Compromised Brain Activity With Age During a Game-Like Dynamic Balance Task: Single- vs. Dual-Task Performance

Background: Postural control and cognition are affected by aging. We investigated whether cognitive distraction influenced neural activity differently in young and older adults during a game-like mediolateral weight-shifting task with a personalized task load.Methods: Seventeen healthy young and 17 older adults performed a balance game, involving hitting virtual wasps, serial subtractions and a combination of both (dual-task). A motion analysis system estimated each subject's center of mass position. Cortical activity in five regions was assessed by measuring oxygenated hemoglobin (HbO2) with a functional Near-Infrared Spectroscopy system.Results: When adding cognitive load to the game, weight-shifting speed decreased irrespective of age, but older adults reduced the wasp-hits more than young adults. Accompanying these changes, older adults decreased HbO2 in the left pre-frontal cortex (PFC) and frontal eye fields (FEF) compared to single-tasking, a finding not seen in young adults. Additionally, lower HbO2 levels were found during dual-tasking compared to the summed activation of the two single tasks in all regions except for the right PFC. These relative reductions were specific for the older age group in the left premotor cortex (PMC), the right supplementary motor area (SMA), and the left FEF.Conclusion: Older adults showed more compromised neural activity than young adults when adding a distraction to a challenging balance game. We interpret these changes as competitive downgrading of neural activity underpinning the age-related deterioration of game performance during dual-tasking. Future work needs to ascertain if older adults can train their neural flexibility to withstand balance challenges during daily life activities.

The relationship between the skill-challenge balance, game expertise, flow and the urge to keep playing complex mobile games

Background and aimsInterest surrounding the relationship between flow and problematic gameplay has surged. An important antecedent of flow in the context of video-gaming is the skill-challenge balance, but researchers have only manipulated this balance by changing speed of play. The current research seeks to examine the skill-challenge balance and flow in a mobile game in which challenge is increased via the complexity of puzzles. We predicted games like Candy-Crush would more strongly support a model of flow in which the greatest flow would be experienced by more skilled players and that high flow games would induce the most urge to continue play.MethodsWe had 60 Candy-Crush players play games near their level standing (maximal skill-challenge balance), or games that were too easy or too hard. Perceived skill, challenge, flow, and urge to continue gameplay were measured after each game.ResultsPlayers felt the highest degree of skill-challenge balance when playing games around their level standing. Easy games produced the least flow, while both regular and hard games produced comparable flow despite hard games being far more challenging and frustrating. The findings support models of flow positing those with highest perceived skill will experience greater flow. Finally, flow and arousal combine to increase urge to keep playing.Discussion and conclusionsOur findings suggest those with high perceived skill will experience deep, immersive flow which motivates players to keep playing.

The Nintendo® Wii Fit Balance Board can be used as a portable and low-cost posturography system with good agreement compared to established systems

Background Almost all epidemiological studies over the past 40 years have determined that the incidence of fragility fractures is increasing. Therefore, the assessment of postural stability and monitoring any progress during balance training for geriatric patients to prevent falls are becoming more important. The Nintendo® Wii Fit Balance Board, with its integrated software and scoring system, might be a cheap and easily accessible tool for this purpose. Methods This prospective study analyzed the diagnostic value of the Wii Fit Balance Board in 41 healthy subjects using two measurements: the yoga task “tree,” which is performed in one-leg stance; and the balance game “table tilt.” Our investigation compared these tasks to two established, regularly used systems, the MFT-S3 Check and the Posturomed, by looking for correlation and agreement, using Bland–Altman plots, as well as for differences to demographic data. All measurement tools were also compared to the Sensory Organization Test—the gold standard for detecting impaired balance. Results We found a moderate correlation between the yoga exercise “tree” and the Sensory Organization Test (correlation coefficient r = 0.514, p = 0.001) as well as the MFT-S3 Check (r = 0.356–0.472, p = 0.002–0.022) and the Posturomed (r = 0.345, p = 0.027). However, results from the balance game “table tilt” did not show a significant correlation with those of the systems to which we compared it (p = 0.301–0.953). Conclusions According to the literature, the raw data from the Wii Fit Balance Board are comparable to that obtained by laboratory-grade force platforms. We have found, however, that the yoga pose “tree,” as integrated into the Nintendo® Wii Fit Balance Board with its own scoring system, also correlates with the gold-standard Sensory Organization Test. It also correlates with two frequently used diagnostic and therapeutic devices. We, therefore, conclude that the Wii Fit Balance Board is suitable for the evaluation of postural stability and may be useful in preventing falls among the geriatric population. Level of evidence 2b.