Improving mobility in glaucoma patients using video games and exercise

The GRADE Randomized Trial: Glaucoma Rehabilitation With Action viDeo Games and Exercise

This study is testing if playing action video games combined with exercise can help glaucoma patients improve their mobility and feel less afraid of falling.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 56 (estimated)
• Ages: 55 Years to 80 Years
• Sex: All
• Sponsor: The Hong Kong Polytechnic University (other)
• Locations: 1 site (Hong Kong, Hong Kong)
• Trial ID: NCT06000865 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to enhance mobility and reduce the fear of falling in glaucoma patients with peripheral vision loss through an innovative intervention involving action video games and physical training. Participants will be randomly assigned to either an interactive video game training group or a conventional physical training group, with both groups undergoing 20 sessions over 10 weeks. The study will assess various outcomes related to mobility, balance, visual cognition, and quality of life before and after the intervention. The goal is to provide a fun and engaging way to improve rehabilitation outcomes for patients with visual impairments.

Who should consider this trial

Good fit: Ideal candidates are individuals with moderate to severe glaucoma and stable peripheral vision loss who have intact cognitive function.

Not a fit: Patients with advanced glaucoma or other significant ocular diseases may not benefit from this intervention.

Why it matters

Potential benefit: If successful, this intervention could significantly reduce fall risk and improve the quality of life for glaucoma patients.

How similar studies have performed: While the use of video games in rehabilitation is a novel approach, similar studies have shown promise in improving outcomes for patients with other conditions.

Eligibility criteria

Inclusion Criteria:

1. Presence of moderate to severe bilateral glaucomatous optic neuropathy (GON) from primary open-angle (including normal tension) or angle-closure glaucoma, as determined by an ophthalmologist, with abnormal Glaucoma Hemifield Test on standard Humphrey Field Analyzer 24-2 testing and matching nerve-fiber layer thinning on optical coherence tomography;
2. Stable vision and visual field loss for at least 3 months;
3. With a best-corrected distance acuity of 6/12 or better (equivalent to 0.3 logMAR acuity or better to confirm that participant's central vision is preserved);
4. With a cognitive functional score of 22 or above in the Montreal Cognitive Assessment - Hong Kong version (to confirm participants' intact cognitive function).

Exclusion Criteria:

1. Advanced glaucoma with GON of median deviation worse than -25 decibel;
2. Ocular diseases other than glaucoma (e.g., age-related macular degeneration, diabetic retinopathy, and moderate to severe cataract);
3. Severe medical problems (e.g., stroke, Parkinson's disease) or self-reported neurological (e.g. brain surgery, brain tumor and peripheral neuropathy), or cognitive disorders (e.g., diagnosed dementia or cognitive impairment);
4. Physical impairments (e.g. need the use of orthopedic and mobility aids) or physical limitations restricting them from independent walking;
5. Self-reported or medically diagnosed vestibular/ cerebellar dysfunction, history of vertigo, or severe hearing loss;
6. Using any medications for any neurological conditions or psychiatric drugs (e.g. sedative, hypnotic) that might interfere motor control; and
7. Currently attending any intensive physical/balance training.

Where this trial is running

Hong Kong, Hong Kong

• The Hong Kong Polytechnic University — Hong Kong, Hong Kong, Hong Kong (RECRUITING)

Study contacts

• Principal investigator: Allen Cheong, PhD — The Hong Kong Polytechnic University
• Study coordinator: Allen Cheong, PhD

Conditions: Glaucoma, Visual Impairment, Peripheral field loss, Action video games, Balance functions, Fear of falling, Quality of life