Q: What age group is Clock Yourself designed for?
A: Clock Yourself wasn’t designed with a specific age group in mind. Because it has adjustable speed and modifiable settings, Clock Yourself can be enjoyed by school aged children, elite athletes, people with Parkinson’s Disease, and pretty much everyone in between.
No matter how sharp or agile you are we suggest you start with the simple colours challenge to familiarise yourself with the concept.
Q: Do I need to speak other languages to incorporate the foreign language prompts into my Clock Yourself activities?
A: No. If you can study and memorise seven foreign words at a time, you can incorporate them into your cognitive exercise by selecting a half clock face. If you want to stick to one language, that is ok too.
Q: Will Clock Yourself exercises prevent dementia?
A: Clock Yourself methodology was certainly designed around dementia-risk-reduction principles, but the effectiveness of this particular app has not yet been studied . We do know for sure that regular physical exercise significantly reduces our risk of developing dementia. You can learn more about the benefits of general exercise for brain health from this report. There is emerging evidence that combining physical exercise with cognitive tasks might provide additional benefit for brain health, cognitive performance and prevention of dementia.
Q: By what mechanism could combining physical exercise + cognitive exercise provide additional benefits for the brain?
The extent to which physical exercise affects cognitive performance is not yet fully understood but it appears to be related to the metabolic activity in the brain. This is new scientific territory for researchers (and for physiotherapists!).
We know that physical exercise increases blood flow to the brain, and with that extra blood flow comes increased oxygen and glucose metabolism. Physical exercise also increases dopaminergic activity in the basal ganglia and increases the concentration of certain biomarkers which improve your memory (e.g. norepinephrine, lactate). It also increases “neuro-protective factors” such as Brain-Derived Neurotrophic Factor (BDNF).
BDNF facilitates new synaptic growth in the hippocampus and the formation of new blood vessels in other areas of the brain.
To bring about these desired neurobiochemical and physiological effects the physical exercise must sufficiently challenge the cardiovascular system (estimated 65-80% of maximum heart rate) and cognitive exercise must sufficiently challenge the brain.
For example, for most people, reciting the alphabet whilst going for a walk is unlikely to achieve the desired neurobiochemical changes in the brain to really leverage these physiological benefits.
Clock Yourself was designed to allow you to continuously increase and progress your physical + cognitive exercise, so that it always remains challenging for you.
To explore the science further, start with reading the systematic reviews cited in the teal green section of our References page.
Q: Will Clock Yourself exercises prevent falls?
A: We don’t know yet, but Clock Yourself was also designed around falls-prevention principles and is used by physiotherapists in balance classes.
There is high quality evidence that volitional or reactive stepping training reduces the rate of falls by 50% in elderly fallers. That systematic review & meta-analysis concluded that “volitional or reactive stepping training should be a major component of falls prevention interventions”.
There is a strong link between cognitive processing speed and the ability to catch oneself to prevent a fall. In clinical trials ‘exer-gaming’ activities for falls prevention were shown to improve cognitive processing speed of the participants.
Q: Will you be conducting clinical trials to test the effectiveness of Clock Yourself?
A: A number of independent clinical trials are underway in Australia, Canada and the USA. These trials are well design and well funded, but they will take several years to be published. The developers of ClockYourself are not researchers and we encourage independent research so the public can trust the results. There is plenty more research to be done and we would welcome interest from researchers, especially those working with specific populations such as stroke, brain injury, Parkinson’s Disease etc.
Q: Can people with a diagnosis of cognitive impairment or dementia use the Clock Yourself app?
A:Everyone’s brain is different. We can have major deficits in some areas without any impairment in others. We believe people with cognitive impairment should not be underestimated.
However, it is important to have a Physiotherapist (Physical Therapist) or Occupational Therapist assess their suitability first, and practice safe set up of the exercise.
ClockYourself has been approved for a large clinical trial funded by the Australian government to investigate its potential to slow cognitive decline in people with Mild Cognitive Impairment. For this trial we added the simple colours challenge to ensure that ClockYourself can be enjoyed by people who may not be able to visualise a clock face. We know that plenty of people in the early stages of dementia can still visualise and reliably draw a clock face, so they may be able to manage the simple clock challenge of Clock Yourself.
Drawing the numbers on the floor can sometimes help them to initially understand the concept.
Higher levels of the app might prove too challenging, because they require abstract reasoning and place greater demand on the working memory. If the person with cognitive impairment is unable to perform these exercises correctly even at the slowest pace, or they appear distressed, the app is not appropriate for them.
Q: How can you ensure that people use the Clock Yourself app safely?
A: We can’t. We can’t assess the cognition or falls risk of people who use our app. In fact we do not collect any medical information at all. What is safe for one person may be less safe for someone else.
In addition to reminding users that the use of the app is at their own risk, we have put in place some measures to increase the likelihood that Clock Yourself will be used safely.
You’ll notice when you download the app that you must agree to the conditions of use. Additionally some general safety instructions appear when you first open the app; these direct people who fear falling to first have their suitability for this exercise assessed by a physiotherapist.
We’ve made the slowest speed at 10 steps per minute, and also added a feature for half clock faces, so they can start by practicing stepping and weight shifting to half the numbers, while holding on to a bench.
Q: Will you produce a version of the app with sensors or mats that can provide feedback about our stepping accuracy?
A: It’s unlikely. We’d have to be convinced that the benefit of accurate feedback outweighs the inconvenience of hooking up wires and /or strapping sensors to your ankles and calibrating them. That kind of tricky set up is a barrier to exercise. The more effort required to get started; the less likely that you will start it at all.
You’ll usually instantly realise if you’ve stepped in the wrong spot, but the visual animations on the screen can be used as an additional guide while you’re learning.
If your mental model of a particular number is 10 degrees different to its true co-ordinate, it doesn’t seem to matter in the grand scheme of things. People still progress in the exercise, they get faster and they keep moving.
What is probably more important is that you take a large step (approximately 80% of your maximum step length), because only a large step would effectively catch you if you lost your balance.
Q: Will you produce a version of the app that can collect data and capture my progress?
A: ClockYourself now displays your daily sep count on the main screen. In the left side-menu, there is an activity log which displays your total step count since installing the app. You can send a copy of your activity log to an email address of your choice. The app will remember your settings from your previous exercise sessions so you can pick up where you left off.
Q: Is it ok if I’m stepping slower than the prompts, as long as I can remember them?
A: This depends on what you want to achieve. If you are using Clock Yourself just to keep your brain active, then it is probably a good thing to exercise at a pace where you have to store a few recent prompts in your working memory.
If you are using the app to train faster stepping reactions, it’s best to select a speed where you can step in time with the prompts and not get too far ahead of it.
As a measure of your progress at any level, count how many steps you still have to complete after the bell rings and the audio finishes. Aim to reduce this number of steps by keeping up with the audio prompts.
Q: Can I print out a copy of the abstract clock faces so I can study them?
A: Yes. Printable versions of the abstract clock faces are available in the resources section of this website
Q: Is there a guide I can give my friend to help them install and learn how to use the ClockYourself app?
A: Yes. There is a guide available in the resources section of this website that steps you through the process of installing and app and getting started with ClockYourself