Dividat Senso Fights Dementia with 'Targeted Play'

Cognitive motor training helps in the fight against Alzheimer's and other forms of dementia, according to a study by an international team of researchers with ETH Zurich, a public research university in Zurich, Switzerland.

"It has been suspected for some time that physical and cognitive training also have a positive effect on dementia," said ETH Zurich researcher Eling de Bruin. "However, in the past it has been difficult to motivate dementia patients to undertake physical activity over extended periods."

To overcome this challenge, Eva van het Reve, a former ETH Zurich doctoral student, founded Dividat in 2013, together with her Ph.D. supervisor de Bruin and another doctoral student.

"We wanted to devise a customized training program that would improve the lives of older people," said van het Reve.

The new company developed fun exercises to encourage people with physical and cognitive impairments to participate. The result of their efforts was the Dividat Senso training platform.

The platform includes a screen that plays game software and a floor panel with four fields that measure steps, weight displacement and balance. Users attempt to complete a sequence of movements with their feet as indicated on the screen, enabling them to train both physical movement and cognitive function simultaneously.

"The first idea of a device like the Dividat Senso came up in 2014 when I was finishing my Ph.D. in Movement Sciences at ETH Zurich, Switzerland," van het Reve told The Good Life. "I investigated the effect of cognitive and motor training solutions in older adults, aiming to help them reduce falls and remain independent as long as possible. The findings were amazing and we reported an 80% fall reduction in a larger study with 182 participants.

"We learned that it is relevant to include exercises that challenge the brain and especially the frontal brain. I also knew about the challenges people face when they get older. At that time, my father was working as a managing director at a senior living facility in our hometown, Schindellegi-Feusisberg, Switzerland. We tested our prototypes there and people enjoyed the exercises a lot."

The Good Life: What makes the Dividat Senso better than simple exercise?

Eva van het Reve: The brain is the conductor of most human movements. Its role should be accordingly central in every training program. The Dividat Senso trains the interaction of cognitive and motor skills simultaneously and thus supports the coordination of the musculoskeletal system.

Harmoniously orchestrated movements are a prerequisite for an independent life in all phases of life. Simple exercises can improve certain aspects of the body the same as certain instruments in an orchestra are played. But to synchronize all your movements, you will need to improve the conductor of your body – the brain.

Muscle mass, as an example, can be increased by strength training, because the loss of muscle mass is mainly a problem of our muscular system. The loss of muscle strength, on the other hand, is a combined problem of our muscular and our central nervous systems. It is not surprising that to gain muscle strength, the body-brain interaction needs to be improved.

TGL: You used the phrase "targeted play" in another interview. What does that phrase mean?

Eva: There are certain aspects in daily life that happen automatically and we don't notice that our brain does a lot of work. Especially in old age or with certain diseases (e.g. neurological diseases) crossing a street or even just walking is a complex task.

The brain does an important job in planning and synchronizing our movements and in allocating enough attention to the involved tasks. The interaction with the environment gets more complicated. Walking, as an example, strongly depends on the cognitive functions that are especially located in our frontal lobe.

To improve walking it is not sufficient just to go walking. Exercises to improve walking should target the core components of these cognitive functions, such as attention, inhibition, and working memory.

Targeted play means that we offer specific and goal-directed cognitive-motor exercises for different health problems and symptoms to find improvements in daily life.

TGL: How does the Dividat Senso slow the progression of Alzheimer's and other dementias?

Eva: A recently published study showed for the first time that a specific training program on the Dividat Senso that addresses cognitive and motor skills can weaken the symptoms of neurocognitive disorders. Improvements in lower extremity functioning, cognitive performance, step reaction time and symptoms of depression have been found.

We strongly assume that people with neurocognitive disorders benefit from the Senso because we focus on brain regions that are often deteriorated in these patients. A next trial will be launched this summer at ETH Zurich with people with mild cognitive impairment. In addition to the training programs that help weaken the symptoms, we will also implement a standardized assessment tool to measure functions that might allow early detection of cognitive changes (e.g. in executive functions, attention or memory).

TGL: What other health benefits does the Dividat Senso have? Does it slow the progression of other age-related diseases such as Parkinson's?

Eva: More than 15 scientific trials have been conducted or are in progress in the fields of geriatric rehabilitation, neurorehabilitation (MS, Parkinson's, stroke and acute vestibular syndrome), cardiac rehabilitation, orthopedic rehabilitation (ACL injury), and also, the first study has been conducted with employees in the sense of health promotion and stress reduction at work.

There is a strong connection between cognitive and motor functions, and the interaction between body and brain is often disrupted in diseases such as Parkinson's. Gait initiation for example is a complex task for these people and we train it a thousand times on the Senso. All these trials found positive effects on body and brain functions and, therefore, quality of life.

My most impressive experiences are when you see old and frail people or people with neurological diseases moving on the Senso almost normal, even if they are not able to walk. The Senso is a new way for these patients to increase their quality of life.

TGL: How are Dividat Senso sales in the U.S., and what plans do you have to increase sales in the U.S.?

Eva: Since 2019, there are around 80 senior living communities that offer their residents training on the Dividat Senso. More and more communities decide to invest in equipment that helps their customers to manage health problems and prevent them.

This year, we decided to increase our sales activities and to quickly go forward in the U.S. because we are sure that the Senso will be an efficient and affordable solution for hospitals, clinics, care homes and at home for the prevention of several health problems.

TGL: What other devices are you working on to help seniors (and others)?

Eva: We are currently working on a solution that can be used at home. The Dividat Senso was mainly designed for institutional clients and in many cases, it is too bulky to place in your living room. We want to get as many people exercising as possible and that's why it is important to have a solution that is lighter and more mobile. The Senso-Flex will be available at the End of 2021.

TGL: Is there anything else you would like to say to seniors in California's Central Valley?

Eva: Health is in constant change and flow, it knows ups and downs, and this in all phases of life.

Your health is the most important asset - protect it, throughout life!