Aging is associated with a decline in physical functions, cognition and brain structure. Considering that human life is based on an inseparable physical-cognitive interplay, combined physical-cognitive training through exergames is a promising approach to counteract age-related impairments. The aim of this study was to assess the effects of an in-home multicomponent exergame training on [i] physical and cognitive functions and [ii] brain volume of older adults compared to a usual care control group. Thirty-seven healthy and independently living older adults aged 65 years and older were randomly assigned to an intervention (exergame training) or a control (usual care) group. Over 16 weeks, the participants of the intervention group absolved three home-based exergame sessions per week (à 30–40 min) including Tai Chi-inspired exercises, dancing and step-based cognitive games. The control participants continued with their normal daily living. Pre- and post-measurements included assessments of physical (gait parameters, functional muscle strength, balance, aerobic endurance) and cognitive (processing speed, short-term attention span, working memory, inhibition, mental flexibility) functions. T1-weighted magnetic resonance imaging was conducted to assess brain volume. Thirty-one participants (mean age = 73.9 ± 6.4 years, range = 65–90 years, 16 female) completed the study. Inhibition and working memory significantly improved post-intervention in favor of the intervention group [inhibition: F₍₁₎ = 2.537, p = 0.046, ${\text{n}}_{\text{p}}^2$ = 0.11, working memory: F₍₁₎ = 5.872, p = 0.015, ${\text{n}}_{\text{p}}^2$ = 0.02]. Two measures of short-term attentional span showed improvements after training in favor of the control group [F₍₁₎ = 4.309, p = 0.038, ${\text{n}}_{\text{p}}^2$ = 0.03, F₍₁₎ = 8.504, p = 0.004, ${\text{n}}_{\text{p}}^2$ = 0.04]. No significant training effects were evident for physical functions or brain volume. Both groups exhibited a significant decrease in gray matter volume of frontal areas and the hippocampus over time. The findings indicate a positive influence of exergame training on executive functioning. No improvements in physical functions or brain volume were evident in this study. Better adapted individualized training challenge and a longer training period are suggested. Further studies are needed that assess training-related structural brain plasticity and its effect on performance, daily life functioning and healthy aging.

Gait performance is an important marker of motor and cognitive decline in older adults. An instrumented gait analysis resorting to inertial sensors allows the complete evaluation of spatiotemporal gait parameters, offering an alternative to laboratory-based assessments. To estimate gait parameters, foot trajectories are typically obtained by integrating acceleration two times. However, to deal with cumulative integration errors, additional error handling strategies are required. In this study, we propose an alternative approach based on a deep recurrent neural network to estimate heel and toe trajectories. We propose a coordinate frame transformation for stride trajectories that eliminates the dependency from previous strides and external inputs. Predicted trajectories are used to estimate an extensive set of spatiotemporal gait parameters. We evaluate the results in a dataset comprising foot-worn inertial sensor data acquired from a group of young adults, using an optical motion capture system as a reference. Heel and toe trajectories are predicted with low errors, in line with reference trajectories. A good agreement is also achieved between the reference and estimated gait parameters, in particular when turning strides are excluded from the analysis. The performance of the method is shown to be robust to imperfect sensor-foot alignment conditions.

Stroke is a disabling disease that requires extensive work of rehabilitation to improve the quality of life of patients. In order to increase the compliance and motivation of the patients, stroke rehabilitation exercises have been developed in a game-like structure using a smartphone. These games were designed to promote and evaluate different movements of the upper limbs and their level of difficulty is adaptable to each patient's impairment level. The feasibility of the use of smartphone built-in inertial sensors to monitor the execution of stroke rehabilitation exercises has been assessed. The accuracy of the angles measured decreased along time and for higher angles, nevertheless the differences between real and measured angles are within acceptable limits. The usability tests in a post-stroke patient case demonstrate the applicability and motivational potential of the developed games. Gamification of stroke rehabilitation exercises using a smartphone is feasible an d may be valuable for stroke rehabilitation

The global population aged 60 years and over rises due to increasing life expectancy. More older adults suffer from “geriatric giants”. Mobility limitations, including immobility and instability, are usually accompanied by physical and cognitive decline, and can be further associated with gait changes. Improvements in physical and cognitive functions can be achieved with virtual reality exergame environments. This study investigated the usability of the newly developed VITAAL exergame in mobility-impaired older adults aged 60 years and older. Usability was evaluated with a mixed-methods approach including a usability protocol, the System Usability Scale, and a guideline-based interview. Thirteen participants (9 female, 80.5 ± 4.9 years, range: 71–89) tested the exergame and completed the measurement. The System Usability Scale was rated in a marginal acceptability range (58.3 ± 16.5, range: 30–85). The usability protocol and the guideline-based interview revealed general positive usability. The VITAAL exergame prototype received positive feedback and can be considered usable by older adults with mobility limitations. However, minor improvements to the system in terms of design, instructions, and technical aspects should be taken into account. The results warrant testing of the feasibility of the adapted multicomponent VITAAL exergame, and its effects on physical and cognitive functions, in comparison with conventional training, should be studied.

In addition to contributing to increased training motivation, exergames are a promising approach to counteract age-related impairments. Mobility limitations, cognitive impairment, and urinary incontinence are very common in older adults. To optimally address these conditions, exergames should include interventions for strength, balance, cognition, and pelvic floor muscle training. In this study, we develop a personalized multicomponent exergame solution for the geriatric rehabilitation of age-related impairments. The exergame can provide interventions for balance, strength, cognition, and urinary incontinence in one single session, accommodating the needs of older adults with multiple disabilities. For its development, we involved a multidisciplinary team that helped us to specify the structure and contents of the exergame considering training requirements, game design principles, and end-user characteristics. In addition to allowing the customization of the training components, the exergame includes automatic adaptation of difficulty/load, in line with player progress over time. The game mechanics ensures the fulfilment of training needs as defined by the therapist. The exergame is cross-platform compatible (web-based) and includes novel means of interaction with wearable sensors.

As sensor-rich mobile devices became a commodity, more opportunities appeared for the creation of location-aware services. While GPS is a well established solution for outdoor localization, there is still no standard solution for localization indoors. This paper presents a novel accurate indoor positioning mechanism that is meant to run in common smartphones to be a readily and widely available solution. The system is based on multiple gait-model based filtering techniques for accurate movement quantification in combination with an advanced fused positioning mechanism that leverages sequences of opportunistic observations towards an accurate localization process. Magnetic field fluctuations, Wi-Fi readings and movement data are incrementally matched with a feature spot map containing multi-dimensional spatially-related features that characterize the building. A novel and convenient way of mapping the architectural and environmental properties of buildings is also introduced, which avoids the burden normally associated with the process. The system has been evaluated by multiple users in open and crowded spaces where overall median localization errors between 1.11 m and 1.68 m were obtained. While the reported errors are already satisfactory in the context of indoor localization, improvements may be readily achieved through the inclusion of additional reference features. High accuracy performance coupled with an opportunistic and infrastructure-free approach creates a very desirable solution for the indoor localization market doge.