Title : Neuro-exergaming for parkinson’s: Clinic-observed trend of cognitive improvement after pedal-n-play with the interactive Physical and Cognitive Exercise System (iPACES)
Abstract:
Given that approximately 40% of Parkinson’s patients may meet criteria for mild cognitive impairment (MCI) and 80% may progress to dementia (Kenney et al., 2022), researchers have pursued interventions that might stave off or ameliorate neuropsychological decline. Numerous studies support physical exercise for its effectiveness in improving brain health and quelling cognitive decline across a variety of neurological conditions, including Alzheimer’s disease and related dementias (ADRDs) and precursor conditions, such as MCI (Kramer & Colcombe, 2018). Neuro?exergaming may not only entice health?focused physical activity through engagement in serious health games, but it has also shown promise for increasing benefits to cognition, perhaps from the two?for?one activity of mental exercise alongside of physical exercise (Anderson?Hanley et al., 2018). Additional research is underway to explore this apparent phenomenon and to try to maximize cognitive benefits by altering the nature of the mental exercise, while also examining generalizability to various neurological populations. The data presented herein is a complement to preliminary experimental data on executive function from a pilot study examining the feasibility for Parkinson’s Disease (PD) patients to pedal?n?play a portable tablet?based neuro?exergame, the interactive Physical and Cognitive Exercise System (iPACES). Archival clinic data, collected as the standard of care over time, was analysed de?identified per IRB approval, for those PD patients who participated in recurrent 8 wk pilot pedal?n?play iPACES group classes (2022?2023). Cognitive functioning was assessed by the clinical team serially over 1.5 yrs for five patients, and results suggest an upward trend (p = .05). While change over time cannot be fully attributed to neuro?exergaming alone, the finding is encouraging since most studies with MCI necessarily, modestly aim to at least preserve cognitive function or perhaps slow decline. Furthermore, the results are not entirely explained away by mere practice effects from repeated testing since alternate forms are utilized at this clinic. In preparing for a follow?up study, awareness was increased for additional unique considerations in clinical monitoring of status in PD with serial testing, including tracking challenges of on/off medication or other treatment effects. The possibility of clinical improvement over time of neuropsychological function in PD patients engaged in neuro?exergaming, as seen in this preliminary clinic data, which represents a more ecologically valid and potentially generalizable promising trend, warrants follow?up, ideally in a larger scale trial.
Audience Take Away
- Clinicians and scientists will increase their understanding of the potential use of serious health games to address cognitive challenges in neurological populations; in particular we will present a novel research?based neuro?exergaming intervention being used for MCI as in Alzheimer’s disease and related dementias, herein piloted for Parkinson’s
- Clinicians might explore the use of neuro?exergames with their patients and/or link up with clinical trials that are currently evaluating these novel behavioral interventions
- Researchers will have a chance to consider collaborating or utilized the iPACES pedal?n?play neuroexergame in future research
