VR2: Treadmill (Win FDM-T Zebris Medical GmbH) exercise program with augmented reality: The subject's tasks will include avoiding, crossing obstacles that appear, resisting inhibitory force in the middle part of the swing phase, aiming with the foot at a preset field in the path area, performing additional cognitive tasks (such as simple mathematical operations). The aim of the training is to stimulate the subjects to lengthen/shorten their stride length at a preset pace and length, higher/lower positioning of the lower limb in the pronation phase, walking at different speeds and cadences, diverting attention from balance control during gait. The first and last of the training will be also monitored in terms of the kinematic parameters of the subjects. Group VR3: Balance training in full immersion: In this module, participants will perform a variety of movements inspired by conventional balance exercises, such as avoiding obstacles, hitting walls and assuming certain positions, which requires the involvement of the entire body and promotes the development of coordination and agility. The training will be conducted using HTC goggles (HTC, Corporation, Taoyuan, Taiwan) and commercial game OhShape (Odders Lab, Spain). The training sessions will take place in the Kinesiology and Biomechnic Laboratory The Jerzy Kukuczka Academy of Physical Education in Katowice, which since 2016 have been certified in quality management of the research process ISO 9001-2015 in the area of kinesiology analysis of selected elements of physical activity and designing research procedures. All training sessions will be monitored by physiotherapists or lab staff. Their task will also be to verify the correctness of the exercises being performed and ensure their safety. The intensity of the training will be recorded using a wrist heart rate monitor and Borg RPE.