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THERAPY-Magazin
Innovative research, evidence-based results

Explore 15+ scientific studies on the THERA-Trainer senso. Evidence shows effectiveness in stroke, MS, dementia, Parkinson’s, and fall prevention—across all ages.

Author
Jakob Tiebel
Business Owner, N+ Digital Health Agency
The THERA-Trainer senso in scientific focus
The research results not only illustrate the evolution of the device, but also show interesting correlations and lay the foundation for future scientific questions.
The THERA-Trainer senso, as an innovative and pioneering training and testing device, has not only gained worldwide recognition for its practical applicability and benefits, but has also been the subject of intensive scientific research. In this article, we take a look at completed and published studies that have placed the senso at the centre of research. These evidence-based findings not only emphasise the versatility of the device, but also its positive effects on the health and well-being of users.

The research on the THERA-Trainer senso spans the period from 2016 to 2023 and offers fascinating insights into the development of this innovative training and testing device. In close co-operation with renowned universities and institutions worldwide, studies have been carried out that not only reflect the technological evolution of the device, but also open up new perspectives in rehabilitation and healthcare (see section “Based on scientific evidence”).

The publications from this period form a scientific mosaic whose parts not only build on each other, but also lay the foundation for future research questions. The main areas of research focus on fall prevention, healthy ageing, dementia, stroke and multiple sclerosis.
Schaettin et al. (2016) - Frontiers in Aging Neuroscience
Adaptations of Prefrontal Brain Activity, Executive Functions, and Gait in Healthy Elderly Following Exergame and Balance Training: A Randomized-Controlled Study

The study by Schaettin et al. from 2016 focused on the adaptations of brain activity, executive functions and gait in healthy older adults after exergame training with the senso. The results showed significant improvements in brain activity, cognitive function and gait.

The aim of this study was to investigate the effectiveness of exergame training with the senso in healthy older adults, focusing on the effects on brain activity (in the prefrontal cortex), on cognitive functions (particularly executive functions) and on gait. The study participants were randomly assigned to either the training group or the control group. The intervention group carried out a training session on the senso three times a week for eight weeks. Each training session lasted 30 minutes and included four training games (Balloon, Step, Space and Season). The control group underwent conventional balance training during this time. Twenty-seven older adults took part in the study. The results showed improvements in brain activity in prefrontal brain areas (measured by EEG) as well as in cognitive functions (divided attention, working memory, cognitive flexibility) and gait pattern (walking speed, stride length, cadence) after training with the senso. Conventional balance training also led to improvements, but in fewer functions.
Swanenburg et al. (2018) - Frontiers in Physiology
Exergaming in a Moving Virtual World to Train Vestibular Functions and Gait

In 2018, Swanenburg et al. investigated the effectiveness of exergame training with the senso on vestibular functions and the gait pattern of older adults. The study showed positive effects on vestibular functions and various aspects of walking.

The aim of this study was to investigate the effectiveness of exergame training with the senso on vestibular functions and the gait pattern of older adults. Ten older adults were included in the study. The study participants carried out eight training sessions (twice a week for four weeks) with the senso. Each training session lasted 20 minutes and included four training games: Simple, Targets, Flexi and Snake. The games were projected onto a white wall using a projector. A special aspect of this training was that this projection moved during the training session (up/down or to the right/left). The study participants were forced to turn their heads while maintaining their body position. In addition, some of the study participants (for one game per training session) did not stand facing the wall with the game projection, but turned 90°, which meant that they had to turn their heads while maintaining a stable body position. The results showed an improvement in vestibular functions (gaze stability during head turns). There was also an improvement in several aspects of walking (gait initiation, walking backwards, walking on a narrow base). Walking with additional head turns also improved.
Morat et al. (2019) - Experimental Gerontology
Effects of stepping exergames under stable versus unstable conditions on balance and strength in healthy community-dwelling older adults: a three-armed randomized controlled trial

In 2019, Morat et al. presented the results of a study that investigated the effects of stepping exergames on stable and unstable surfaces. Training with the senso led to improvements in balance and calf muscle strength.

The aim of this study was to investigate the effects of training with the senso on a stable surface (normal senso) and on an unstable surface (senso on a Posturomed moving platform). Study participants were healthy older adults who were randomly assigned either to one of the training groups (senso stable, senso unstable) or to the control group (inactive). The participants in the two training groups trained with the senso three times a week for eight weeks, each training session lasting 45 minutes. Fifty-one participants were included in the study. The results showed an improvement in balance and calf muscle strength in both training groups with the senso. However, there are superior effects for training on the unstable, moving senso for reactive balance and functional mobility. No adverse events such as falls occurred in either group. It appears that training on unstable surfaces requires motor skills that are relevant to fall prevention.

de Bruin (2019) - Frontiers in Aging Neuroscience
Playing Exergames Facilitates Central Drive to the Ankle Dorsiflexors During Gait in Older Adults; a Quasi-Experimental Investigation

The 2019 study by de Bruin investigated the effects of exergame training with the senso on neuronal drive during walking in older adults. The results showed an improvement in the neuronal drive of the lower extremities.

The aim of this study was to investigate whether exergame training with the senso has an effect on neuronal drive, measured here using EMG-EMG coherence in the tibialis anterior muscle during walking. Neuronal drive essentially means that “the brain talks to the body” or the connection between brain and body. Twenty older adults were included in the study. The study participants completed 18 training sessions on the senso, each lasting 20 minutes (three times a week over six weeks). The following training games were used for the training: Simple, Targets, Divided, Simon, Flexi, Snake, Seasons and Tetris. The results showed an improvement in the neuronal drive of the lower extremities after training with the senso. There was also an improvement in gait pattern (minimal toe clearance).
Rebsamen et al. (2019) - Frontiers in Physiology
Exergame-Driven High-Intensity Interval Training in Untrained Community Dwelling Older Adults: A Formative One Group Quasi-Experimental Feasibility Trial

In 2019, Rebsamen et al. conducted a study on exergame-driven high-intensity interval training (HIIT) with the senso. The results showed excellent usability, high training participation and improvements in maximum performance.

The aim of this study was to investigate the feasibility and effectiveness of high-intensity interval training (HIIT) on the senso in untrained older adults. Twelve study participants performed HIIT on the senso three times a week for four weeks, with each training session lasting around 30 minutes on average. The training game Rocket was used for the HIIT, which was carried out in 2-minute units (with a heart rate of 70–90% HRmax) with 1-minute breaks in between. Less intensive training games were played during the breaks (e.g. Simple, Flexi, Simon, Snake etc.). The results showed excellent usability, very high training participation (91%) as well as high satisfaction and acceptance of this training by the solder adults. No undesirable events occurred. There was also an improvement in maximum performance in a cardiovascular exercise test.
Bakker et al. (2020) - Experimental Gerontology
Balance training monitoring and individual response during unstable vs. stable balance Exergaming in elderly adults: Findings from a randomized controlled trial

In 2020, Bakker et al. analysed balance during exergaming on stable and unstable surfaces. The study showed that the perceived exertion was higher when exercising on unstable surfaces.

The aim of this study was to investigate individual effort during exergame training with the senso, as this is relevant for training success. This is a secondary analysis of a study that investigated the training effects of training with the senso (on stable and unstable surfaces, see Morat et al. 2019). The aim of this secondary analysis was to investigate the internal and external load during training with the senso (on stable and unstable surfaces). The study participants were healthy older adults who were randomly assigned to one of the training groups (senso stable, senso unstable) or the control group (inactive). The participants in the two training groups trained with the senso three times a week for eight weeks, each training session lasting 45 minutes. The performance in the training games was regarded as external stress, and the subjectively perceived effort (recorded by means of an assessment procedure) was regarded as “internal stress”. Fifty-one participants were included in the study. Interestingly, the results showed that the performance in the training games was not significantly different between the two training groups (on the stable or unstable senso). However, it was found that the subjectively perceived exertion was higher for those who exercised on the unstable senso.
Swanenburg et al. (2020) - Frontiers in Neurology
Exergaming with integrated head turn task improves compensatory saccade pattern in some patients with chronic peripheral unilateral vestibular hypofunction

In 2020, Swanenburg et al. investigated the effects of exergame training with an integrated head rotation task on patients with peripheral vestibular hypofunction. The training showed an improvement in compensation in the vestibular system.

The aim of this study was to test the use of exergame training with the senso in vestibular rehabilitation. The effectiveness of training with the senso on vestibular functions and gait pattern of patients with chronic peripheral vestibular hypofunction (cPVH) was investigated. Twelve patients were included in the study. The study participants carried out eight training sessions (twice a week for four weeks) with the senso. Each training session lasted 22 minutes and included four training games: Simple, Targets, Flexi and Snake. The games were projected onto a white wall using a projector. A special aspect of this training was that this projection moved during the training session (up/down or to the right/left). The study participants were forced to turn their heads while maintaining their body position. In addition, some of the study participants (for one game per training session) did not stand facing the wall with the game projection, but turned 90°, which meant that they had to turn their heads while maintaining a stable body position. The results showed an improvement in vestibular functions (vestibular compensation in terms of smaller saccade amplitude) in patients with cPVH. There was also an improvement in walking (e.g. walking with additional head rotation).
Huber et al. (2021) - Frontiers in Aging Neuroscience
Personalized Motor-Cognitive Exergame Training in Chronic Stroke Patients – A Feasibility Study

The 2021 study by Huber et al. focused on personalised motor-cognitive exergame training for chronic stroke patients. The results showed a high level of training participation and improvements in balance, gait pattern and psychomotor speed.

The aim of this study was to investigate the feasibility and effectiveness of a training programme with the senso for chronic stroke patients in an initial pilot study. The training programme was developed based on theory and includes personalised, progressive training for each patient. The training took place twice a week for eight weeks. The duration of the individual training sessions was 15–20 minutes at the beginning and was increased over time (in 3-minute increments per week) to 30–45 minutes. Ten patients completed the study. The results showed a high level of training participation (95%). The study also found an improvement in balance and gait pattern as well as psychomotor speed. These results motivated us to continue working on the training programme and to conduct another larger study.
A. Schättin et al. (2021) - JMIR Serious Games
Design and Evaluation of User-Centered Exergames for Patients With Multiple Sclerosis: Multilevel Usability and Feasibility Studies

The development of specific exergames for patients with multiple sclerosis was the focus of the study by A. Schättin et al. The usability and feasibility of the games were rated positively.

As part of an Innosuisse project by Dividat together with ETH Zurich (Motor Control & Learning) and the Zurich University of the Arts (ZHdK), exergames/training games were developed specifically for the needs of multiple sclerosis (MS) patients. An interdisciplinary team (movement scientists, neuropsychologists, game designers) was put together for this purpose. Focus groups were held with MS patients and therapists. The newly developed games (Ladybug, Scooper/Sam’s Garden and Cloudy) were tested in two studies, which investigated the usability and feasibility of the games with MS patients. The games were revised based on the results. The results showed that the newly developed training games are usable and applicable for patients with MS and that they find this type of training very motivating.
Swinnen et al. (2021) - Alzheimer’s Research & Therapy
The efficacy of exergaming in people with major neurocognitive disorder residing in long-term care facilities: A pilot randomized controlled trial

In 2021, Swinnen et al. presented the results of a pilot study on the effectiveness of exergaming with the senso in people with Alzheimer’s disease. The training showed positive effects on cognitive performance.

The aim of this study was to investigate the effectiveness of cognitive-motor training on the senso for people with severe cognitive impairments (in long-term care facilities). The study participants were randomly assigned to either the training group or the control group. The intervention group trained with the senso for at least 15 minutes three times a week for eight weeks. The training programme focused on the games Simple, Birds and Targets, and Habitats was also added depending on the restrictions. The control group watched music videos during this time. Forty-five patients completed the study. The results showed improvements in walking speed, balance, reaction speed, general cognitive status and mental well-being in patients who trained with the senso. Training with the senso is a practical and effective approach for patients with severe cognitive impairments (e.g. in the context of dementia) and can help to improve physical and cognitive functions.
Jäggi et al. (2023) - European Journal of Medical Research
Feasibility and effects of cognitive– motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients

The study investigated the feasibility and effectiveness of a senso training programme for Parkinson’s patients in a rehabilitation clinic, showing a high training participation rate (97%) and an improvement in physical and cognitive functions such as balance and reaction time. Senso training proved to be a practicable, safe and effective approach for inpatient Parkinson’s rehabilitation.

The aim of this study was to investigate the feasibility and effectiveness of a senso training programme for patients with Parkinson’s disease in a rehabilitation clinic. The study participants were randomly assigned to either the training group or the control group. The control group received the standard treatment offered at the clinic. The intervention group also carried out training with the senso five days a week. Each training session lasted at least 15 minutes and included around five to seven training games. Depending on how long a patient was at the clinic, the intervention period lasted eight to 28 days with daily training. Forty patients took part in the study. The results showed good usability/operability and a very high training participation rate (97%). There were no adverse events such as falls. The study also found an improvement in physical and cognitive functions such as balance, responsiveness and attention in patients who trained with the senso. Training with the senso is a practical, safe and effective approach for Parkinson’s patients in inpatient rehabilitation.
Seinsche et al. (2023) - Frontiers in Public Health
Older adults’ needs and requirements for a comprehensive exergame-based telerehabilitation system

The study analysed the needs for telerehabilitation among older people and healthcare professionals. Results show great interest, provided that the technologies are user-friendly and training and a contact person are available. Based on this, Dividat is developing the SensoFlex system for cognitive-motor training at home.

The aim of this study was to investigate the needs and requirements that older individuals/patients and healthcare professionals have with regard to telerehabilitation. Telerehabilitation means that information and communication technologies (ICT) can be used to provide training or therapy without physical contact, sometimes over long distances (e.g. at home). Six focus groups were conducted with a total of 34 participants. The results showed that both older people/patients and healthcare professionals are very interested in such approaches to telerehabilitation and would like to try them out. Important requirements are that the technologies used are easy to use, that appropriate training is provided and that a contact person is always available. Based on these results, Dividat is developing a telerehabilitation system with a product (SensoFlex) for cognitive-motor training at the patient’s home.
Altorfer et al. (2023) - Frontiers in Aging Neuroscience
Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study

The study investigated the feasibility and effectiveness of senso training for geriatric patients in a rehabilitation clinic. The results showed high usability, 99% training participation and improvements in walking speed, step reaction time and attention, confirming the training as safe, effective and suitable for geriatric patients.

The aim of this study was to investigate the feasibility and effectiveness of a senso training programme for geriatric patients in a rehabilitation clinic. The study participants were randomly assigned to either the training group or the control group. The control group received the standard treatment offered at the clinic. The intervention group also carried out training with the senso five days a week. Each training session lasted at least 10–15 minutes and included six or seven training games. Depending on how long a patient was at the clinic, the intervention period lasted two to three weeks with daily training.

39 patients took part in the study. The results showed excellent usability/operability and a very high training participation rate (99%) with no dropouts or adverse events. The study also found an improvement in walking speed, step reaction time and attention in patients who trained with the senso. This has reduced the risk factors for falls. The study was able to show that training with the senso is a practicable, safe and effective approach for geriatric patients in inpatient rehabilitation.
Conclusion

The wide range of scientific studies on the THERA-Trainer senso not only underscores the high relevance of this device in various areas of rehabilitation and health promotion, but also provides valuable findings for the further development and optimisation of training methods. The evidence-based results form a solid basis for the integration of senso into therapeutic approaches and show that innovative technologies such as the THERA-Trainer senso can make a significant contribution to improving quality of life and functional ability.
The research landscape surrounding the THERA-Trainer senso extends from 2016 to 2023 and offers a fascinating insight into the development of this innovative training and testing device.
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Author
Jakob Tiebel
Business Owner, N+ Digital Health Agency
Jakob Tiebel studied applied psychology with a focus on health economics. He has clinical expertise from his previous therapeutic work in neurorehabilitation. He conducts research and publishes on the theory-practice transfer in neurorehabilitation and is the owner of Native.Health, an agency for digital health marketing.
Author
Manuela Adcock
Head of Research, Dividat AD
Manuela Adcock is Head of Research at Dividat AG and holds a doctorate from ETH Zurich. from the ETH Zurich. Manuela Adcock is a neuropsychologist with many years of clinical years of clinical experience at the University Hospital Zurich.
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