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Hosseini M, Thomas R, Pilutti L, Fallavollita P, Jutai JW. Acceptance of physical activity virtual reality games by residents of long-term care facilities: A qualitative study. PLoS One 2024; 19:e0305865. [PMID: 38917119 PMCID: PMC11198859 DOI: 10.1371/journal.pone.0305865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Little is known about the experience and the social and contextual factors influencing the acceptance of virtual reality (VR) physical activity games among long-term care (LTC) residents. Our study aims to address this research gap by investigating the unique experience of older adults with VR games. The findings will provide valuable insights into the factors influencing VR acceptance among LTC residents and help design inclusive VR technology that meets their needs and improves physical activity (PA) and well-being. OBJECTIVE We aimed to: (1) investigate how participants experience VR exergames and the meaning they associate with their participation; and (2) examine the factors that influence the participant's experience in VR exergames and explore how these factors affect the overall experience. METHODS We used a qualitative approach that follows the principles of the Interpretive Description methodology. Selective Optimization and Compensation (SOC) theory, Socioemotional Selectivity theory (SST) and technology acceptance models underpinned the theoretical foundations of this study. We conducted semi-structured interviews with participants. 19 Participants of a LTC were interviewed: five residents and ten tenants, aged 65 to 93 years (8 female and 7 male) and four staff members. Interviews ranged from 15 to 30 minutes and were transcribed verbatim and were analyzed using thematic analysis. RESULTS We identified four themes based on older adults' responses that reflected their unique VR gaming experience, including (1) enjoyment, excitement, and the novel environment; (2) PA and motivation to exercise; (3) social connection and support; and (4) individual preferences and challenges. Three themes were developed based on the staff members' data to capture their perspective on the factors that influence the acceptance of VR among LTC resident including (1) relevance and personalization of the games; (2) training and guidance; and (3) organizational and individual barriers. CONCLUSIONS VR gaming experiences are enjoyable exciting, and novel for LTC residents and tenants and can provide physical, cognitive, social, and motivational benefits for them. Proper guidance and personalized programs can increase understanding and familiarity with VR, leading to a higher level of acceptance and engagement. Our findings emphasize the significance of social connection and support in promoting acceptance and enjoyment of VR gaming among older adults. Incorporating social theories of aging helps to gain a better understanding of how aging-related changes influence technology acceptance among older adults. This approach can inform the development of technology that better meets their needs and preferences.
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Affiliation(s)
- Marjan Hosseini
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Lara Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Mind Research Institute, University of Ottawa, Ontario, Ottawa, Canada
| | - Pascal Fallavollita
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Ottawa, Canada
- School of Electrical Engineering and Computer Science, Faculty of Engineering, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, and Life Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Jiang Y, Chow YE, Oide K, Chen C, Lee PY, Chua MCH, Yoong SQ. Crafting Community Well-Being: Development of an AI-Powered SinDance Exergame for Older Adults in Singapore-A Pilot Randomized Trial. J Am Med Dir Assoc 2024; 25:105043. [PMID: 38830599 DOI: 10.1016/j.jamda.2024.105043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/05/2024] [Indexed: 06/05/2024]
Affiliation(s)
- Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Yue En Chow
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kei Oide
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Changwu Chen
- Department of Occupational Therapy, Jurong Community Hospital, National University Healthcare System, Singapore
| | - Poh Yin Lee
- Nursing Department, National University Hospital, National University Healthcare System, Singapore
| | - Matthew Chin Heng Chua
- Department of Biomedical Informatics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Abd El-Kafy EM, Alayat MS, Subahi MS, Badghish MS. C-Mill Virtual Reality/Augmented Reality Treadmill Training for Reducing Risk of Fall in the Elderly: A Randomized Controlled Trial. Games Health J 2024. [PMID: 38563663 DOI: 10.1089/g4h.2023.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Objective: Falling is considered one of the major problems that may affect the elderly, leading to multiple health issues. Walking adaptability to environmental demands is essential for safe walking in the elderly. The aim of this study was to evaluate the efficacy of virtual reality (VR)/augmented reality (AR) treadmill training on balance performance and the risk of falls in the elderly. Materials and Methods: Sixty Saudi elderly individuals of both genders, aged between 60 and 70 years, participated in the study. The participants were categorized into two groups: the experimental and the control groups. Both groups received 1 hour of training: 30 minutes of conventional exercises and 30 minutes of gait training on the C-Mill VR/AR treadmill. The experimental group used the C-Mill treadmill with VR and AR games therapy. The control group had gait training on the C-Mill treadmill without VR and AR. The training for both groups was conducted for 6 successive weeks/three times a week. The changes in the scores of the following variables were recorded at baseline, after 6 weeks of training, and 4 weeks after the completion of training. These variables involved the time needed for completing the Timed Up and Go (TUG) test, overall stability indices of the Fall Risk (FR) test and Limit of Stability (LOS) test evaluated using the Biodex Balance System (BBS), and the time required for completing the LOS test. Results: Both groups demonstrated significant improvement in all measured variables immediately post-training, and this improvement persisted for 4 weeks after completing the training. The experimental group exhibited greater improvement in the recorded values of all measured variables compared with the control group following the training. Conclusions: This study concluded that C-Mill VR/AR treadmill training is effective in improving balance control and reducing the fall risk in the elderly.
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Affiliation(s)
- Ehab Mohamed Abd El-Kafy
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohamad Salaheldien Alayat
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Moayad Saleh Subahi
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
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Ning H, Chen F, Li J, Du Y, Chen X, Wu S, Joseph A, Gao Y, Cao Z, Feng H. Effectiveness of a multicomponent exercise intervention in community-dwelling older Chinese people with cognitive frailty: protocol for a mixed-methods research. Front Aging Neurosci 2024; 16:1282263. [PMID: 38410748 PMCID: PMC10895061 DOI: 10.3389/fnagi.2024.1282263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/15/2024] [Indexed: 02/28/2024] Open
Abstract
Aims To evaluate the effectiveness of a multicomponent exercise intervention and to clarify the underlying mechanisms of the program in community-dwelling older adults with cognitive frailty. Additionally, the perception of participants in the program will be explored. Design A mixed-methods design, including a randomized controlled trial and an exploratory qualitative study, was used. Methods Each group consists of 41 participants. The experimental group will undergo a 12-week multicomponent exercise intervention, including warm-up, exergaming aerobic exercise, elastic-band resistance exercise, and cool-down. This intervention was developed based on the Health Belief Model (HBM) and Self-Efficacy Model (SEM). The control group will not receive any intervention. Physical frailty and cognitive function will be considered as primary outcomes. Data will be collected both at baseline and at the end of the intervention period. Fisher's exact test, analysis of covariance, and generalized linear models will be conducted to compare mean changes between the two groups. Additionally, the mediation models will be used to examine whether any intervention effects are mediated through exercise self-efficacy. Discussion The findings of this study are anticipated to provide valuable insights for healthcare providers, enabling them to learn about effective strategies to enhance exercise adherence and promote improved functionality, independence, and quality of life for older adults with cognitive frailty.Clinical trial registration: [https://clinicaltrials.gov/], identifier [ChiCTR2200058850].
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Fenghui Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Yan Du
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Xi Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Shuang Wu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Abigael Joseph
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Yinyan Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zeng Cao
- Department of Physical Medicine and Rehabilitation, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Hosseini M, Thomas R, Pilutti L, Fallavollita P, Jutai JW. Assessing virtual reality acceptance in long-term care facilities: a quantitative study with older adults. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 38146956 DOI: 10.1080/17483107.2023.2295946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Our study aimed to investigate the factors associated with the acceptance of virtual reality (VR) games among older adults living in LTC, with a particular emphasis on identifying social and individual factors that have been overlooked in existing technology acceptance models. MATERIALS AND METHODS We conducted VR gaming sessions, followed by a composite questionnaire to explore the factors associated with the acceptance of VR games among residents of LTC with a focus on technology acceptance models (TAM) and social factors derived from Selective Optimization with Compensation (SOC) theory and Socioemotional Selectivity Theory (SST). RESULTS We studied 20 older adults aged 65 and older. Participants were moderately sedentary, with the majority of them having prior gaming experience. Participants with prior gaming experience had higher mean scores in most SOC theory and SST subscales, except for elective selection. Participants perceived the technology as useful and easy to use, with no heightened gaming-related anxiety. Significant correlations were found between perceived ease of use and selection strategies, and between attitudes towards gaming and elective selection strategies. No significant score differences were observed between male and female participants. CONCLUSIONS The positive correlation between VR acceptance and using SOC strategies suggests a positive response to straightforward experiences. Our study highlights VR exergaming's potential benefits for encouraging LTC residents' engagement in valued activities and pursuing goals. Moreover, social theories of aging can inform technology acceptance and guide the design and marketing of VR exergames to better suit older adults' needs and preferences in LTC.IMPLICATIONS FOR REHABILITATIONThe findings of this study have important implications for rehabilitation programs aimed at enhancing physical activity (PA) and engagement among older adults living in long-term care (LTC) facilities. The use of virtual reality (VR) games can be an important tool to promote PA and improve the overall well-being of LTC residents. Based on the results, the following implications can be drawn:Integrating VR exergaming in rehabilitation:The positive perception of VR technology's usefulness and ease of use among older adults in LTC suggests that VR exergaming can be effectively integrated into rehabilitation programs. Healthcare professionals and rehabilitation specialists in LTC facilities can consider incorporating VR-based exercise routines and gaming sessions to motivate and engage residents in physical activities. By doing so, they can create enjoyable and interactive rehabilitation experiences that may lead to improved adherence to exercise regimens.Addressing social factors for VR acceptance:Our study highlights the significance of social factors derived from theories of aging, such as Selective Optimization with Compensation (SOC) and Socioemotional Selectivity Theory (SST), in influencing VR acceptance among LTC residents. Rehabilitation programs should take into account these social aspects and create a supportive and encouraging environment for older adults to engage with VR exergames. Encouraging social interactions and providing opportunities for residents to share their experiences with VR gaming may enhance acceptance and overall engagement.Tailoring VR exergames for older adults:The correlation between VR acceptance and the use of SOC strategies indicates that customized experiences may be well-received by LTC residents. Game developers and rehabilitation specialists should consider designing VR exergames that align with the specific preferences and needs of older adults. This could involve providing choices and options for users to optimize their gaming experiences based on their individual abilities and interests.Recognizing gaming experience:Our study highlights that prior gaming experience positively influenced participants' attitudes towards VR gaming. Rehabilitation professionals should acknowledge and leverage this prior experience when introducing VR exergaming to older adults in LTC. By incorporating elements familiar to older adults or providing guidance for those new to gaming, rehabilitation programs can foster a more seamless and enjoyable transition to VR exergames.Promoting goal pursuit and valued activities:Our study suggests that VR exergaming has the potential to encourage LTC residents' engagement in valued activities and goal pursuit. Rehabilitation programs can utilize VR exergaming as a means to help residents achieve specific rehabilitation goals and engage in activities that are meaningful to them. This approach can contribute to a sense of purpose and satisfaction in the rehabilitation process.Overall, the integration of VR exergaming in rehabilitation for older adults in LTC facilities has promising implications for improving physical activity levels, enhancing engagement, and addressing the holistic well-being of residents. By considering the social factors influencing VR acceptance and tailoring experiences to individual preferences, rehabilitation professionals can optimize the potential benefits of VR technology in LTC settings.
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Affiliation(s)
- Marjan Hosseini
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Roanne Thomas
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Lara Pilutti
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - Pascal Fallavollita
- Faculty of Health Sciences, Faculty of Engineering, Interdisciplinary School of Health Sciences, School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, Life Research Institute, University of Ottawa, Ottawa, Canada
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Seinsche J, de Bruin ED, Saibene E, Rizzo F, Carpinella I, Ferrarin M, Moza S, Ritter T, Giannouli E. A Newly Developed Exergame-Based Telerehabilitation System for Older Adults: Usability and Technology Acceptance Study. JMIR Hum Factors 2023; 10:e48845. [PMID: 38060283 PMCID: PMC10739244 DOI: 10.2196/48845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/08/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Telerehabilitation has gained significance as a tool to deliver and supervise therapy and training as effective as traditional rehabilitation methods yet more accessible and affordable. An exergame-based telerehabilitation system has recently been developed within the scope of the international Continuum-of-Care (COCARE) project. The system comprises training devices for use in clinics (Dividat Senso) and at home (Dividat Senso Flex), an assessment system, and a rehabilitation cockpit, and its focus lies on home-based motor-cognitive training, which is remotely managed by health care professionals (HPs). OBJECTIVE This study aims to analyze the usability, acceptance, and enjoyment of the COCARE system from the perspective of primary (older adults [OAs]) and secondary (HPs) end users. METHODS At 3 trial sites (located in Switzerland, Italy, and Cyprus), participants engaged in a single-session trial of the COCARE system, including testing of exergames and assessments. Mixed methods encompassing qualitative approaches (eg, think aloud) and quantitative measures (eg, Exergame Enjoyment Questionnaire [EEQ], System Usability Scale [SUS], and Unified Theory of Acceptance and Use of Technology [UTAUT] questionnaire) were used to analyze participants' perceptions of the system and identify potential barriers to its implementation in a home setting. In addition, the associations of performance during gameplay and assessments, demographics, and training motivation (Behavioral Regulation in Exercise Questionnaire-3 [BREQ-3]) with usability, acceptance, and enjoyment were explored. RESULTS A total of 45 OAs and 15 HPs participated in this study. The COCARE system achieved good acceptance ratings (OAs: 83%, range 36%-100% and HPs: 81%, range 63.8%-93.3% of the maximum score), and OAs indicated high enjoyment (mean 73.3, SD 12.7 out of 100 points in the EEQ) during the exergame session. The system's usability, assessed with the SUS, received scores of 68.1 (SD 18.8; OAs) and 70.7 (SD 12.3; HPs) out of 100 points, with substantial differences observed between the trial sites. Several requirements for improvement were identified. Commonly mentioned barriers to adoption included the movement-recognition sensitivity of the Senso Flex, its limited markings, and difficulties in understanding certain instructions for assessments and games. Performance in games and assessments showed the highest significant correlations with the SUS (Spearman ρ=0.35, P=.02 to ρ=0.52, P<.001). The BREQ-3 had significant correlations with all usability measures, thereby even large significant correlations with enjoyment (Spearman ρ=0.58; P<.001). Age had moderately significant correlations with the SUS (Spearman ρ=-0.35; P=.02) and the UTAUT total score (ρ=-0.35; P=.02) but no significant correlation with the EEQ. Concerning sex and years of education, no significant correlations were found. CONCLUSIONS The study's findings will inform the further development of the COCARE system toward a user-friendly and widely accepted version, enhancing cognitive and physical functions in OAs. Future randomized controlled trials should evaluate the system's feasibility and effectiveness.
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Affiliation(s)
- Julia Seinsche
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Enrico Saibene
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Francesco Rizzo
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Ilaria Carpinella
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Maurizio Ferrarin
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | | | - Tanja Ritter
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eleftheria Giannouli
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Drazich BF, Crane BM, Taylor JL, Szanton SL, Moored KD, Eldreth D, Ahmad O, Krakauer JW, Resnick B, Carlson MC. OLDER ADULTS' SUBJECTIVE WELL-BEING EXPERIENCING THE EXERGAME "I AM DOLPHIN". Int J Qual Stud Health Well-being 2023; 18:2170013. [PMID: 36730308 PMCID: PMC9897765 DOI: 10.1080/17482631.2023.2170013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023] Open
Abstract
The objective of this study was to understand older adults' perceptions of the connections between an exergame intervention, "I Am Dolphin," and their subjective well-being. Researchers conducted three focus groups with 14 older adults who participated in the exergame feasibility study. The semi-structured focus groups were transcribed, coded, and analysed using deductive and inductive techniques. Three themes were constructed related to playing the exergame and participants' subjective well-being: 1) elevated mood (through scheduled activity, immersion, and socialization), 2) feelings of achievement (especially following frustration and competition), and 3) perceived cognitive or physical changes. These findings will help researchers better understand how exergames may relate to the well-being of older adults. Future investigators could use these findings to create and implement new exergame interventions.
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Affiliation(s)
- Brittany F. Drazich
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Breanna M. Crane
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Janiece L. Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah L. Szanton
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kyle D. Moored
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dana Eldreth
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Omar Ahmad
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - John W. Krakauer
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Michelle C. Carlson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Welch V, Ghogomu ET, Barbeau VI, Dowling S, Doyle R, Beveridge E, Boulton E, Desai P, Huang J, Elmestekawy N, Hussain T, Wadhwani A, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Hébert P, Mikton C. Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1369. [PMID: 38024780 PMCID: PMC10681039 DOI: 10.1002/cl2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search Methods We searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection Criteria Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data Collection and Analysis We developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Main Results We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' Conclusions The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Sierra Dowling
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | - Ella Beveridge
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Elisabeth Boulton
- School of Health Sciences, Division of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Payaam Desai
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Jimmy Huang
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Arpana Wadhwani
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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Ning H, Li J, Chen X, Li M, Cao Z, Feng H. Challenges and suggestions for exergaming program in exercise among older adults. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2023; 48:1621-1628. [PMID: 38432891 PMCID: PMC10929900 DOI: 10.11817/j.issn.1672-7347.2023.230149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 03/05/2024]
Abstract
Engaging in physical activity and exercise is one of the important ways for health promotion. However, older adults are often physically inactive or have a sedentary lifestyle and have poor compliance with physical activity. Exergaming program with their unique advantages could make physical activity a more joyful experience and motivate older adults to participate in physical activity. Promoting older adults' health through engagement in exergaming programs is still in the early stage, and still faces many challenges. Analyzing the challenges and difficulties faced by exergaming program for older adults and exploring in-depth strategies to promote the implementation of exergaming program for older adults are of great significance for the design and implementation of sports games for older adults.
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha 410013, China.
| | - Junxin Li
- Johns Hopkins University School of Nursing, Baltimore Maryland 21205, USA
| | - Xi Chen
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Min Li
- Department of Nursing, Changsha County Xingsha Hospital, Changsha 410119, China
| | - Zeng Cao
- Department of Rehabilitation Medicine, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha 410013, China.
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Vasodi E, Saatchian V, Dehghan Ghahfarokhi A. Virtual reality-based exercise interventions on quality of life, some balance factors and depression in older adults: A systematic review and meta-analysis of randomized controlled trials. Geriatr Nurs 2023; 53:227-239. [PMID: 37598426 DOI: 10.1016/j.gerinurse.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the impact of virtual reality-based exercise on the quality of life, some balance variables, and depression among older adults aged 60 years or older. METHOD We systematically searched five electronic databases. RESULTS Twenty-seven articles met our inclusion criteria. Meta-analysis revealed that exercise using virtual reality had a significant positive effect on overall quality of life (p = 0.05), mental (p = 0.001) and physical component scores (p = 0.01), social relation (p = 0.0002), psychological health(p = 0.01), physical health(p = 0.04), and environmental health (p = 0.04). Additionally, depression significantly improved following virtual reality-based exercise (p = 0.01). However, there were significant improvements in the balance berg scale (p<0.00001) and ABC scale (p<0.00001) but not in timed-up-and-go(TUG) or 8-foot-up-and-go(8-FUG). DISCUSSION Virtual reality-based exercise has a positive impact on various aspects of quality of life, BBS and ABC scores, and depression. More studies with larger sample sizes and less heterogeneity in design and assessments are required.
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Affiliation(s)
- Elham Vasodi
- Department of Physical Education and Sport Sciences, Shahrood University of Technology, Shahrood, Iran
| | - Vahid Saatchian
- Department of Physical Education and Sport Sciences, Imam Reza international University, Mashhad, Iran.
| | - Amin Dehghan Ghahfarokhi
- Sport Management Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Kukkohovi S, Siira H, Arolaakso S, Miettunen J, Elo S. The effectiveness of digital gaming on the functioning and activity of older people living in long-term care facilities: a systematic review and meta-analysis. Aging Clin Exp Res 2023:10.1007/s40520-023-02459-y. [PMID: 37338731 PMCID: PMC10363061 DOI: 10.1007/s40520-023-02459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND The population is aging globally. Older people living in long-term care facilities have many functional impairments, such as mobility problems and depression. Digital games and so-called exergames can offer a motivating and entertaining way to maintain older people's physical activity and thus their ability to function. However, previous studies have reported conflicting results about the effects of digital gaming and have focused on community-dwelling older people. OBJECTIVE To identify, critically appraise, and synthesize evidence about the effectiveness of digital games on older people's physical, psychological, and social functioning and physical and social activity in long-term care facilities. METHODS Five databases were systematically searched, and relevant studies were screened. Fifteen randomized-controlled trials and quasi-experimental studies (total N = 674) were included in meta-analysis. RESULTS All digital games used in interventions were exergames. Meta-analysis showed that exergame interventions have a statistically significant large effect on physical functioning [number of studies (N) = 6, standardized mean difference (SMD) = 0.97, p = 0.001] measured by Timed Up and Go or Short Physical Performance Battery and self-assessed physical activity (N = 3, SMD = 1.20, p < 0.001) and medium effect on social functioning (N = 5, SMD = 0.74, p = 0.016) compared to alternative intervention or no intervention. Social activity was not measured in any study. CONCLUSIONS The results are encouraging that exergames effectively increase the functioning and activity of older adults living in long-term facilities. Successful implementation of such activities requires the competence of nursing staff and rehabilitation professionals in digitalization.
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Affiliation(s)
- Saara Kukkohovi
- GeroNursing Centre, Research Unit of Health Science and Technology, University of Oulu, Oulu, Finland.
| | - Heidi Siira
- GeroNursing Centre, Research Unit of Health Science and Technology, University of Oulu, Oulu, Finland
| | | | - Jouko Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Satu Elo
- Oulu University of Applied Sciences, Oulu, Finland
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Rüth M, Schmelzer M, Burtniak K, Kaspar K. Commercial exergames for rehabilitation of physical health and quality of life: a systematic review of randomized controlled trials with adults in unsupervised home environments. Front Psychol 2023; 14:1155569. [PMID: 37333591 PMCID: PMC10272737 DOI: 10.3389/fpsyg.2023.1155569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
Background Commercial exergames are widely available tools that can support physical rehabilitation at home. However, the effects of the unsupervised use of commercial exergames in home environments are not yet clear. Hence, we provide a systematic review on the effects of unsupervised commercial exergaming at home on adults' physical health (RQ1) and quality of life (RQ2). We also scrutinize adults' experiences with exergaming at home regarding participant support, adherence, and adverse outcomes (RQ3). Methods We searched Web of Science, PsycINFO, PubMed, Embase, and CINAHL for peer-reviewed randomized controlled trials with adults in need of rehabilitation. Overall, 20 studies (1,558 participants, 1,368 analyzed) met our inclusion criteria. The quality of evidence was assessed with the Cochrane risk of bias tool. Results Effects of unsupervised commercial exergaming at home on physical health were higher in seven studies and similar in five studies regarding the respective comparison or control conditions; eight studies reported non-significant findings. Of the 15 studies that also examined effects on quality of life, improvements were higher in seven studies and similar in two studies regarding the respective comparison or control conditions; results were non-significant in six studies. Participant support consisted of setup of the exergaming system, instructions, training, and contact with participants. Adherence was high in eight studies, moderate in six studies, and low in one study. Adverse outcomes related to exergaming were found in four studies and were at most moderate. Concerning the quality of evidence, six studies were related to a high risk of bias due to outcome reporting bias or ceiling effects in the primary outcome. Additionally, 10 studies yielded some concerns, and four studies were related to a low risk of bias. Discussion This systematic review summarizes promising evidence that the unsupervised use of commercial exergames can support and complement rehabilitation measures in home environments. Still, future studies based on larger samples and using more recent commercial exergames are needed to obtain more high-quality evidence on the effects of different exercise prescriptions. Overall, considering the necessary precautions, the unsupervised use of commercial exergames at home can improve the physical health and quality of life in adults with needs for physical rehabilitation. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341189, identifier: PROSPERO, Registration number: CRD42022341189.
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Lee K. Home-Based Exergame Program to Improve Physical Function, Fall Efficacy, Depression and Quality of Life in Community-Dwelling Older Adults: A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11081109. [PMID: 37107943 PMCID: PMC10137686 DOI: 10.3390/healthcare11081109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to investigate the effects of home-based exergame programs on physical function, fall efficacy, depression, and health-related quality of life in community-dwelling older adults. Fifty-seven participants aged 75 years or older were divided into control and experimental groups. The experimental group received a home-based exergame program that included balance and lower-extremity muscle strength for 8 weeks. The participants exercised at home for 50 min three times a week and were monitored through a video-conference application. Both groups received online education on musculoskeletal health once a week, whereas the control group did not exercise. Physical function was assessed using the one-leg standing test (OLST), Berg balance scale (BBS), functional reaching test (FRT), timed up-and-go test (TUGT), and five-times sit-to-stand (FTSTS). Fall efficacy was assessed using the modified falls efficacy scale (MFES). Depression was assessed using the geriatric depression scale (GDS). Health-related quality of life was assessed using a 36-item short-form health survey (SF-36). The experimental group showed an overall improvement in OLST, BBS, FRT, TUGT, and FTSTS (p < 0.05). MFES was significantly increased in the experimental group after the intervention (p < 0.05). The GDS significantly decreased in the experimental group after the intervention (p < 0.05). In SF-36, role limitations due to physical health, general health, and fatigue (energy and fatigue) items improved in the experimental group after intervention (p < 0.05). An 8-week home-based exergame program improved physical function, fall efficacy, depression, and health-related quality of life in older adults. The study was registered on ClinicalTrials.gov (NCT05802537).
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Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, College of Health Science, Kyungdong University, Wonju 24764, Republic of Korea
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14
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Gilani M, Torkaman G, Bahrami F, Bayat N. Virtual Reality Exergaming Capability to Change Muscle Strategy During the Limits of Stability Test and Reduce Fear of Falling in Primary Osteoporotic Women. Games Health J 2023. [PMID: 36940295 DOI: 10.1089/g4h.2022.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Objective: Muscle strength and balance impairment change the control strategy and increase the probability of falling. This study aimed to investigate the effect of 6-week strength-balance training through virtual reality exergaming (VRE) on muscle strategy during the limits of stability (LOS) test, fear of falling, and quality of life (QOL) in osteoporotic women. Materials and Methods: Twenty volunteer postmenopausal women with osteoporosis were randomly allocated to the VRE (n = 10) and traditional training (TRT as control, n = 10) groups. The VRE and TRT strength-balance training was performed for 6 weeks and three sessions per week. Before and after exercise, the muscle activity (onset time, peak root means square [PRMS]) and hip/ankle activity ratio were assessed by the wireless electromyography system. The muscle activities of the dominant leg were recorded during LOS functional test. The fall efficacy scale and QOL were assessed. Paired t-test was used to compare results within groups, and an independent t-test was used to compare the percentage changes in parameters between the two groups. Results: The VRE improved the onset time and PRMS. The VRE significantly reduced the hip/ankle activity ratio in the LOS test's forward, backward, and right directions (P < 0.05). No significant change was seen in all directions of the LOS functional test in the TRT group (P > 0.05). VRE reduced the fall efficacy scale (P = 0.042). Both VRT and TRT improved the total QOL score (P = 0.010). Conclusion: VRE was more effective in decreasing the onset time and hip/ankle ratio of muscle activation. The VRE is recommended to induce a better ability to reduce the fear of falling and control balance during functional activity in osteoporotic women. Clinical Trial Registration number: IRCT20101017004952N9.
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Affiliation(s)
- Mohammad Gilani
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Giti Torkaman
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fariba Bahrami
- Human Motor Control and Computational Neuroscience Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Noushin Bayat
- Department of Rheumatology, Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Yu J, Huang HC, Cheng TCE, Wong MK, Teng CI. Effects of Playing Exergames on Quality of Life among Young Adults: A 12-Week Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1359. [PMID: 36674115 PMCID: PMC9858715 DOI: 10.3390/ijerph20021359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 05/13/2023]
Abstract
Objective: The purpose of this paper is to investigate whether playing exergames can enhance quality of life among young adults and it examines the potential moderators. Methods: A 12-week randomized controlled trial was conducted. Quality of life was measured using the short-form 36-item version (SF-36) scale. All the participants were between 20 and 24 years old in Taiwan. Participants in the intervention group (n = 55) were asked to play exergames for 12 weeks, three times a week and 30 minutes at a time, while participants in the control group (n = 62) did not play exergames. The changes in the scores on quality of life between the beginning and the end of the 12-week trial were calculated. Independent t-tests were used to analyze the differences. Results: The intervention group participants experienced an enhanced quality of life in terms of physical functioning, role-physical (role limitations due to physical health), general health, and social functioning. Moreover, the intervention group participants who were not enthusiastic about exercisers experienced an enhanced quality of life in physical functioning, role-physical, and general health. The intervention group participants who attempted to control their weight experienced enhanced general health, vitality, and mental health. Conclusion: Playing exergaming could contribute to users' quality of life in terms of both physical and mental health.
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Affiliation(s)
- Jiajun Yu
- School of Management, Guangzhou Huashang College, Guangzhou 511300, China
- School of Innovation and Entrepreneurship, Guangzhou Huashang College, Guangzhou 511300, China
- Graduate Institute of Management, Chang Gung University, Taoyuan 333, Taiwan
| | - Han-Chung Huang
- Center for General Education, China University of Technology, Taipei 219, Taiwan
| | - T. C. E. Cheng
- Department of Logistics and Maritime Studies, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - May-Kuen Wong
- Taoyuan Branch, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Ching-I Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan 333, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Department of Business and Management, Ming Chi University of Technology, New Taipei 243, Taiwan
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eSports Participation among Hong Kong Middle-Aged and Older Adults: A Qualitative Study. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2023. [DOI: 10.1155/2023/6798748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The HK Special Administrative Region Government has been making efforts to promote active aging among older adults. This qualitative study is aimed at gaining an understanding of the perception of and experiences in eSports among middle-aged and older adults in HK, China, using the Theory of Planned Behavior. Thirty-nine adults aged >45 years were stratified by (a) whether they had experience of participating in eSports and (b) age (i.e., 45–64 years vs. ≥65 years). In addition, 10 administrators working in community centres for middle-aged and older adults were invited for a semistructured interview. The results revealed the pertinent themes of (a) behavioral beliefs (physical benefits (enhanced physical activity levels, body coordination, and cognition), social benefits (increased interactions and team communication and enlarged social circle), psychological benefits (stereotype breaking, sense of recognition, enjoyment, and improved mood), and adverse health effects (psychological intensity, frustration, obsession with winning, overuse strain, and sleep disturbance)), (b) normative beliefs (support and encouragement from family and nonfamily members), and (c) control beliefs (game content, program personnel attitude, resource availability (venue, equipment, and manpower), administrators’ perspectives, and support from the industry). The study results will be instrumental to the development of related interventions and instruments for middle-aged and older adults, will enable researchers to explore the benefits of eSports programs for the studied population, and will promote healthy and active aging in the long term.
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Li G, Li X, Chen L. Effects of virtual reality-based interventions on the physical and mental health of older residents in long-term care facilities: A systematic review. Int J Nurs Stud 2022; 136:104378. [DOI: 10.1016/j.ijnurstu.2022.104378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022]
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Shah SHH, Karlsen AST, Solberg M, Hameed IA. A social VR-based collaborative exergame for rehabilitation: codesign, development and user study. VIRTUAL REALITY 2022; 27:1-18. [PMID: 36465891 PMCID: PMC9702607 DOI: 10.1007/s10055-022-00721-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/13/2022] [Indexed: 06/17/2023]
Abstract
Immersive virtual reality (VR)-based exercise video games (exergames) are increasingly being employed as a supportive intervention in rehabilitation programs to promote engagement in physical activity, especially for elderly users. A multifaceted and iterative codesign process is essential to develop sustainable exergaming solutions. The social aspect is considered one of the key motivating factors in exergames; however, research on the social aspect of VR exergames has been limited. Previous studies have relied on competitiveness in exergames, but research has shown that competition can lead to adverse effects on users. With the aim of motivating elderly individuals to participate in physical exercise and improving social connectedness during rehabilitation, this work presents a social VR-based collaborative exergame codesigned with elderly participants and therapists. This exergame stimulates full-body exercise and supports social collaboration among users through a collaborative game task. Furthermore, this article presents a user study based on a mixed-methods approach to gather user feedback on exergame design and the effect of social collaboration versus playing alone in a VR exergame in terms of physical exertion and motivation. This study spanned five weeks (99 exergaming sessions) with 14 elderly participants divided into two groups, one playing collaboratively and the other playing individually. Between-group comparisons were performed at baseline (first week) and in the fourth week, and within-group comparisons were performed in the fifth week, when the participants played the exergame in counterbalanced order. In contrast to the first week, the participants exergaming collaboratively in the fourth week reported significantly higher intrinsic motivation on all subscales (enjoyment: p < 0.02, effort: p < 0.002, usefulness: p < 0.01) and physical exertion (p < 0.001) than those playing alone. Thereafter, exergaming in counterbalanced order during the fifth week resulted in significant differences (medium to large effect size) within groups. The participants found the social VR gameplay enjoyable and agreed that collaboration played a vital role in their motivation. They reported various health benefits, a minimal increase in symptoms of simulator sickness, and excellent usability scores (83.75±13.3). In this work, we also identify various key design principles to support healthcare professionals, researchers and industrial experts in developing ergonomic and sustainable VR-based exergames for senior citizens.
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Affiliation(s)
- Syed Hammad Hussain Shah
- Department of ICT and Natural Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
| | - Anniken Susanne T. Karlsen
- Department of ICT and Natural Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
| | - Mads Solberg
- Department of Health Sciences, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
| | - Ibrahim A. Hameed
- Department of ICT and Natural Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
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Baragash RS, Aldowah H, Ghazal S. Virtual and augmented reality applications to improve older adults’ quality of life: A systematic mapping review and future directions. Digit Health 2022; 8:20552076221132099. [PMCID: PMC9629585 DOI: 10.1177/20552076221132099] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The use of virtual reality and augmented reality to improve older adults’ quality of life has rapidly increased in recent years. This systematic mapping review aimed to provide a comprehensive overview of existing research that identifies and classifies current virtual reality and augmented reality applications that enhance the quality of life of older adults to increase the understanding of the impact of these technologies. Methods To reach this objective, a systematic mapping review was conducted of the studies published between 2009 and 2020 in major scientific databases, such as IEEE Xplore, Web of Science, Scopus, and PubMed. A total of 57 studies were analyzed and classified into four main quality of life domains: physical, cognitive, psychological, and social well-being. Results The findings showed that virtual reality and augmented reality have found their places in many quality of life studies of older adults. Although virtual reality and augmented reality applications are notably growing in the physical and cognitive well-being domains in training and rehabilitation settings, they are still in the early stages of development in psychological and social well-being research as well as healthcare settings. Our findings also revealed that virtual reality games, particularly motion-based exergames, and 3D augmented reality systems are the most common virtual reality and augmented reality types among the reviewed studies. Moreover, balance and attention were the most prevalent physical and cognitive functions when using motion-based and immersive virtual reality exergames and augmented reality systems and games, respectively, while confidence and interaction were the most dominant psychological and social functions. Conclusion This mapping review provides a comprehensive overview of potential areas for further research in this field, thereby assisting researchers, technologists, and health practitioners in expanding this field of research.
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Affiliation(s)
- Reem Sulaiman Baragash
- Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia,Reem Sulaiman Baragash, Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
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| | - Hanan Aldowah
- Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| | - Samar Ghazal
- Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
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Kim Y, Hong S, Choi M. Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2022; 24:e37753. [PMID: 36066964 PMCID: PMC9490522 DOI: 10.2196/37753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/11/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. OBJECTIVE This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. METHODS A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. RESULTS A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD -0.54, 95% CI -0.79 to -0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD -0.61, 95% CI -0.95 to -0.26; P<.001) than in hospital settings (SMD -0.46, 95% CI -0.85 to -0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD -0.60, 95% CI -0.95 to -0.25; P<.001) and games for both (SMD -0.73, 95% CI -1.29 to -0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. CONCLUSIONS Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. TRIAL REGISTRATION PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5.
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Affiliation(s)
- Yesol Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Soomin Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Mona Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea.,Yonsei Evidence Based Nursing Centre of Korea, A JBI Affiliated Group, Seoul, Republic of Korea
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Campo-Prieto P, Cancela-Carral JM, Rodríguez-Fuentes G. Feasibility and Effects of an Immersive Virtual Reality Exergame Program on Physical Functions in Institutionalized Older Adults: A Randomized Clinical Trial. SENSORS (BASEL, SWITZERLAND) 2022; 22:6742. [PMID: 36146092 PMCID: PMC9505598 DOI: 10.3390/s22186742] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/29/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
One of the pillars which underpins active aging is found in the performance of physical activity. While adherence to physical activity programs has traditionally been low in older people, immersive virtual reality (IVR) could provide an alternative and complementary training mode. A randomized clinical trial was conducted to explore the feasibility and effects of a 10-week IVR exergame program on physical functions of 24 institutionalized older adults who were allocated to an experimental group (EG n = 13; 85.08 ± 8.48 years) and control group (CG n = 11; 84.82 ± 8.10 years). The IVR intervention was feasible, with no adverse effects being reported (no Simulator Sickness Questionnaire symptoms; low negative experience scores on the Game Experience Questionnaire < 0.34/4), no dropouts, high adherence, and good post-gaming usability (System Usability Scale > 73.96%). The EG showed significant improvements: Tinetti scores for balance (1.84 ± 1.06; p < 0.001), gait (1.00 ± 1.08; p < 0.001), total score (2.84 ± 1.67; p < 0.001), and handgrip (4.96 ± 4.22; p < 0.001) (pre−post assessment). The CG showed significantly worsened compared to the EG: Five times sit-to-stand test, Tinetti scores for balance, gait, and total score, and the Timed Up and Go test total score (post-assessment). The findings show that the IVR intervention is a feasible method to approach a personalized exercise program and an effective way by which to improve physical function in the target population.
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Affiliation(s)
- Pablo Campo-Prieto
- Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, 36005 Pontevedra, Spain
- HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, 36213 Vigo, Spain
| | - José Mª Cancela-Carral
- HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, 36213 Vigo, Spain
- Department of Special Didactics, Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain
| | - Gustavo Rodríguez-Fuentes
- Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, 36005 Pontevedra, Spain
- HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, 36213 Vigo, Spain
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Ringgenberg N, Mildner S, Hapig M, Hermann S, Kruszewski K, Martin-Niedecken AL, Rogers K, Schättin A, Behrendt F, Böckler S, Schmidlin S, Jurt R, Niedecken S, Brenneis C, Bonati LH, Schuster-Amft C, Seebacher B. ExerG: adapting an exergame training solution to the needs of older adults using focus group and expert interviews. J Neuroeng Rehabil 2022; 19:89. [PMID: 35974409 PMCID: PMC9382774 DOI: 10.1186/s12984-022-01063-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exergames are playful technology-based exercise programs. They train physical and cognitive functions to preserve independence in older adults (OAs) with disabilities in daily activities and may reduce their risk of falling. This study gathered in-depth knowledge and understanding of three different user groups' experiences in and relevant needs, worries, preferences, and expectations of technology-based training, to develop an exergame training device for OAs. METHODS We conducted a qualitative study using semi-structured focus group interviews of primary (OAs in geriatric or neurological rehabilitation) and secondary (health professionals) end users, as well as expert interviews of tertiary end users (health insurance experts or similar), exploring user perspectives on adjusting an existing exergame to OAs' needs. Voice-recorded interviews were transcribed by researchers and analyzed using thematic analysis (TA) following an inductive, data-driven, iterative approach. RESULTS We interviewed 24 primary, 18 secondary, and 9 tertiary end users at two rehabilitation centers in Austria and Switzerland. Our TA approach identified five to six themes per user group. Themes in the primary end user group reflected aspects of safety, training goals, individuality, game environment, social interactions, and physical and technical overload. Themes in the secondary end user group comprised facets of meaningfulness, distraction through the game environment, safety, gamification elements, the availability and accessibility of the exergame. Tertiary end users' themes addressed aspects of financial reimbursement, suitable target populations, professional training for the handling of exergame devices, training goals, and concerns about the use of exergames in geriatric rehabilitation. CONCLUSIONS In conclusion, an exergame for OAs must be safe, motivating and fully adaptable to the target group while promoting the return to or preservation of autonomy and independence in daily life. Our findings contribute to developing hard- and software extensions for the ExerG training device. Further research is needed to expand the validity of our findings to larger populations.
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Affiliation(s)
- Nathalie Ringgenberg
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Sarah Mildner
- Department of Health Sciences, IMC University of Applied Sciences Krems, Krems, Austria
| | - Marcia Hapig
- Research Center on Vascular Aging and Stroke, VASCage GmbH, Innsbruck, Austria
| | - Sarah Hermann
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
| | | | - Anna Lisa Martin-Niedecken
- Department of Design, Subject Area Game Design, Zurich University of the Arts, Zurich, Switzerland.,Sphery Ltd, Zurich, Switzerland
| | - Katja Rogers
- Stratford School of Interaction Design and Business, University of Waterloo, Waterloo, ON, Canada
| | | | - Frank Behrendt
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
| | - Sonja Böckler
- Department of Design, Subject Area Game Design, Zurich University of the Arts, Zurich, Switzerland
| | - Stefan Schmidlin
- Department of Design, Subject Area Game Design, Zurich University of the Arts, Zurich, Switzerland
| | - Roman Jurt
- Department of Design, Subject Area Game Design, Zurich University of the Arts, Zurich, Switzerland
| | | | - Christian Brenneis
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria.,Karl Landsteiner Institute of Interdisciplinary Rehabilitation Research, Münster, Austria
| | - Leo H Bonati
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.,Department of Neurology, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Corina Schuster-Amft
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.,Institute of Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland
| | - Barbara Seebacher
- Karl Landsteiner Institute of Interdisciplinary Rehabilitation Research, Münster, Austria.,Department of Rehabilitation Research, Clinic for Rehabilitation Münster, Münster, Austria.,Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Zhang J, Luximon Y, Pang MYC, Wang H. Effectiveness of exergaming-based interventions for mobility and balance performance in older adults with Parkinson's disease: systematic review and meta-analysis of randomised controlled trials. Age Ageing 2022; 51:6653486. [PMID: 35930726 DOI: 10.1093/ageing/afac175] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/01/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND exergaming-based interventions (EbIs) have been proposed to improve older adults' mobility and balance performance. However, the effectiveness of such interventions for older adults with Parkinson's disease (OAPD) remains unclear. METHODS seven databases (Web of Science, Medline, Academic Search Premier, CINAHL Complete, PsycINFO, PsychARTICLE and PubMed) were searched up to 7 April 2022. We assessed mobility and balance performance between EbIs groups and control groups or traditional physical training interventions (TPTIs) groups by comparing the outcomes of the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), Berg Balance Scale (BBS), gait velocity, stride length and Functional Gait Assessment (FGA). RESULTS we scanned 1,190 articles and meta-analysed 19 trials (sample size = 781). In general, the results revealed statistical differences between EbIs groups and TPTIs groups in the TUG [mean difference (MD) = -1.030 s; 95% confidence interval (CI) = -2.029 to -0.031; P = 0.043; high quality of evidence], 6MWT (MD = 63.483 m; 95% CI = 9.542 to 117.425; P = 0.021; moderate quality of evidence), BBS (MD = 2.129; 95% CI = -1.293 to 2.965; P < 0.001; high quality of evidence) and FGA (MD = 2.099 95% CI = -0.306 to 3.893; P = 0.022; moderate quality of evidence). No significant difference was discovered between EbIs groups and TPTIs groups in enhancing gait velocity and stride length. CONCLUSIONS EbIs are statistically better than TPTIs in improving OAPD's performance in TUG, 6MWT, BBS and FGA, whereas only the change between EbIs and TPTIs in 6MWT can reach the value of minimal clinically important difference. Further studies are needed to better assess the effectiveness of exergaming-based interventions.
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Affiliation(s)
- Jiaxin Zhang
- School of Design, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Immersive Virtual Reality as a Novel Physical Therapy Approach for Nonagenarians: Usability and Effects on Balance Outcomes of a Game-Based Exercise Program. J Clin Med 2022; 11:jcm11133911. [PMID: 35807196 PMCID: PMC9267554 DOI: 10.3390/jcm11133911] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023] Open
Abstract
Physical exercise has been recognized as an important strategy in the promotion of healthy aging. Positive effects on older adults' motor ability are brought about by engaging their motor skills and promoting sensorimotor learning and cortical plasticity. These processes could be increased with the use of immersive virtual reality (IVR) technology, since the multisensory stimulation is greater. The aim of this study was to explore the usability and balance effects of an IVR exercise program in community-dwelling nonagenarian people. A sample of 12 women were allocated to an experimental group (EG n = 6; 91.67 ± 1.63 years) and a control group (CG n = 6; 90.83 ± 2.64 years). For 10 weeks, the EG used a commercial IVR exergame three times a week. All the sample completed the program without adverse effects (without Simulator Sickness Questionnaire symptoms). Post-gaming usability was good (System Usability Scale 78.33). The EG improved some balance parameters significantly (Tinetti test: balance (10.97 %; Sig = 0.017), gait (9.23%; Sig = 0.047) and total score (10.20%; Sig = 0.014) and maintained total TUG test times (-0.45%)). There were significant differences between groups (Tinetti test: balance (Sig = 0.004) and total score (Sig = 0.0032)). We successfully demonstrated that IVR training is feasible and is an effective and personalized method to enhance balance and to reduce the risk of falls in community-dwelling nonagenarian women.
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Diener J, Rayling S, Bezold J, Krell-Roesch J, Woll A, Wunsch K. Effectiveness and Acceptability of e- and m-Health Interventions to Promote Physical Activity and Prevent Falls in Nursing Homes—A Systematic Review. Front Physiol 2022; 13:894397. [PMID: 35669573 PMCID: PMC9163679 DOI: 10.3389/fphys.2022.894397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/27/2022] [Indexed: 01/23/2023] Open
Abstract
Age-related decreases in physical activity (PA) and a decline in physical functioning lead to increased fall risk. As falls are a major cause of accidental deaths and hospitalization in older adults, PA promotion and fall prevention are important measures, especially in nursing homes (NH). With advances in information and communication technology, e- and m-health solutions have been developed to positively influence various health-related factors. To date, only little research exists on the implementation of these technologies to promote health in NH. Therefore, the objective of this systematic review was to provide an overview of the effectiveness, acceptability, and feasibility of e- and m-health interventions aimed at promoting PA and preventing falls in NH. Additionally, the effectiveness of such interventions regarding the secondary outcomes physical function, cognitive function, neuropsychiatric symptoms, and psychosocial status was examined. A systematic literature search was performed in five databases and studies published until 15 November 2021, were considered for inclusion. All studies that examined the effectiveness and/or the acceptability and feasibility of e- or m-health interventions in promoting PA and preventing falls in NH, without restriction on language or date of publication, were included in the final synthesis. Of the 1,358 records retrieved, 28 studies were included in this systematic review. Twenty-four studies contained digital exergaming as an intervention or as a part of the intervention, the four additional studies on e-health interventions only examined a small number of outcomes. No m-health intervention study was identified. Data synthesis indicates that exergaming may be effective in reducing the number of falls and fall risk in NH residents. Several significant improvements were also reported regarding secondary outcomes albeit not consistent across studies. No conclusion can be drawn about the effects of exergaming and other e-health interventions on PA, as data is scarce. E-health interventions were mostly reported as feasible and well accepted by NH residents. However, these findings may not be applicable to NH residents with advanced physical and/or cognitive impairments, since they were excluded in many studies. Therefore, more research examining other digital solutions besides exergaming to promote PA in this specific population is critical. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42021289488
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26
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Tan Q, Li J, Yin Y, Shao W. The Role of Growth Factors in the Repair of Motor Injury. Front Pharmacol 2022; 13:898152. [PMID: 35662720 PMCID: PMC9160921 DOI: 10.3389/fphar.2022.898152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Qiaoyin Tan
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Jiayu Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Yanmin Yin
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Weide Shao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Suleiman-Martos N, García-Lara R, Albendín-García L, Romero-Béjar JL, Cañadas-De La Fuente GA, Monsalve-Reyes C, Gomez-Urquiza JL. Effects of active video games on physical function in independent community-dwelling older adults: A systematic review and meta-analysis. J Adv Nurs 2021; 78:1228-1244. [PMID: 34935178 DOI: 10.1111/jan.15138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/25/2021] [Accepted: 12/09/2021] [Indexed: 02/02/2023]
Abstract
AIM To analyse the effects of active video games on physical function in independent community-dwelling older adults. DESIGN Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES The CINAHL, LILACS, Medline, Proquest and Scopus databases were consulted, with no restriction by year of publication. REVIEW METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The meta-analysis was performed using RevMan software. RESULTS The analysis included 22 randomized controlled trials with a total of 1208 participants (all ≥55 years old). In our meta-analyses, the effects produced by playing the active video games (mean differences) were statistically significant for the variables Gait speed and Timed up-and-go. The differences between the control and experimental groups were not significant in the following tests: 6-minute walk, 30-second chair stand, balance (measured with the Berg Balance Scale), cadence, grip strength, knee extension strength, 8-Foot Up-and-Go or velocity. CONCLUSIONS Physical exercise from participation in active video games has beneficial effects on two clinical parameters (Gait speed and Timed up-and-go) in independent community-dwelling older adults. However, the effects on other parameters do not differ from those obtained with conventional exercise training. Therefore, the clinical significance of these benefits is limited. IMPACT Older adults usually perform little physical activity. In consequence, researchers have increasingly considered alternatives to traditional forms of exercise. One such is that provided by active video games, which can be a source of stimulation, encouraging adherence and motivation in exercise programmes. Our review shows that active video games can improve gait speed and mobility, but in other respects obtain no differences from conventional exercises. Further tailored randomized clinical trials should be undertaken with diverse populations of older adults to evaluate different physical function variables to determine the most appropriate training approach and its optimal design and duration.
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Affiliation(s)
| | - Rubén García-Lara
- Granada-Northeast Health Management Area, Andalusian Health Service, Granada, Spain
| | - Luis Albendín-García
- Granada-Metropolitano Health District, Andalusian Health Service, Granada, Spain
| | - José L Romero-Béjar
- Statistics and Operational Research Department, University of Granada, Granada, Spain
| | | | - Carolina Monsalve-Reyes
- Social Sciences Department, Catholic University of La Santísima Concepción, Concepción, Chile
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28
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Jaarsma T, Klompstra L, Strömberg A, Ben Gal T, Mårtensson J, van der Wal MH. Exploring factors related to non-adherence to exergaming in patients with chronic heart failure. ESC Heart Fail 2021; 8:4644-4651. [PMID: 35167729 PMCID: PMC8712787 DOI: 10.1002/ehf2.13616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/23/2021] [Accepted: 09/04/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS This study aimed to explore factors related to non-adherence to exergaming in patients with heart failure. METHODS AND RESULTS Data from patients in the exergame group in the HF-Wii trial were used. Adherence to exergaming was defined as playing 80% or more of the recommended time. Data on adherence and reasons for not exergaming at all were collected during phone calls after 2, 4, 8, and 12 weeks. Logistic regression was performed between patients who were adherent and patients who were non-adherent. Secondly, a logistic regression was performed between patients who not exergamed at all and patients who were adherent to exergaming. Finally, we analysed the reasons for not exergaming at all with manifest content analysis. Almost half of the patients were adherent to exergaming. Patients who were adherent had lower social motivation [odds ratio (OR) 0.072; 95% confidence interval (CI) 0.054-0.095], fewer sleeping problems (OR 0.84; 95% CI 0.76-0.092), and higher exercise capacity (OR 1.003; 95% CI 1.001-1.005) compared with patients who were non-adherent. Patients who not exergamed at all had lower cognition (OR 1.18; 95% CI 1.06-1.31) and more often suffered from peripheral vascular disease (OR 3.74; 95% CI 1.01-13.83) compared with patients who were adherent to exergaming. Patients most often cited disease-specific barriers as a reason for not exergaming at all. CONCLUSIONS A thorough baseline assessment of physical function and cognition is needed before beginning an exergame intervention. It is important to offer the possibility to exergame with others, to be able to adapt the intensity of physical activity.
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Affiliation(s)
- Tiny Jaarsma
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
| | - Leonie Klompstra
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
| | - Anna Strömberg
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
- Department of CardiologyLinkoping UniversityLinkopingSweden
| | - Tuvia Ben Gal
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Jan Mårtensson
- Department of Nursing, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Martje H.L. van der Wal
- Department of Medicine, Health and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Cardiology, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Woldegiorgis BH, Lin CJ, Sananta R. Using Kinect body joint detection system to predict energy expenditures during physical activities. APPLIED ERGONOMICS 2021; 97:103540. [PMID: 34364129 DOI: 10.1016/j.apergo.2021.103540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to explore the potential of Kinect body joint detection to facilitate the calculation of energy expenditure during exergame exercises. Two Kinect-based biomechanical models - mechanical energy (KineticE) and work (WorkE) were employed to estimate the energy expenditure during four Wii™ exergame session. Consequently, two stepwise regression models were developed from nineteen participants' data and then validated by five holdout participants. The data collected using an accelerometer (r = 0.835, p < 0.001) had the highest correlation as compared to that of the WorkE (r = 0.805, p < 0.001) and KineticE (r = 0.466, p < 0.001) correlations with the reference indirect calorimetry using Quark activity energy expenditure (QuarkAEE). The regression results show that KineticE and the weight of the participant were significant factors for mechanical energy prediction (AEEKinetic). However, according to the work prediction equation (AEEWork), only WorkE was significant. The new energy prediction models showed significant agreement with the standard QuarkAEE (AEEKinect, r = 0.641, p = 0.02; AEEWork, r = 0.793, p < 0.001), and they were comparable to accelerometer predictions (r = 0.682, p = 0.001). The findings indicate that Kinect can be a potentially viable alternative to measure energy expenditures. The models can be applied with higher accuracy, especially when the activity demands high body movements.
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Affiliation(s)
- Bereket H Woldegiorgis
- Department of Industrial Management, National Taiwan University of Science and Technology, NO.43, SEC. 4, Keelung rd., Da'an dist., Taipei city, 10607, Taiwan, ROC
| | - Chiuhsiang J Lin
- Department of Industrial Management, National Taiwan University of Science and Technology, NO.43, SEC. 4, Keelung rd., Da'an dist., Taipei city, 10607, Taiwan, ROC.
| | - Riotaro Sananta
- Department of Industrial Management, National Taiwan University of Science and Technology, NO.43, SEC. 4, Keelung rd., Da'an dist., Taipei city, 10607, Taiwan, ROC
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Effects of Cognicise-Neurofeedback on Health Locus of Control, Depression, and Quantitative Electroencephalography Alpha Asymmetry in Elderly Women. Brain Sci 2021; 11:brainsci11070899. [PMID: 34356133 PMCID: PMC8304606 DOI: 10.3390/brainsci11070899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND With an increase in the aged population, there is a growing concern regarding the care of the elderly. This study aims to identify effects of cognicise-neurofeedback on health locus of control, depression, and quantitative electroencephalography (QEEG) alpha asymmetry in elderly women. METHODS A quasi-experimental control group pre-test-post-test design was used. Korean women aged 65 years or over at a senior welfare center were randomly allocated to the control (n = 12) or experimental (n = 19) groups from July to October 2019. The intervention consisted of cognicise (exercise with intensified cognitive activity) and neurofeedback twice a week for 10 weeks. The locus of control and depression were measured via self-reported questionnaires. QEEG alpha asymmetry was measured using BrainMaster. RESULTS Depression significantly decreased in the experimental group (t = 4.113, p = 0.001), while internality in the locus of control significantly decreased in the control group (t = 3.023, p = 0.012). On the other hand, QEEG alpha asymmetry index differences in F3-F4 between the pre-test and post-test were not significant in the experimental group (t = 0.491, p = 0.629) or control group (t = 0.413, p = 0.678). CONCLUSIONS Due to the coronavirus disease (COVID-19) pandemic, contact between the elderly and healthcare workers in the clinical practice field has become more restricted. These findings can help decrease negative emotions among elderly women in the community based on an integrated neuroscientific approach.
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Alhasan HS, Wheeler PC, Fong DTP. Application of Interactive Video Games as Rehabilitation Tools to Improve Postural Control and Risk of Falls in Prefrail Older Adults. CYBORG AND BIONIC SYSTEMS 2021; 2021:9841342. [PMID: 36285138 PMCID: PMC9494730 DOI: 10.34133/2021/9841342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/02/2021] [Indexed: 11/26/2023] Open
Abstract
The purpose of this study was to examine whether interactive video game (IVG) training is an effective way to improve postural control outcomes and decrease the risk of falls. A convenience sample of 12 prefrail older adults were recruited and divided into two groups: intervention group performed IVG training for 40 minutes, twice per week, for a total of 16 sessions. The control group received no intervention and continued their usual activity. Outcome measures were centre of pressure (COP), mean velocity, sway area, and sway path. Secondary outcomes were Berg Balance Scale, Timed Up and Go (TUG), Falls Efficacy Scale International (FES-I), and Activities-Specific Balance Confidence (ABC). Assessment was conducted with preintervention (week zero) and postintervention (week eight). The intervention group showed significant improvement in mean velocity, sway area, Berg Balance Scale, and TUG (p < 0.01) compared to the control group. However, no significant improvement was observed for sway path (p = 0.35), FES-I (p = 0.383), and ABC (p = 0.283). This study showed that IVG training led to significant improvements in postural control but not for risk of falls.
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Affiliation(s)
- Hammad S. Alhasan
- National Centre for Sport and Exercise Medicine-East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Patrick C. Wheeler
- National Centre for Sport and Exercise Medicine-East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel T. P. Fong
- National Centre for Sport and Exercise Medicine-East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
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Janhunen M, Karner V, Katajapuu N, Niiranen O, Immonen J, Karvanen J, Heinonen A, Aartolahti E. Effectiveness of Exergame Intervention on Walking in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther 2021; 101:6307336. [PMID: 34160022 PMCID: PMC8459884 DOI: 10.1093/ptj/pzab152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/19/2021] [Accepted: 05/05/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used, and the risk of bias. METHODS A literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo, and PEDro up to January 10, 2020. Studies with a randomized controlled trial design, people ≥60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking-related outcomes were included. Cochrane RoB2, meta-analysis, meta-regression, and Grading of Recommendations, Assessment, Development and Evaluation were used to estimate quality, treatment effect, covariates' effect, and the certainty of evidence, respectively. RESULTS In the studies included (n = 66), the overall risk of bias was low (n = 2), unclear (n = 48), or high (n = 16). Compared with comparison groups, exergaming interventions were more effective for walking improvements (standardized mean difference = -0.21; 95% CI = -0.36 to -0.06; 3102 participants, 58 studies; moderate-quality evidence) and more or equally effective (standardized mean difference = -0.32; 95% CI = -0.64 to 0.00; 1028 participants, 13 studies; low-quality evidence) after nonexergaming follow-up. The strongest effect for covariates was observed with the type of comparison group, explaining 18.6% of the variance. CONCLUSION For older adults without neurological disorders, exergame-based training improved walking, and improvements were maintained at follow-up. Greater benefits were observed when exergaming groups were compared with inactive comparison groups. To strengthen the evidence, further randomized controlled trials on the effectiveness of gamified exercise intervention are needed. IMPACT Exergaming has an effect equivalent to other types of exercising on improving walking in older adults. Physical therapists and other rehabilitation professionals may consider exergaming as a promising form of exercise in this age group.
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Affiliation(s)
- Maarit Janhunen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland,Address all correspondence to Mrs Janhunen at:
| | - Vera Karner
- Physiotherapy, University of Applied Sciences for Health Professions Upper Austria, Linz, Austria
| | - Niina Katajapuu
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland,Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | - Oona Niiranen
- Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | - Jaakko Immonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha Karvanen
- Faculty of Mathematics and Science, University of Jyväskylä, Jyväskylä, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eeva Aartolahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Abstract
BACKGROUND Few investigators have explored challenges and facilitators to exergaming, essential factors to exergaming adherence, among patients with heart failure. OBJECTIVES In this qualitative study, we explored facilitators and challenges using a home-based exergame platform, the Nintendo Wii Sports, in patients with heart failure. METHODS Semistructured face-to-face interviews were conducted in 13 participants given a diagnosis of heart failure (age range, 34-69 years). Participants were asked about their experiences with exergaming. Transcribed interviews were analyzed with content analysis. RESULTS The following 4 facilitators were identified: (1) enjoyment and competition motivated gaming, (2) accessibility at home gave freedom and lowered participants' barriers to exercise, (3) physical benefits when decreasing sedentary lifestyle, and (4) psychosocial benefits on stress, mood, and family interactions. Challenges included (1) diminished engagement over time due to boredom playing similar games and (2) frustrations due to game difficulty and lack of improvement. CONCLUSION Exergaming can increase individuals' physical activity because of easy accessibility and the fun and motivating factors the games offer. Participants initially found exergaming enjoyable and challenging. However, engagement diminished over time because of boredom from playing the same games for a period of time. Participants' preferences and capacities, participants' past experiences, and social support must be considered to avoid boredom and frustrations. Future studies are warranted to determine adherence to exergaming among patients with heart failure and, ultimately, increased overall well-being and healthcare delivery in this patient population.
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Ma RC, Yin YY, Liu X, Wang YQ, Xie J. Effect of Exercise Interventions on Quality of Life in Patients With Lung Cancer: A Systematic Review of Randomized Controlled Trials. Oncol Nurs Forum 2021; 47:E58-E72. [PMID: 32301933 DOI: 10.1188/20.onf.e58-e72] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PROBLEM IDENTIFICATION Improving quality of life (QOL) is a key issue for patients with lung cancer. Exercise interventions could positively affect patients' QOL; however, there is no clear-cut understanding of the role of exercise in improving QOL in patients with lung cancer. LITERATURE SEARCH The PubMed®, Embase®, Cochrane Library, and Web of Science electronic databases were searched from inception to September 6, 2019. DATA EVALUATION 16 randomized controlled trials met the inclusion criteria. A qualitative synthesis method was used to identify the effect of exercise interventions on QOL in patients with lung cancer. SYNTHESIS This review indicates that exercise interventions may have beneficial effects on the QOL of patients with lung cancer. The effectiveness seems to be affected by the duration of the intervention, as well as exercise frequency, intensity, and adherence. IMPLICATIONS FOR PRACTICE Exercise interventions can be integrated into management plans for patients with lung cancer to improve their QOL. Healthcare providers should consider developing optimal exercise prescriptions to maximize the results for this population.
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Virtual Reality Rehabilitation and Exergames—Physical and Psychological Impact on Fall Prevention among the Elderly—A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11094098] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The present review is aimed at the effectiveness of virtual reality (VR) and exergames in the prevention of falls among the elderly. Falls become a significant problem in the aging population and lead to psychological, social, and physical impairment. Prevention of falls is crucial to the well-being of the elderly population and is one of the challenges of contemporary rehabilitation. Recently, in view of the threat of the SARS-CoV-2 pandemic, contactless methods of rehabilitation, including telerehabilitation, appear as valuable rehabilitation tools. This review is based on the PRISMA guidelines and was carried out in five databases: PubMed, Medline, Web of Science, Scopus, and PEDro. Twenty-one randomized controlled trials, focused on the application of VR and exergames in the prevention of falls, were included. This review suggests that VR training in rehabilitation appears to be a promising complement to traditional techniques of physiotherapy to improve specific physical outcomes. VR and exergames could be considered as a complement of standard physiotherapy and its possible continuation at home for elderly. However, further high-quality studies, with carefully designed protocols and proper blinding, are needed.
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Alhasan H, Alshehri MA, Wheeler PC, Fong DTP. Effects of Interactive Videogames on Postural Control and Risk of Fall Outcomes in Frail and Pre-frail Older Adults: A Systematic Review and Meta-Analysis. Games Health J 2021; 10:83-94. [PMID: 33651955 DOI: 10.1089/g4h.2020.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Interactive videogames (IVGs) have been used to reduce risk of falls in the older adult and improve postural control (PC) outcomes. Objective: To systematically review trials that examine whether IVGs training is effective in improving PC and managing falls in frail and pre-frail older adults. Data Sources: Four databases were searched, Scopus, Web of science, PubMed, and MEDLINE, from January 2007 to March 2019. Eligibility Criteria: Frail and pre-frail older adults aged 65+. Interventions were any Nintendo® Wii™ training. The outcome measures were PC and risk of falls as measured by any validated outcome measure. Studies Appraisal Method: The PEDro (Physiotherapy Evidence Database) scale and Cochrane risk-of-bias tool were used by two independent authors. Results: Eleven papers were included, involving 388 participants, with a mean age of 79 ± 5.7 years. The mean duration of IVGs sessions was 8.8 ± 3.8 weeks, the mean total number of sessions was 20 ± 11.1 session, and the mean length of training was 44 ± 15.7 minutes. Meta-Analysis: IVGs achieved better results compared with traditional exercises and control on the Berg Balance Scale (mean difference [MD] 2.80; 95% confidence interval [CI] 1.21 to 4.39; P < 0.001; I2 = 16%), as well as in the short term on Timed Up and Go (MD -1.23; 95% CI -2.37 to -0.09; P = 0.03; I2 = 0%). Limitation: Definitive judgement could not be made due to the variability in training, training duration and outcomes measurement. Conclusion: IVGs is a promising modality that has a positive effect on PC but not on the outcome of falls, so it should be prescribed with caution among frail older adults. Systematic Review Registration: PROSPERO registration number: CRD42019129611.
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Affiliation(s)
- Hammad Alhasan
- National Centre for Sport and Exercise Medicine - East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.,Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mansour Abdullah Alshehri
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia.,NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Patrick C Wheeler
- National Centre for Sport and Exercise Medicine - East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.,Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine - East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
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dos Santos IK, de Medeiros RCDSC, de Medeiros JA, de Almeida-Neto PF, de Sena DCS, Cobucci RN, Oliveira RS, Cabral BGDAT, Dantas PMS. Active Video Games for Improving Mental Health and Physical Fitness-An Alternative for Children and Adolescents during Social Isolation: An Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041641. [PMID: 33572159 PMCID: PMC7915633 DOI: 10.3390/ijerph18041641] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/11/2022]
Abstract
The aim of this study was to synthesize the evidence on the effects of active video games (AVGs) on mental health, physical fitness and body composition of children and adolescents. A search was conducted in the following databases: PubMed; MEDLINE (by Ovid); SportDiscus, Cochrane library systematic reviews (CENTRAL) and EMBASE with no language restrictions during October 2020. Reviews on the use of AVGs were included in the study. We use the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) scale to analyze the methodological quality of the studies. Seventeen systematic reviews and meta-analyzes were included on the effects of AVGs with 30 to 4728 children and adolescents of both sexes with ages ranging from 6 to 19 years. In five studies, the population was overweight or obese. Regarding the quality, 12 studies were of moderate quality, two had high quality, two had low quality and one showed very low quality. The analyzed data indicate that the use of AVGs with a frequency of 1 to 3 times a week with durations of between 10 and 90 min per day shows positive effects on mental health and physical functioning. There was moderate quality evidence that AVGs can result in benefits for self-esteem, increased energy expenditure, physical activity and reduced body mass index in children and adolescents who used AVGs in the home environment. Further research is needed on this tool to help in the process of social isolation and consequently in promoting health and well-being.
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Affiliation(s)
- Isis Kelly dos Santos
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (I.K.d.S.); (R.C.d.S.C.d.M.); (J.A.d.M.)
| | | | - Jason Azevedo de Medeiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (I.K.d.S.); (R.C.d.S.C.d.M.); (J.A.d.M.)
| | - Paulo Francisco de Almeida-Neto
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (P.F.d.A.-N.); (D.C.S.d.S.)
| | - Dianne Cristina Souza de Sena
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (P.F.d.A.-N.); (D.C.S.d.S.)
| | - Ricardo Ney Cobucci
- Biotechnology Graduate Program, Potiguar University of Rio Grande do Norte, Natal 59078-970, Brazil;
| | - Ricardo Santos Oliveira
- Department of Physical Activity, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (R.S.O.); (B.G.d.A.T.C.)
| | | | - Paulo Moreira Silva Dantas
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (I.K.d.S.); (R.C.d.S.C.d.M.); (J.A.d.M.)
- Department of Physical Activity, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (R.S.O.); (B.G.d.A.T.C.)
- Correspondence: ; Tel./Fax: +55-84-3215-3450
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Da Silva Júnior JLA, Biduski D, Bellei EA, Becker OHC, Daroit L, Pasqualotti A, Tourinho Filho H, De Marchi ACB. A Bowling Exergame to Improve Functional Capacity in Older Adults: Co-Design, Development, and Testing to Compare the Progress of Playing Alone Versus Playing With Peers. JMIR Serious Games 2021; 9:e23423. [PMID: 33512319 PMCID: PMC7880815 DOI: 10.2196/23423] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/02/2020] [Accepted: 12/24/2020] [Indexed: 12/25/2022] Open
Abstract
Background Older people often do not meet the recommended levels of exercise required to reduce functional decline. Social interaction is mentioned by this cohort as a reason for joining group-based exercises, which does not occur when exercising alone. This perspective shows that exergames can be used as motivational resources. However, most available exergames are generic, obtained from commercial sources, and usually not specifically designed or adapted for older people. Objective In this study, we aim to co-design and develop a new exergame alongside older participants to (1) tailor the game mechanics and optimize participants’ adherence to and enjoyment of exercise; (2) test the participants’ functional capacity, motivation, and adherence to the exergaming program; and (3) compare these scores between those who played alone and those who played with peers. Methods We conducted a co-design process to develop a new exergame adapted to older people. For user testing, 23 participants were divided into 2 groups to play individually (alone group) or to compete in pairs (with peers group). They played the game twice a week, resulting in 21 exergaming sessions. We assessed the participants’ General Physical Fitness Index (GPFI) before and after the user testing. We also administered questionnaires about the gaming experience and exercise adherence with its motivators and barriers. Results We introduced a new bowling exergame for Xbox with a Kinect motion sensor that can be played in single or multiplayer mode. For the GPFI measurements, the sample was homogeneous in the pretest (with peers group: mean 40.5 [SD 9.6], alone group: mean 33.9 [SD 7.8]; P=.11). After the exergame testing sessions, both groups had significant gains (with peers group: mean 57.5 [SD 8.7], P=.005; alone group: mean 44.7 [SD 10.6]; P=.02). Comparing the posttest between groups, it was found that the group in which participants played with peers had better outcomes than the group in which participants played alone (P=.02). Regarding the gaming experience and exercise adherence, both groups recognized the benefits and expressed enthusiasm toward the exergame. Conclusions The findings suggest that the developed exergame helps in improving the functional capacity and adherence to physical exercise among older people, with even better results for those who played with peers. In addition to leading to more appropriate products, a co-design approach may positively influence the motivation and adherence of participants.
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Affiliation(s)
| | - Daiana Biduski
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, Brazil
| | - Ericles Andrei Bellei
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, Brazil
| | | | - Luciane Daroit
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, Brazil
| | - Adriano Pasqualotti
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, Brazil.,Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, Brazil
| | - Hugo Tourinho Filho
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Carolina Bertoletti De Marchi
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, Brazil.,Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, Brazil
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Boada I, Rodriguez Benitez A, Thió-Henestrosa S, Soler J. A Serious Game on the First-Aid Procedure in Choking Scenarios: Design and Evaluation Study. JMIR Serious Games 2020; 8:e16655. [PMID: 32812882 PMCID: PMC7468643 DOI: 10.2196/16655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 05/28/2020] [Accepted: 06/11/2020] [Indexed: 12/14/2022] Open
Abstract
Background Choking is one of the causes of unintentional injury death. Gaining the knowledge of the first-aid procedure that has to be applied in case of choking can increase the chances of survival of persons with choking. Serious games can be a good channel for educating people about choking scenarios and the actions to be taken to save the persons with choking. Objective The objective of this study is to present and evaluate the effectiveness of a serious game designed to prevent choking and to promote the first-aid procedure that needs to be applied in case of choking. Methods In this study, we present a serious game as a set of minigames that reproduces the main steps of the protocol for the first-aid performed in choking. In the proposed game, the player acquires the role of a helper who has to save the person in a choking emergency by applying the main steps of the protocol. Time and score restrictions are imposed to pass each minigame. To test this game, we performed a pilot study with 48 high school students. Different tests were performed to assess the students’ preferences and their knowledge on choking before and after playing the proposed game. The obtained results were analyzed using Mann-Whitney U test when a grade variable was involved and by using Fisher exact test when 2 categorical variables were involved. Results The findings of our study showed that the players enjoyed the game. No statistical differences were detected when considering the gender of the player, their preferences for video games, or their previous experience in choking emergencies. By comparing the knowledge of these students before and after playing the game, we found that all the indicators of the knowledge about how to act in case of a choking emergency were improved through this serious game. Conclusions The findings of our study show that the proposed game is a good strategy for promoting and teaching first-aid procedures in choking emergencies to nonexperts in this field.
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Affiliation(s)
- Imma Boada
- Graphics and Imaging Laboratory, Escola Politècnica Superior, Edifici Politècnica IV, 17003 Girona, Spain
| | - Antonio Rodriguez Benitez
- Graphics and Imaging Laboratory, Escola Politècnica Superior, Edifici Politècnica IV, 17003 Girona, Spain
| | - Santiago Thió-Henestrosa
- Graphics and Imaging Laboratory, Escola Politècnica Superior, Edifici Politècnica IV, 17003 Girona, Spain
| | - Josep Soler
- Graphics and Imaging Laboratory, Escola Politècnica Superior, Edifici Politècnica IV, 17003 Girona, Spain
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Byra J, Czernicki K. The Effectiveness of Virtual Reality Rehabilitation in Patients with Knee and Hip Osteoarthritis. J Clin Med 2020; 9:E2639. [PMID: 32823832 PMCID: PMC7465023 DOI: 10.3390/jcm9082639] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) is a common health problem leading to pain, limitation in physical function, a decrease in the quality of life and disability. OA affects 60-70% of the population above 65 years of age all over the world, and is associated with a high cost of healthcare. The main method of treatment of OA, apart from pharmacotherapy and surgery, is comprehensive rehabilitation. Advances in medical technology have resulted in the possibility of using computer-assisted interventions in rehabilitation. The present narrative review is aimed at investigating the effectiveness of virtual reality (VR) in the rehabilitation of elderly patients with knee or hip osteoarthritis, including patients after arthroplasty. This literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out in five databases: PubMed, Medline, Web of Science, Scopus and PEDro. It includes ten randomized controlled trials focused on the application of games and biofeedback in the rehabilitation of patients with knee and hip osteoarthritis. There are no conclusive reports that interventions based on VR are more effective than standard physical therapy. Moreover, evidence regarding patients after total hip arthroplasty (THA) is very scarce. The effectiveness of VR-based rehabilitation is unclear, although interventions based on VR are promising in view of pain management, postural and proprioception training. However, this evidence is not sufficient to create clinical guidelines and further high-quality studies are needed.
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Affiliation(s)
- Joanna Byra
- Faculty of Health Sciences, Jagiellonian University Medical College, Michalowskiego 12, 31-126 Cracow, Poland
- Department of Rehabilitation, Lesser Poland Orthopaedic and Rehabilitation Hospital, Modrzewiowa 22, 30-224 Cracow, Poland;
| | - Krzysztof Czernicki
- Department of Rehabilitation, Lesser Poland Orthopaedic and Rehabilitation Hospital, Modrzewiowa 22, 30-224 Cracow, Poland;
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Delgado F, Der Ananian C. The Use of Virtual Reality Through Head-Mounted Display on Balance and Gait in Older Adults: A Scoping Review. Games Health J 2020; 10:2-12. [PMID: 32598189 DOI: 10.1089/g4h.2019.0159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Falls are the most prominent cause of injury and injury-related deaths among older adults (OAs). Virtual reality has been utilized as a method of improving balance and gait in OAs. However, the use of virtual reality through a head-mounted display (VR-HMD) in this area is limited. Objective: The objective of this scoping review was to identify research that used VR-HMD in relation to balance and gait in OAs and to evaluate how VR-HMD is being used with this population. Materials and Methods: A systematic search of the literature was carried out from June 2019 to July 2019 through the following databases: Scopus, Web of Science, PUBMED, and PsycInfo. Eligible studies involved the use of VR-HMD to assess or intervene in balance or gait outcomes of OAs (≥65 years). Articles were not limited to any specific study design or by the year of publication. Results: Our search identified 306 possible articles, of which eight citations met the eligibility criteria. Four studies utilized VR-HMD as an assessment tool or to perturb the balance, while the other four used VR-HMD in their interventions. Conclusions: Currently, it is not clear whether VR-HMD alone is an effective tool for improving balance and gait. However, this review suggests that it is feasible to use VR-HMD with OAs to affect balance and gait. More research is needed in this area, although there appears to be great potential in utilizing VR-HMD with OAs to improve balance outcomes.
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Affiliation(s)
- Ferdinand Delgado
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Cheryl Der Ananian
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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Coats AJS. Exergaming for heart failure: an idea so good it just ought to work. Eur J Heart Fail 2020; 23:125-126. [PMID: 32391941 DOI: 10.1002/ejhf.1842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 01/27/2023] Open
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Jaarsma T, Klompstra L, Ben Gal T, Ben Avraham B, Boyne J, Bäck M, Chialà O, Dickstein K, Evangelista L, Hagenow A, Hoes AW, Hägglund E, Piepoli MF, Vellone E, Zuithoff NPA, Mårtensson J, Strömberg A. Effects of exergaming on exercise capacity in patients with heart failure: results of an international multicentre randomized controlled trial. Eur J Heart Fail 2020; 23:114-124. [PMID: 32167657 DOI: 10.1002/ejhf.1754] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/09/2020] [Accepted: 01/16/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | - Tuvia Ben Gal
- Heart Failure Unit, Cardiology department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Binyamin Ben Avraham
- Heart Failure Unit, Cardiology department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Maria Bäck
- Department of Health, Medicine and Caring Sciences, Division of Physiotherapy, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Oronzo Chialà
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Kenneth Dickstein
- University of Bergen, Stavanger University Hospital, Stavanger, Norway
| | | | - Andreas Hagenow
- Center for Clinical Research Südbrandenburg, Elsterweda, Germany
| | - Arno W Hoes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Eva Hägglund
- Department of Cardiology, Karolinska Theme of Heart and Vessel, Heart Failure, Karolinska University Hospital, Stockholm, Sweden
| | - Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza, Italy.,University of Parma, IT2 Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicolaas P A Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Jan Mårtensson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden.,Department of Cardiology, Linköping University, Linköping, Sweden
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Meneghini V, Hauser E, Lourenço CLM, Barbosa AR. Effects of exergames and resistance training on well-being in older adults: a randomized clinical trial. GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-212320202000042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To analyze the effects of an exergame-based training compared to resistance training on the quality of life and symptoms of depression in older adults. METHODS: This was a two-arm, non-blinded, randomized clinical trial. Thirty-five participants (62.09 ± 7.11 years) were randomized either on the Exergame-based Training Group (n = 17) or the Resistance Training Group (n = 18). Sessions lasted 50 to 60 minutes, three times per week, for 13 weeks. For the Exergame-based Training Group, we used games that simulate sports and adventure activities through Xbox360 Kinect™. The Resistance Training Group performed ten exercises per session for upper and lower limbs using free weights and machines, following linear periodization and individualized loads. Quality of life and symptoms of depression were assessed using the World Health Organization Quality of Life assessment - an abbreviated version (WHOQOL-BREF) and the Geriatric Depression Scale, respectively. We performed a two-way analysis of variance (p ≤ 0.05). RESULTS: Only time effects were identified for overall quality of life, general health, and symptoms of depression. After the intervention, overall quality of life score increased (3.82 ± 0.95 versus 4.18 ± 0.53, p = 0.05), whereas symptoms of depression decreased (3.35 ± 1.73 versus 2.59 ± 1.54, p = 0.02) in the Exergame-based Training Group, and the general health improved in the Resistance Training Group (3.78 ± 0.81 versus 4.11 ± 0.68, p = 0.05) compared with the baseline scores. CONCLUSION: Both training groups improved different aspects of quality of life. The Exergaming-based Training Group improved the overall perception, whereas the Resistance Training Group improved the general health-related perception. Participants in the Exergame-based Training Group also decreased the number of symptoms of depression.
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Bond S, Laddu DR, Ozemek C, Lavie CJ, Arena R. Exergaming and Virtual Reality for Health: Implications for Cardiac Rehabilitation. Curr Probl Cardiol 2019; 46:100472. [PMID: 31606141 DOI: 10.1016/j.cpcardiol.2019.100472] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 08/29/2019] [Indexed: 12/13/2022]
Abstract
Cardiac Rehabilitation (CR) programs, focused on improving the health trajectory of patients with cardiovascular disease, strive to increase physical activity (PA) and cardiorespiratory fitness. However, historically low compliance with recommended PA has prompted exploration of alternatives to traditional courses of exercise therapy. One alternative, exergaming, or the requirement of physical exercise inherent to a video game's activities, has shown to have a promising impact in improving patient self-efficacy for exercise training using digital hardware (eg, the Wii or the Xbox Kinect). Furthermore, novel technologies in virtual reality can provide an engaging, immersive environment for exergaming techniques, maximizing goal-oriented training and building self-efficacy for patients during CR. Many groundbreaking institutions are already calculating energy expenditure of commercially successful virtual reality games and finding promise in the cardiometabolic responses to a number of virtual reality games. Research is still limited in establishing the efficacy of these games, but virtual reality and exergaming are quickly proving to be appropriate and equivalent alternatives to traditional exercise programs. Though studies have examined the impact of prescriptive exergaming on PA, they have yet to examine the potential for genuine integration of game-based motivational techniques and immersive environments into clinical interaction. The purpose of this review is to describe the current body of evidence and the impact and future potential of virtual reality and exergaming. Further, we will introduce the concept of a "Clinical Arcade" as a new approach to integration of these techniques in CR care.
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The effect of whole body vibration on health-related quality of life in patients with chronic conditions: a systematic review. Qual Life Res 2019; 28:2859-2870. [DOI: 10.1007/s11136-019-02274-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 12/19/2022]
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