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Voinescu A, Papaioannou T, Petrini K, Stanton Fraser D. Exergaming for dementia and mild cognitive impairment. Cochrane Database Syst Rev 2024; 9:CD013853. [PMID: 39319863 PMCID: PMC11423707 DOI: 10.1002/14651858.cd013853.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
BACKGROUND Dementia and mild cognitive impairment are significant contributors to disability and dependency in older adults. Current treatments for managing these conditions are limited. Exergaming, a novel technology-driven intervention combining physical exercise with cognitive tasks, is a potential therapeutic approach. OBJECTIVES To assess the effects of exergaming interventions on physical and cognitive outcomes, and activities of daily living, in people with dementia and mild cognitive impairment. SEARCH METHODS On 22 December 2023, we searched the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost), Web of Science Core Collection (Clarivate), LILACS (BIREME), ClinicalTrials.gov, and the WHO (World Health Organization) meta-register the International Clinical Trials Registry Portal. SELECTION CRITERIA We included randomised controlled trials (RCTs) that recruited individuals diagnosed with dementia or mild cognitive impairment (MCI). Exergaming interventions involved participants being engaged in physical activity of at least moderate intensity, and used immersive and non-immersive virtual reality (VR) technology and real-time interaction. We planned to classify comparators as inactive control group (e.g. no treatment, waiting list), active control group (e.g. standard treatment, non-specific active control), or alternative treatment (e.g. physical activity, computerised cognitive training). Outcomes were to be measured using validated instruments. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies for inclusion, extracted data, assessed the risk of bias using the Cochrane risk of bias tool RoB 2, and assessed the certainty of the evidence using GRADE. We consulted a third author if required. Where possible, we pooled outcome data using a fixed-effect or random-effects model. We expressed treatment effects as standardised mean differences (SMDs) for continuous outcomes and as risk ratios (RRs) for dichotomous outcomes, along with 95% confidence intervals (CIs). When data could not be pooled, we presented a narrative synthesis. MAIN RESULTS We included 11 studies published between 2014 and 2023. Six of these studies were pre-registered. Seven studies involved 308 participants with mild cognitive impairment, and five studies included 228 individuals with dementia. One of the studies presented data for both MCI and dementia separately. Most comparisons exhibited a high risk or some concerns of bias. We have only low or very low certainty about all the results presented below. Effects of exergaming interventions for people with dementia Compared to a control group Exergaming may improve global cognitive functioning at the end of treatment, but the evidence is very uncertain (SMD 1.47, 95% 1.04 to 1.90; 2 studies, 113 participants). The evidence is very uncertain about the effects of exergaming at the end of treatment on global physical functioning (SMD -0.20, 95% -0.57 to 0.17; 2 studies, 113 participants) or activities of daily living (ADL) (SMD -0.28, 95% -0.65 to 0.09; 2 studies, 113 participants). The evidence is very uncertain about adverse effects due to the small sample size and no events. Findings are based on two studies (113 participants), but data could not be pooled; both studies reported no adverse reactions linked to the intervention or control group. Compared to an alternative treatment group At the end of treatment, the evidence is very uncertain about the effects of exergaming on global physical functioning (SMD 0.14, 95% -0.30 to 0.58; 2 studies, 85 participants) or global cognitive functioning (SMD 0.11, 95% -0.33 to 0.55; 2 studies, 85 participants). For ADL, only one study was available (n = 67), which provided low-certainty evidence of little to no difference between exergaming and exercise. The evidence is very uncertain about adverse effects of exergaming compared with alternative treatment (RR 7.50, 95% CI 0.41 to 136.52; 2 studies, 2/85 participants). Effects of exergaming interventions for people with mild cognitive impairment (MCI) Compared to a control group Exergaming may improve global cognitive functioning at the end of treatment for people with MCI, but the evidence is very uncertain, (SMD 0.79, 95% 0.05 to 1.53; 2 studies, 34 participants). The evidence is very uncertain about the effects of exergaming at the end of treatment on global physical functioning (SMD 0.27, 95% -0.41 to 0.94; 2 studies, 34 participants) and ADL (SMD 0.51, 95% -0.01 to 1.03; 2 studies, 60 participants). The evidence is very uncertain about the effects of exergaming on adverse effects due to a small sample size and no events (0/14 participants). Findings are based on one study. Compared to an alternative treatment group The evidence is very uncertain about global physical functioning at the end of treatment. Only one study was included (n = 45). For global cognitive functioning, we included four studies (n = 235 participants), but due to considerable heterogeneity (I² = 96%), we could not pool results. The evidence is very uncertain about the effects of exergaming on global cognitive functioning. No study evaluated ADL outcomes. The evidence is very uncertain about adverse effects of exergaming due to the small sample size and no events (n = 123 participants). Findings are based on one study. AUTHORS' CONCLUSIONS Overall, the evidence is very uncertain about the effects of exergaming on global physical and cognitive functioning, and ADL. There may be an improvement in global cognitive functioning at the end of treatment for both people with dementia and people with MCI, but the evidence is very uncertain. The potential benefit is observed only when exergaming is compared with a control intervention (e.g. usual care, listening to music, health education), and not when compared with an alternative treatment with a specific effect, such as physical activity (e.g. standing and sitting exercises or cycling). The evidence is very uncertain about the effects of exergaming on adverse effects. All sessions took place in a controlled and supervised environment. Therefore, we do not know if exergaming can be safely used in a home environment, unsupervised.
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Affiliation(s)
| | | | - Karin Petrini
- Department of Psychology, University of Bath, Bath, UK
- Centre for the Analysis of Motion, Entertainment Research and Applications, University of Bath, Bath, UK
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Bao H, Pai SGS, Singh NB, Pham BTP, Siva Subramaniam SM, Theng YL, Lee EWJ. Single or Multiplayer Mode? Examining the Effects of Exergames in Improving Physical Health and Well-Being Among Older Adults. Games Health J 2024. [PMID: 39172740 DOI: 10.1089/g4h.2023.0241] [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: 08/24/2024] Open
Abstract
Objective: This study assesses the impact of single-player and multiplayer exergaming modes on improving exercise intentions, reduction of fear of falling, and emotional well-being among older adults, primarily from low socioeconomic status (SES) backgrounds-a group often underrepresented in exergame research. Method: We engaged 48 participants, primarily from low-SES communities in Singapore for a 4-week community-based exergaming intervention. Participants were divided into four groups as follows: (1) conventional exercise alone, (2) exergames alone, (3) exergames with a health coach, and (4) exergames with a peer. Using two-way repeated-measures ANOVA, we analyzed the effects of these interventions. Results: The findings revealed that all exergaming modes positively influenced exercise intentions, fear of falling, and emotional well-being to varying extents. Notably, exergaming with a health coach significantly improved participants' exercise intentions and emotional well-being, underscoring the value of expert guidance in motivating and supporting older adults in adopting healthier lifestyles. Exergaming with a peer was most effective in reducing fear of falling, highlighting the importance of social support and peer interaction in addressing physical health concerns among this population. Conclusion: This study emphasizes the potential of tailored exergame interventions incorporating various social interactions to improve health outcomes for older adults, contributing to more inclusive health promotion strategies.
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Affiliation(s)
- Huanyu Bao
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Sai G S Pai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Navrag B Singh
- Laboratory for Movement Biomechanics, Institute for Biomechanics, Department of Health Science & Technology, ETH Zürich, Zürich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Ben Tan Phat Pham
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | | | - Yin-Leng Theng
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
- Ageing Research Institute for Society and Education (ARISE), Nanyang Technological University, Singapore
| | - Edmund W J Lee
- Department of Media and Communication, City University of Hong Kong, Hong Kong, China
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Deng N, Soh KG, Abdullah BB, Tan H, Huang D. Active video games for improving health-related physical fitness in older adults: a systematic review and meta-analysis. Front Public Health 2024; 12:1345244. [PMID: 38694976 PMCID: PMC11061467 DOI: 10.3389/fpubh.2024.1345244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Background The global population is experiencing a rapid rise in the quantity and percentage of older people. In an effort to enhance physical activity among older adults, active video games (AVGs) are being suggested as a compelling alternative and are currently under scrutiny to evaluate their efficacy in promoting the health of older people. Objective This review aims to synthesize current studies and formulate conclusions regarding the impact of AVGs on the health-related physical fitness of older adults. Methods Seven databases (PubMed, Web of Science, SCOPUS, SPORTDiscus, EMBASE, MEDLINE, and CINAHL) were searched from inception to January 21, 2024. Eligible studies included randomized controlled trials examining the effect of AVGs compared to control conditions on health-related physical fitness outcomes in older adults. The methodological quality of the included trials was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE approach. A random-effects model was used to calculate effect sizes (ES; Hedge's g) between experimental and control groups. Results The analysis included 24 trials with a total of 1428 older adults (all ≥ 60 years old). Compared to controls, AVGs produced significant increases in muscular strength (moderate ES = 0.64-0.68, p < 0.05) and cardiorespiratory fitness (moderate ES = 0.79, p < 0.001). However, no significant effects were found for body composition (trivial ES = 0.12-0.14; p > 0.05) and flexibility (trivial ES = 0.08; p = 0.677). The beneficial effects of AVGs were greater after a duration of ≥ 12 vs. < 12 weeks (cardiorespiratory fitness; ES = 1.04 vs. 0.29, p = 0.028) and following ≥ 60 minutes vs. < 60 minutes of session duration (muscular strength; ES = 1.20-1.24 vs. 0.27-0.42, p < 0.05). Conclusion AVGs appear to be an effective tool for enhancing muscular strength and cardiorespiratory fitness in older adults, although their impact on improving body composition and flexibility seems limited. Optimal improvement in cardiorespiratory fitness is associated with a longer duration of AVGs (≥ 12 weeks). Moreover, a session duration of ≥ 60 minutes may provide greater benefits for the muscular strength of older adults. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=482568, identifier CRD42023482568.
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Affiliation(s)
- Nuannuan Deng
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Borhannudin Bin Abdullah
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hermione Tan
- School of Computer Information Sciences, University of the Cumberlands, Williamsburg, KY, United States
| | - Dandan Huang
- College of Physical Education, Chongqing University, Chongqing, China
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Takei K, Morita S, Watanabe Y. Acceptability of Physical Therapy Combined with Nintendo Ring Fit Adventure Exergame for Geriatric Hospitalized Patients. Games Health J 2024; 13:33-39. [PMID: 37566481 DOI: 10.1089/g4h.2023.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
Geriatric hospitalized patients often experience complications associated with frailty and impaired functioning in activities of daily living. To enhance their functional independence, repetitive and continuous high-frequency exercises are necessary. However, conventional physical therapy (PT) can be monotonous and lead to reduced adherence. The introduction of Nintendo Ring Fit Adventure exergame (EG) as a complement to PT for geriatric inpatients has the potential to improve exercise enjoyment and acceptability. This study aimed to evaluate the acceptability of combining EG with PT for geriatric inpatients. A total of 30 geriatric inpatients were included in the study, receiving EG+PT on day 1 and PT only on day 2. The rate of perceived exertion (RPE) was assessed using the Borg scale, whereas enjoyment, motivation to continue, and perceived effectiveness were evaluated through a questionnaire after each exercise session and subsequently compared. The RPE for the lower extremities and the sense of enjoyment (P = 0.06) were found to be higher after the EG+PT session. The results suggest that combining PT with EG can enhance the enjoyment of exercise sessions and facilitate an increase in the intensity and frequency of exercise therapy. Incorporating EGs into geriatric PT holds promise as an effective strategy to improve patient engagement and adherence to exercise regimens. Further research is warranted to explore the long-term benefits and potential applications of EGs in geriatric rehabilitation settings.
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Affiliation(s)
- Keiichi Takei
- Department of Physical Therapy, Tokyo Professional University of Health Sciences, School of Rehabilitation, Tokyo, Japan
| | - Shinpei Morita
- Department of Rehabilitation, Shiomi Hospital, Asaka City, Japan
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Campelo AM, Weisberg A, Sheehan DP, Schneider K, Cossich VRA, Katz L. Physical and Affective Physical Literacy Domains Improved After a Six-Week Exergame Exercise Program in Older Adults: A Randomized Controlled Clinical Trial. Games Health J 2023; 12:366-376. [PMID: 37311178 DOI: 10.1089/g4h.2022.0212] [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] [Indexed: 06/15/2023] Open
Abstract
Introduction: We investigated the effects of an exergames-based exercise program for older adults, and its benefits on their physical literacy (PL) domains, such as physical (mobility skills), affective (motivation and confidence), cognitive (knowledge about physical activity [PA]), and behavioral (daily exertion) when compared with a conventional exercise program and no training (NT) (control). Material and Methods: Forty older adults (mean age 72 years) volunteered and were randomized within three groups-exergame training (ET; n = 15), conventional training (CT; n = 14), and NT (n = 11). ET group performed training sessions based on a commercially available exergame console, while the CT group enrolled in a convention exercise program (aerobic, strength, balance, and flexibility exercises). The training program was conducted three times a week for 6 weeks. The Timed Up and Go Test (TUG), Exercise Confidence Survey (ECS), Motives for Physical Activity Measure-Revised (MPAM-R), Knowledge and Understanding Questionnaire (K&UQ), and total PA tracking (using wearable technology) were used as the study's outcomes. Outcome variables were measured at preintervention (week 0), postintervention (week 6), and at the time of final follow-up (week 9). Results: We observed a reduction in the ET TUG time at postintervention and follow-up. Also, a significant main effect for group and moment of measurement was observed for the Fitness-Health subscore, derived from MPAM-R. The values demonstrated by ET and CT were statistically different (P = 0.01) and a within-group comparison revealed significant differences in the ET from preintervention to both postintervention and follow-up (both, P = 0.01). We did not observe any other significant difference. Conclusion: Our results suggest that a 6-week exergame-based training program may have the potential in improving the physical and affective domains of PL in community-dwelling older adults. The topics related to fitness and health seem to be of interest in this population and programs can make use of them to improve the PL domains.
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Affiliation(s)
- Alexandre Monte Campelo
- Sport Technology Research Lab, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Alanna Weisberg
- Sport Technology Research Lab, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Dwayne P Sheehan
- Faculty of Health, Community and Education, Mount Royal University, Calgary, Canada
| | - Kathryn Schneider
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Victor R A Cossich
- Sport Technology Research Lab, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Larry Katz
- Sport Technology Research Lab, Faculty of Kinesiology, University of Calgary, Calgary, Canada
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Sayar R, Sinaei E, Daryanoosh F, Koshki M, Sobhani S. Comparing the effects of 30 minutes exergaming versus brisk walking on physiological and psychological measurements of older adults. J Bodyw Mov Ther 2023; 36:69-73. [PMID: 37949602 DOI: 10.1016/j.jbmt.2023.06.011] [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: 07/19/2022] [Revised: 04/21/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Active video games can make physical activity more appealing and enjoyable for older people. This study compared the effects of 30 min of Exergaming versus walking on the physiological and psychological measures of asymptomatic older adults. METHODS Forty eligible participants (mean age = 69.60 ± 4.16 y/o) were randomly divided into two groups of 20 in a crossover design, who either performed Brisk Walking or Exergaming, one week apart. Before each session, each participant's blood pressure was measured, and the subjects were encouraged to play/walk continuously for 30 min using a self-selected intensity. During both sessions, average and peak heart rate, time spent in each of the heart rate zones, blood pressure, and double product were assessed through a Polar H10 heart rate monitor. Participants also filled out the modified Physical Activity Enjoyment Scale (PACES) questionnaire and Rate of Perceived Exertion (RPE) scale. RESULTS Findings indicated a significantly higher average (P = 0.003) and peak heart rate (P < 0.001) and double product (P = 0.002) during Exergaming compared to Brisk Walking. Also, the RPE score was significantly lower and PACES score was significantly higher (P < 0.001) during the Exergaming session. The analyses of blood pressure showed significant changes in systolic and diastolic blood pressures following each session, while no statistically significant difference was reported between the two exercise modalities (P = 0.012 and P < 0.001, respectively). CONCLUSION This study showed that Exergaming can be a good alternative to traditional exercises like walking for older adults, providing physiological benefits while being less exhausting and more enjoyable.
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Affiliation(s)
- Reza Sayar
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Ehsan Sinaei
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA; Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Daryanoosh
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz, Iran.
| | - Maryam Koshki
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz, Iran
| | - Sobhan Sobhani
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Yu K, Wen S, Xu W, Caon M, Baghaei N, Liang HN. Cheer for me: effect of non-player character audience feedback on older adult users of virtual reality exergames. VIRTUAL REALITY 2023; 27:1-17. [PMID: 37360816 PMCID: PMC10009836 DOI: 10.1007/s10055-023-00780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/17/2023] [Indexed: 06/28/2023]
Abstract
The presence of an audience and its feedback could affect people's performance and experience during an event, especially related to sports such as tennis or boxing. Similarly, in videogames, players' gameplay could be affected if there is an audience and its feedback in response to players' performance in the environment. The inclusion of an audience with non-player characters (NPC) is common in videogames in general. However, there is a limited exploration of the use of an NPC audience in virtual reality (VR) exergames, especially focusing on elderly players. To fill this gap, this work examines the effect of an NPC audience and its associated feedback (with/without) on elderly users of VR exergames. In a user study, we used 120 NPC in a virtual audience. Results showed that the presence of the NPC audience with responsive feedback led to higher performance (with a higher success rate of performing gesture actions, more successful combinations of actions (or combos for short) performed, and more opponent's combos prevented) and better gameplay experience (with higher levels of competence, autonomy, relatedness, immersion, and intuitive controls) of elderly players. Our results can help frame the design and engineering of VR exergames that are targeted at elderly users to help them have an enhanced gameplay experience and improve their health.
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Affiliation(s)
- Kangyou Yu
- Department of Computing, Xi’an Jiaotong-Liverpool University, Suzhou, China
- Department of Computer Science, The University of California, Santa Barbara, Santa Barbara, CA USA
| | - Shaoyue Wen
- Department of Computing, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Wenge Xu
- DMT Lab, Birmingham City University, Birmingham, UK
| | - Maurizio Caon
- School of Management of Fribourg, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
| | - Nilufar Baghaei
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD Australia
| | - Hai-Ning Liang
- Department of Computing, Xi’an Jiaotong-Liverpool University, Suzhou, China
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Kushniruk A, Bergschöld JM, Whitmore C, Winters M, Kayser L. Involving Older People With Frailty or Impairment in the Design Process of Digital Health Technologies to Enable Aging in Place: Scoping Review. JMIR Hum Factors 2023; 10:e37785. [PMID: 36705959 PMCID: PMC9919541 DOI: 10.2196/37785] [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: 03/07/2022] [Revised: 07/08/2022] [Accepted: 11/20/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND With an increase in life expectancy globally, the focus on digital health technologies that can enhance physical and mental health among older people with frailty and impairment has increased. Similarly, research interest in how digital health technology can promote well-being and self-management of health in older age has increased, including an increased focus on methods for designing digital health technologies that meet the various medical, psychological, and social needs of older population. Despite the increased focus, there remains a necessity to further understand the needs of this population group to ensure uptake and to avoid introduction of additional challenges when introducing technologies, for example, because of poor technological design. The scope is limited to digital health technologies meant to enable older people with frailty and impairment to age in place. OBJECTIVE In this study, we aimed to explore how older people with frailty and impairment are involved in various parts of the design processes of digital health technologies and identify gaps or neglected steps in a user-involving design process. This included a focus on recruitment strategies, contributions, and methods used to address the perspectives, needs, and desires of older people with frailty and impairment in the development of digital health technologies. METHODS A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting from February 2021 to April 2021. Literature searches were conducted in PubMed, Scopus, Embase, and IEEE using a search string covering the concepts of health technology, older people, frailty and impairment, user-centered design, and self-management. RESULTS In total, 1891 studies were imported for screening from the initial search. A total of 22 studies were included in this review after full-text screening and manual search. Invitation through partners was the most reported recruitment strategy to involve older people with frailty and impairment in the design process of digital health technologies. Furthermore, they were commonly involved in the final evaluation of the development process. Three main gaps identified were the use of outreach approaches to recruit older people with frailty and impairment in the design process of digital health technologies, description of the value of involvement and outcome of the contribution of participants, and knowledge regarding involvement in all parts of the design process. CONCLUSIONS Although there is literature on methods for involving older people with frailty and impairment in the design of digital health technology, there is little methodological dialogue on the nuances of how different methods for involvement relate to and shape the outcome of the development process.
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Affiliation(s)
| | | | - Carly Whitmore
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | | | - Lars Kayser
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Müller H, Baumeister J, Bardal EM, Vereijken B, Skjæret-Maroni N. Exergaming in older adults: the effects of game characteristics on brain activity and physical activity. Front Aging Neurosci 2023; 15:1143859. [PMID: 37213536 PMCID: PMC10196070 DOI: 10.3389/fnagi.2023.1143859] [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: 01/13/2023] [Accepted: 04/19/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Exergames are increasingly used in rehabilitation settings for older adults to train physical and cognitive abilities. To meet the potential that exergames hold, they need to be adapted to the individual abilities of the player and their training objectives. Therefore, it is important to know whether and how game characteristics affect their playing. The aim of this study is to investigate the effect of two different kinds of exergame (step game and balance game) played at two difficulty levels on brain activity and physical activity. Methods Twenty-eight older independently living adults played two different exergames at two difficulty levels each. In addition, the same movements as during gaming (leaning sideways with feet in place and stepping sideways) were performed as reference movements. Brain activity was recorded using a 64-channel EEG system to assess brain activity, while physical activity was recorded using an accelerometer at the lower back and a heart rate sensor. Source-space analysis was applied to analyze the power spectral density in theta (4 Hz-7 Hz) and alpha-2 (10 Hz-12 Hz) frequency bands. Vector magnitude was applied to the acceleration data. Results Friedman ANOVA revealed significantly higher theta power for the exergaming conditions compared to the reference movement for both games. Alpha-2 power showed a more diverse pattern which might be attributed to task-specific conditions. Acceleration decreased significantly from the reference movement to the easy condition to the hard condition for both games. Discussion The results indicate that exergaming increases frontal theta activity irrespective of type of game or difficulty level, while physical activity decreases with increasing difficulty level. Heart rate was found to be an inappropriate measure in this population older adults. These findings contribute to understanding of how game characteristics affect physical and cognitive activity and consequently need to be taken into account when choosing appropriate games and game settings for exergame interventions.
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Affiliation(s)
- Helen Müller
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- *Correspondence: Helen Müller,
| | - Jochen Baumeister
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
| | - Ellen Marie Bardal
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nina Skjæret-Maroni
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Hastürk G, Akyıldız Munusturlar M. The Effects of Exergames on Physical and Psychological Health in Young Adults. Games Health J 2022; 11:425-434. [PMID: 36126314 DOI: 10.1089/g4h.2022.0093] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aims to examine the effects of Kinect-based exergaming on physical (balance and reaction time) and psychosocial health factors (mental well-being and subjective happiness level) in young adults. Materials and Methods: A total of 22 men aged between 18 and 40, who play sedentary videogames at least once a week, were randomly divided into 2 groups to participate in either a Kinect-based exergame program (experimental group, n = 11) or to continue playing sedentary videogames without making any changes (control group, n = 11). The Kinect-based exergame program, including three exergames (Kinect Adventure: Reflex Ridge, Dance Central 3, Kinect Sports: Volleyball), was implemented with the experimental group for 5 weeks, three times a week, and 45 minutes per session. Balance and reaction time were assessed using SportKAT® 4000 Kinesthetic Ability Trainer and FitLight Trainer™ devices, respectively. To measure mental well-being and subjective happiness level, scales with proven psychometric qualities, whose validity and reliability studies were conducted, were used. Results: Results of the study showed statistically significant improvement for the experimental group on the measures of reaction time [t(10) = -4.69, P = 0.001], subjective happiness [t(10) = 8.94, P = 0.000], and mental well-being [t(10) = 4.62, P = 0.001]. In addition, the difference between the groups in reaction time [t(20) = 1.66, P = 0.01], right leg static balance [t(20) = -2.96, P = 0.008], mental well-being [t(20) = 2.77, P = 0.012], and subjective happiness levels (U = 0.50, P = 0.000) was found to be statistically significant in favor of the experimental group. Conclusion: The findings suggest that Kinect-based exergaming positively supports adults' reaction time, mental well-being, and subjective happiness.
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Affiliation(s)
- Günnur Hastürk
- Department of Recreation, Faculty of Sport Sciences, Eskisehir Technical University, Eskisehir, Turkey,
| | - Müge Akyıldız Munusturlar
- Department of Recreation, Faculty of Sport Sciences, Eskisehir Technical University, Eskisehir, Turkey,
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11
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Chien TY, Chern JS, Wang SP, Yang Y. Effects of multitask training on cognition and motor control in people with schizophrenia spectrum disorders. PLoS One 2022; 17:e0264745. [PMID: 35771832 PMCID: PMC9246115 DOI: 10.1371/journal.pone.0264745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/11/2022] [Indexed: 11/19/2022] Open
Abstract
Schizophrenia spectrum disorder (SSD) is a disabling mental illness that causes considerable deficits in motor and cognitive functions. The purpose of this study was to examine the effects of combining traditional multitask training (TMT) and video games--a new form of multitask training (video game multitask training VGMT)--on cognition and motor control performance in people with SSD. This was a quasi-experimental, pretest-posttest design study. A total of 25 patients participated in this study voluntarily (13 males and 12 females, average age = 59.61 years, SD– 11.46 years). All participants underwent two stages of training. The first stage involved TMT, and the second stage involved VGMT. Each training stage was 12 weeks long, with sessions twice a week that lasted for 40 minutes. Cognition, upper extremity motor and postural control performance, and functional mobility and subjective balance confidence were measured at three times: before and after the first-stage training and after the second-stage training. The results revealed that TMT and the combination of TMT and VGMT improved SSD patient’s cognition, upper extremity motor control, functional mobility and postural control performance. The subjective confidence of balance during the performance of daily activities was also mildly improved. Training with multitasks in the form of video games tended to further improve the outcome measures. Patients with SSD could benefit from regular participation in various forms of multitasking activities. Whether video games training are better than TMT in improving the functional ability of people with SSD needs further investigation. Study protocol registration: Clinicaltrials.gov, ID: NCT04629898. Registered brief title: Level of Immersion of Virtual Reality and Cognition and Motor Performance in Patients of Schizophrenia Spectrum Disorder.
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Affiliation(s)
- Tzu-Yun Chien
- Department of Occupational Therapy, Ministry of Health and Welfare Yuli Hospital, Hwa-lien, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
- * E-mail:
| | - San-Ping Wang
- Department of Occupational Therapy, Ministry of Health and Welfare Yuli Hospital, Hwa-lien, Taiwan
| | - Yu Yang
- Department of Occupational Therapy, Tri-Service General Hospital Beitou Branch, Taipei, Taiwan
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12
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Hai L, Hou HY, Zhou C, Li HJ. The Effect of Exergame Training on Physical Functioning of Healthy Older Adults: A Meta-Analysis. Games Health J 2022; 11:207-224. [PMID: 35653720 DOI: 10.1089/g4h.2021.0173] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Exergames have attracted increasing attention from both the public and researchers. Although previous systematic reviews provided evidence that exergame training is beneficial for improving balance or mobility in older adults, multidimensional physical function measurements, including balance, upper body strength, lower body strength, aerobic endurance, and gait, might help us achieve more robust and reliable results. This meta-analysis aims to quantify the effects of exergame training on overall and specific physical function in healthy older adults. We systematically searched exergame training studies published between January 1985 and June 2021. Forty-eight studies were included in the present meta-analysis, with a total of 1099 participants included in the training group and 1098 participants in the control group. Random-effects meta-analyses found that older adults obtained a small benefit in overall physical function performance (g = 0.43, 95% confidence interval [CI] = 0.33 to 0.53), moderate benefits in balance (g = 0.59, 95% CI = 0.46 to 0.71), upper body strength (g = 0.65, 95% CI = 0.20 to 1.10), lower body strength (g = 0.51, 95% CI = 0.37 to 0.65), and aerobic endurance (g = 0.65, 95% CI = 0.44 to 0.86), a small benefit in gait (g = 0.33, 95% CI = 0.08 to 0.59), and negligible effects on upper body flexibility (g = 0.13, 95% CI = -0.06 to 0.32) and lower body flexibility (g = 0.10, 95% CI = -0.45 to 0.67) from exergame training. The mini-mental state examination score was positively associated with the overall training efficacy (β = 0.08, P = 0.01), while body mass index and the sample size in the training group were negatively associated with the overall training efficacy (β = -0.01, P < 0.01; β = -0.004, P < 0.01). The current meta-analytic findings revealed that exergame training produced general benefits for overall physical function and different effects on specific physical function domains in older adults.
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Affiliation(s)
- Lagan Hai
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hai-Yan Hou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Zhou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hui-Jie Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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13
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Liu H, Xing Y, Wu Y. Effect of Wii Fit Exercise With Balance and Lower Limb Muscle Strength in Older Adults: A Meta-Analysis. Front Med (Lausanne) 2022; 9:812570. [PMID: 35602499 PMCID: PMC9120538 DOI: 10.3389/fmed.2022.812570] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Falls and fall-related injuries are not uncommon among older adults and may lead to serious health deterioration and decreased quality of life. Numerous types of physical activity have been proposed to improve balance and strength in older adults with varying degrees of success. Nintendo's Wii Fit video exergame uses body movement as a game controller and provides real-time feedback for games designed to enhance balance and muscle strength. However, whether Wii Fit exercise improves the balance and lower limb muscle strength of older adults remains uncertain. Objective To evaluate the current literature by using meta-analyses to assess whether Wii Fit exercise is associated with improved balance and lower limb muscle strength in older adults. Methods We searched PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data from inception to February 16, 2022, for relevant studies and conducted a manual search of the literature. Data extraction of the included studies were independently performed by two authors. The methodologic quality of each included study was assessed using the Physical Therapy Evidence Database (PEDro) scale. Meta-analyses were conducted using Review Manager 5.3. Results Of 991 articles initially identified, 10 articles (379 participants; aged ≥65 years, range 65–92 years; 188 participants in Wii Fit exercise groups, and 191 participants in control groups), including 8 randomized controlled trials, were assessed in this meta-analysis. The methodologic quality of the included studies evaluated with the PEDro average score was 6.4 and ranged from 5 to 8 points, indicating moderate quality. Compared with no exercise, Wii Fit exercise was associated with significant improved scores on the Berg Balance Scale, which evaluates functional balance (mean difference, 1.38; 95% CI, 0.61–2.16; I2 = 31%; P = 0.0005) and on the Timed Up and Go test, which evaluates static and dynamic balance (standardized mean difference, −0.51; 95% CI,−0.88 to −0.14; I2 = 52%; P = 0.007). However, for the three studies assessed, Wii Fit exercise did not significantly improve scores on the 30-s chair stand test, which evaluates the functional strength and endurance of the lower limb muscles (mean difference, 0.82; 95% CI, −0.14 to 1.77; z = 1.68; P = 0.09). Conclusions Our findings indicated that Wii Fit exercise is an effective approach to improve functional, static, and dynamic balance among older adults. Additional meta-analyzes with higher numbers of randomized controlled trials are suggested to confirm the benefits of Wii Fit exercise on balance in older adults, to establish whether functional strength and endurance of lower limb muscles are improved, and to explore the relationship between improved balance and fall prevention in this population.
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14
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Torre MM, Temprado JJ. Effects of Exergames on Brain and Cognition in Older Adults: A Review Based on a New Categorization of Combined Training Intervention. Front Aging Neurosci 2022; 14:859715. [PMID: 35431905 PMCID: PMC9009337 DOI: 10.3389/fnagi.2022.859715] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
The literature on exergames has reported inconsistent benefits on brain and cognitive functions. Moreover, it is still unknown whether they yield to equal or superior benefits as compared to other forms of physical exercise. However, until now, a review of exergaming literature was lacking, that would reverse the “product first” approach to replacing it with a “training first” approach that is, an analysis of the different studies based on a detailed description of the type of combined training interventions that was supported by the utilized exergames. In the present review, thanks to a structured framework build around seven interacting constructs (stimuli, settings, targets, markers, outcomes, moderators, and mechanisms), which collectively afford a global picture of the determining factors of exergames training, we aimed to determine whether and under which conditions exergames could be more effective than conventional training. Twenty three studies were finally selected for review and analyzed. We concluded that, in spite of their potential to improve brain and cognition, beneficial factors contributing to exergaming efficacy as well as its underlying mechanisms need to be investigated more systematically thanks to common experimental designs based on gold standards. We proposed some directions in this respect.
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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. [PMID: 36339904 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
| | - 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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16
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Wii or Kinect? A Pilot Study of the Exergame Effects on Older Adults' Physical Fitness and Psychological Perception. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412939. [PMID: 34948547 PMCID: PMC8701390 DOI: 10.3390/ijerph182412939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Exergames are now often implemented among older adults for health purposes. This study aimed to investigate whether playing Kinect and Wii exergames has effects on older adults’ physical fitness and psychological perceptions towards exergames. A total of 23 older participants aged above 60 years were recruited and randomly assigned into two groups, in which they played either Kinect or Wii Bowling exergames for three sessions in one week. Physiological and psychological measures were collected including heart rate, blood pressure, shoulder flexibility, as well as perceived benefits and intentions for future use. Findings indicated that exergames are equivalent to light-intensity exercises, and hence pose no or minimal risk to older adults. Older adults had a positive attitude towards exergames and have a strong willingness to engage in exergaming on a regular basis. Although no significant platform difference was identified, observation and qualitative findings suggested that Wii might provide a more intense physical activity than Kinect, while Kinect might obtain a higher perception among older adults than Wii. The study has several practical implications for both health professionals and exergame designers targeting the ageing population.
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17
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Litz E, Werner C, Bauer JM, Hauer K. Effects and Feasibility of a Memory Exergame Training in Older Adults: A Randomized Controlled Trial. Games Health J 2021; 10:383-390. [PMID: 34860129 DOI: 10.1089/g4h.2021.0032] [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: 11/12/2022] Open
Abstract
Objective: The aim of the study is to assess the feasibility, sustainability, and effectiveness of task-specific memory exergame training on motor-cognitive performance in older adults. Materials and Methods: Fifty older adults (age: 78.8 ± 7.0 years) participated in a randomized controlled trial with a 10-week intervention and 3-month follow-up period. Both the intervention group (IG: n = 29) and control group (CG: n = 21) underwent a once-weekly exercise program, including strength and balance exercises, while the IG performed an additional exergame training, combining dynamic balance with visuospatial memory tasks. Outcome measures were completion time for distinct levels of memory exergame tasks without (condition 1) and with procedural support (condition 2) and (sub)-total game scores documented by a game-specific assessment strategy. Results: Significant improvements in the IG compared with the CG over the intervention period were found for completion times in most of the analyzed levels of condition 1 (P < 0.001-0.047; ηp2 = 0.238-0.335) and one level of condition 2 (P < 0.001, ηp2 = 0.267), for the subtotal game score of condition 1 (P = 0.002; ηp2 = 0.186), and for the total game score (P = 0.005; ηp2 = 0.162). Improvements were partially sustained 3 months after training cessation (P = 0.008-0.039, ηp2 = 0.095-0.174). Completion rates for initial levels were 86%-98%. No clinical events or safety issues were observed during the training. Conclusion: The study demonstrates that additional memory exergame training effectively, and sustainably, improves performance in complex motor-cognitive tasks involving dynamic balance and visuospatial memory in older adults.
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Affiliation(s)
- Elena Litz
- AGAPLESION Bethanien Hospital, Geriatric Centre of Heidelberg University, Heidelberg, Germany
| | - Christian Werner
- AGAPLESION Bethanien Hospital, Geriatric Centre of Heidelberg University, Heidelberg, Germany.,Centre of Geriatric Medicine, Heidelberg University, Heidelberg, Germany
| | - Juergen M Bauer
- AGAPLESION Bethanien Hospital, Geriatric Centre of Heidelberg University, Heidelberg, Germany.,Centre of Geriatric Medicine, Heidelberg University, Heidelberg, Germany
| | - Klaus Hauer
- AGAPLESION Bethanien Hospital, Geriatric Centre of Heidelberg University, Heidelberg, Germany
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18
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Shiau CWC, Lim SM, Cheng LJ, Lau Y. Effectiveness of Game-Based Self-Management Interventions for Individuals with Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Games Health J 2021; 10:371-382. [PMID: 34860133 DOI: 10.1089/g4h.2020.0203] [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: 11/13/2022] Open
Abstract
Objective: Self-management is essential for individuals with diabetes. However, traditional self-management interventions may be hard to follow for other patients. Although games can stimulate extrinsic motivations, its application on self-management remains unclear. This review aims to evaluate the effects of game-based self-management interventions on health outcomes. Materials and Methods: We utilize PubMed, CINAHL, Cochrane Central, EMBASE, ProQuest Dissertation and Theses, PsycINFO, and Scopus from their inception until January 20, 2020. Meta-analyses are performed using Comprehensive Meta-analysis 3.0 software. The overall effect is measured using Hedges' g and determined using Z-statistics at significance level of P < 0.05. Heterogeneity is assessed using χ2 and I2 statistics. The risk of bias tool and the grades of recommendation, assessment, development, and evaluation system are used to assess individual and overall quality of evidence, respectively. Results: A total of 2150 records are identified, and 13 randomized controlled trials are selected. Meta-analyses revealed that game-based self-management interventions significantly improved patients' change in glycated hemoglobin (HbA1c) level (g = 0.18, P = 0.02), adherence to physical activities (g = 0.59, P < 0.001), balance (g = 0.94-1.14, P < 0.001), and fall efficacy (g = 1.01, P < 0.001). Significant results were only found for the three-trial meta-analysis for HbA1c changes, but not for the two other HbA1c meta-analyses that included more trials. Furthermore, negligible improvements were observed in glycated hemoglobin at postintervention and follow-up assessments, diabetes knowledge, and self-efficacy. Conclusion: Game-based self-management can consider a supplementary intervention. Overall evidence is ranging from very low to low. Future studies can consider a large sample size with high-quality design according to the Consolidated Standards of Reporting Trials statement criteria.
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Affiliation(s)
| | - Shi Min Lim
- Department of Nursing, National University Hospital, National University Health System, Singapore
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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19
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[Ethical implications in the development of functional training in mixed and augmented reality environments to treat hypertension in old age: A qualitative content analysis]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2021; 164:23-34. [PMID: 34253479 DOI: 10.1016/j.zefq.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/17/2021] [Accepted: 05/07/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND E-Health is of increasing importance in ensuring demand-oriented health care. In addition to technical feasibility, issues concerning the normative requirements for their use are growing. This paper discusses the ethical, legal and social implications of the use of mixed reality (MR) and augmented reality (AR) technologies in the therapy of elderly people with hypertension. It is based on the results of a study conducted as a part of the BMBF project BewARe. METHODS In the context of the above-mentioned background, an expert workshop was held with various stakeholders in an early phase of the BewARe project in accordance with the MEESTAR model, in which ethical, social and legal requirements for the development and use of AR/MR technologies were anticipated. The results of the workshop were subsequently evaluated using content analysis. RESULTS Content analysis identified eight main challenges for the development and use of AR/MR technologies in the therapy of elderly people with hypertension: ethical challenges for the decision-making and action capacity of older users (1), stereotyping (2), user-oriented development and implementation (3), data protection (4), support (5), health risks (6), social participation (7), and the need for an integrative approach (8). DISCUSSION In line with other studies, it can be shown that orientation towards medical guidelines and behavioral principles is essential to promote acceptance and adherence among end users and to minimize potential health risks. In addition, end users should be more strongly involved in the development process to overcome existing user stereotypes and establish qualification strategies for health-promoting use. Finally, legal and health economic framework conditions must be created to ensure data security and sustainable application concepts. CONCLUSION For a successful diffusion of AR/MR applications in health care, a holistic implementation concept is required which must involve various groups of social actors. In this context, the article discusses eight main challenges that can be understood as current challenges in this process.
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20
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Temprado JJ. Can Exergames Be Improved to Better Enhance Behavioral Adaptability in Older Adults? An Ecological Dynamics Perspective. Front Aging Neurosci 2021; 13:670166. [PMID: 34122047 PMCID: PMC8193355 DOI: 10.3389/fnagi.2021.670166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Finding effective training solutions to attenuate the alterations of behavior and cognition in the growing number of older adults is an important challenge for Science and Society. By offering 3D computer-simulated environments to combine perceptual-motor and cognitive exercise, exergames are promising in this respect. However, a careful analysis of meta-analytic reviews suggests that they failed to be more effective than conventional motor-cognitive training. We analyzed the reasons for this situation, and we proposed new directions to design new, conceptually grounded, exergames. Consistent with the evolutionary neuroscience approach, we contend that new solutions should better combine high level of metabolic activity with (neuro)muscular, physical, perceptual-motor, and cognitive stimulations. According to the Ecological Dynamics rationale, we assume that new exergames should act at the agent-environment scale to allow individuals to explore, discover, and adapt to immersive and informationally rich environments that should include cognitively challenging tasks, while being representative of daily living situations.
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Affiliation(s)
- Jean-Jacques Temprado
- Aix-Marseille Université & CNRS, ISM UMR 7287, Institut des Sciences du Mouvement, Marseille, France
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21
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Espy D, Reinthal A, Dal Bello-Haas V. A Clinical Decision-Making Framework for the Use of Video Gaming as a Therapeutic Modality. Front Neurol 2021; 12:610095. [PMID: 34122293 PMCID: PMC8193226 DOI: 10.3389/fneur.2021.610095] [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: 09/25/2020] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
Virtual reality and video gaming offer modulation of more exercise and motor learning parameters simultaneously than other modalities; however, there is a demonstrated need for resources to facilitate their effective use clinically. This article presents a conceptual framework to guide clinical-decision making for the selection, adaptation, modulation, and progression of virtual reality or gaming when used as a therapeutic exercise modality, and two cases as exemplars. This framework was developed by adapting the steps of theory derivation, whereby concepts and parent theories are brought together to describe a new structure or phenomenon of interest. Specifically, motor learning theory, integrated motor control theory, Gentile's Taxonomy of Tasks, and therapeutic exercise principles were integrated to develop this framework. It incorporates person (body segment), environmental, and task demands; each demand is comprised of realm, category, choice, and continuum parameters as motor training considerations and alternatives for decision-making. This framework: (1) provides structure to guide clinical decisions for effective and safe use of virtual reality or gaming to meet therapeutic goals and requirements, (2) is a concise and organized method to identify, document, and track the therapeutic components of protocols and client progression over time; (3) can facilitate documentation for reimbursement and communication among clinicians; and, (4) structures student learning, and (5) informs research questions and methods.
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Affiliation(s)
- Debbie Espy
- School of Health Sciences, Cleveland State University, Cleveland, OH, United States
| | - Ann Reinthal
- School of Health Sciences, Cleveland State University, Cleveland, OH, United States
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22
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A Solution for the Remote Care of Frail Elderly Individuals via Exergames. SENSORS 2021; 21:s21082719. [PMID: 33921548 PMCID: PMC8069394 DOI: 10.3390/s21082719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022]
Abstract
Internet of Things (IoT) solutions are a concrete answer to many needs in the healthcare framework since they enable remote support for patients and foster continuity of care. Currently, frail elderly people are among end users who most need and would benefit from IoT solutions from both a social and a healthcare point of view. Indeed, IoT technologies can provide a set of services to monitor the healthcare of the elderly or support them in order to reduce the risk of injuries, and preserve their motor and cognitive abilities. The main feature of IoT solutions for the elderly population is ease of use. Indeed, to fully exploit the potential of an IoT solution, patients should be able to autonomously deal with it. The remote-monitoring validation engineering system (ReMoVES) described here is an IoT solution that caters to the specific needs of frail elderly individuals. Its architecture was designed for use at rehabilitation centers and at patients' homes. The system is user-friendly and comfortably usable by persons who are not familiar with technology. In addition, exergames enhance patient engagement in order to curb therapy abandonment. Along with the technical presentation of the solution, a real-life scenario application is described referring to sit-to-stand activity.
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23
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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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Santos LHDO, Okamoto K, Otsuki R, Hiragi S, Yamamoto G, Sugiyama O, Aoyama T, Kuroda T. Promoting Physical Activity in Japanese Older Adults Using a Social Pervasive Game: Randomized Controlled Trial. JMIR Serious Games 2021; 9:e16458. [PMID: 33404507 PMCID: PMC7817358 DOI: 10.2196/16458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/17/2020] [Accepted: 12/07/2020] [Indexed: 11/17/2022] Open
Abstract
Background Pervasive games aim to create more fun and engaging experiences by mixing elements from the real world into the game world. Because they intermingle with players’ lives and naturally promote more casual gameplay, they could be a powerful strategy to stimulate physical activity among older adults. However, to use these games more effectively, it is necessary to understand how design elements of the game affect player behavior. Objective The aim of this study was to evaluate how the presence of a specific design element, namely social interaction, would affect levels of physical activity. Methods Participants were recruited offline and randomly assigned to control and intervention groups in a single-blind design. Over 4 weeks, two variations of the same pervasive game were compared: with social interaction (intervention group) and with no social interaction (control group). In both versions, players had to walk to physical locations and collect virtual cards, but the social interaction version allowed people to collaborate to obtain more cards. Changes in the weekly step counts were used to evaluate the effect on each group, and the number of places visited was used as an indicator of play activity. Results A total of 20 participants were recruited (no social interaction group, n=10; social interaction group, n=10); 18 participants remained active until the end of the study (no social interaction group, n=9; social interaction group, n=9). Step counts during the first week were used as the baseline level of physical activity (no social interaction group: mean 46,697.2, SE 7905.4; social interaction group: mean 45,967.3, SE 8260.7). For the subsequent weeks, changes to individual baseline values (absolute/proportional) for the no social interaction group were as follows: 1583.3 (SE 3108.3)/4.6% (SE 7.2%) (week 2), 591.5 (SE 2414.5)/2.4% (SE 4.7%) (week 3), and −1041.8 (SE 1992.7)/0.6% (SE 4.4%) (week 4). For the social interaction group, changes to individual baseline values were as follows: 11520.0 (SE 3941.5)/28.0% (SE 8.7%) (week 2), 9567.3 (SE 2631.5)/23.0% (SE 5.1%) (week 3), and 7648.7 (SE 3900.9)/13.9% (SE 8.0%) (week 4). The result of the analysis of the group effect was significant (absolute change: η2=0.31, P=.04; proportional change: η2=0.30, P=.03). Correlations between both absolute and proportional change and the play activity were significant (absolute change: r=0.59, 95% CI 0.32 to 0.77; proportional change: r=0.39, 95% CI 0.08 to 0.64). Conclusions The presence of social interaction design elements in pervasive games appears to have a positive effect on levels of physical activity. Trial Registration Japan Medical Association Clinical Trial Registration Number JMA-IIA00314; https://tinyurl.com/y5nh6ylr (Archived by WebCite at http://www.webcitation.org/761a6MVAy)
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Affiliation(s)
- Luciano Henrique De Oliveira Santos
- Department of Social Informatics, Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuya Okamoto
- Department of Social Informatics, Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Ryo Otsuki
- Department of Social Informatics, Graduate School of Informatics, Kyoto University, Kyoto, Japan
| | - Shusuke Hiragi
- Department of Social Informatics, Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Goshiro Yamamoto
- Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Osamu Sugiyama
- Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Kuroda
- Department of Social Informatics, Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
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25
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Mohd Jai NA, Mat Rosly M, Abd Razak NA. Physiological Responses of Exergaming Boxing in Adults: A Systematic Review and Meta-Analysis. Games Health J 2020; 10:73-82. [PMID: 33297818 DOI: 10.1089/g4h.2020.0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: Studies investigating the effects of exergaming in available platforms are still limited. This review aims to systematically identify available studies on physiological intensities of exergaming boxing in able-bodied adults and recategorize them based on different platforms or environments. The meta-analysis further analyzes the physiological responses during exergaming boxing into a set of pooled data for any evidence of outliers, heterogeneity, or publication bias. Materials and Methods: A systematic search was conducted by using databases from Google Scholar, PubMed, and Web of Science. Population, intervention, comparison, and outcomes (PICO) and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were used in the study selection process for the review. Results: From the 1534 articles examined, 16 articles were included for further analyses. Results indicated that exergaming boxing exhibits a wide range of metabolic equivalent of task (MET) values and intensity, from very light to vigorous, with elements of heterogeneity and bias detected. The Xbox® Kinect boxing platform produced higher MET (mean = 5.3) compared with the Nintendo® Wii™ boxing (mean = 3.8). Conclusion: The results of this review suggest that boxing exergames can produce intensity-adequate physical activity among younger adults that are beneficial for cardiometabolic improvements, regardless of platforms used. Exergaming boxing may be employed as an effective exercise tool to increase energy expenditure and physical activity level in young adults.
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Affiliation(s)
- Nor Aina Mohd Jai
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Maziah Mat Rosly
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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26
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Gallou-Guyot M, Mandigout S, Bherer L, Perrochon A. Effects of exergames and cognitive-motor dual-task training on cognitive, physical and dual-task functions in cognitively healthy older adults: An overview. Ageing Res Rev 2020; 63:101135. [PMID: 32768594 DOI: 10.1016/j.arr.2020.101135] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/31/2022]
Abstract
This overview aims to summarize the effectiveness of cognitive-motor dual-task and exergame interventions on cognitive, physical and dual-task functions in healthy older adults, as well as the feasibility, safety, adherence, transfer and retention of benefits of these interventions. We searched for systematic reviews or meta-analyses assessing the effects of cognitive-motor dual-task and exergame interventions on cognitive, physical and dual-task functions in cognitively healthy older adults through eight databases (CDSR (Cochrane), MEDLINE (PubMed), Scopus, EMBASE, CINAHL, PsycINFO, ProQuest and SportDiscus). Two reviewers performed the selection, data extraction and risk of bias evaluation independently (PROSPERO ID: CRD42019143185). Eighteen reviews were included in this overview. Overall, positive effects of cognitive-motor dual-task interventions on cognitive, physical and dual-task functions, as well as exergames on cognitive functions only, were observed in cognitively healthy older adults. In contrast, the effects of exergames on physical functions are more controversial, and their effects on dual-task functions have not been studied. The feasibility, safety, adherence, transfer and retention of benefits for both intervention types are still unclear. Future studies should follow more rigorous methodological standards in order to improve the quality of evidence and provide guidelines for the use of cognitive-motor dual-task and exergame interventions in older adults.
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Affiliation(s)
| | - S Mandigout
- HAVAE, EA 6310, Université de Limoges, Limoges, France
| | - L Bherer
- Department of Medicine, Université de Montréal, Montreal, Canada; Research Centre, Montreal Heart Institute, Montreal, Canada; Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - A Perrochon
- HAVAE, EA 6310, Université de Limoges, Limoges, France.
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27
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Kaushal N, Keith N, Aguiñaga S, Hagger MS. Social Cognition and Socioecological Predictors of Home-Based Physical Activity Intentions, Planning, and Habits during the COVID-19 Pandemic. Behav Sci (Basel) 2020; 10:E133. [PMID: 32878142 PMCID: PMC7551445 DOI: 10.3390/bs10090133] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 01/23/2023] Open
Abstract
'Shelter in place' and 'lockdown' orders implemented to minimize the spread of COVID-19 have reduced opportunities to be physically active. For many, the home environment emerged as the only viable option to participate in physical activity. Previous research suggests that availability of exercise equipment functions as a determinant of home-based physical activity participation among the general adult population. The purpose of this study was to use a socioecological framework to investigate how the availability of exercise equipment at home predicts behavioral decisions, namely, intention, planning, and habits with respect to participation in physical activity. Participants (n = 429) were adults recruited in U.S. states subject to lockdown orders during the pandemic who completed measures online. A structural equation model indicated that availability of cardiovascular and strength training equipment predicted physical activity planning. Social cognition constructs mediated the relationship between each type of exercise equipment and intentions. Autonomous motivation and perceived behavioral control were found to mediate the relationship between each type of exercise equipment and habit. The availability of large cardiovascular and strength training equipment demonstrated significant predictive effects with intention, planning, habit, and autonomous motivation. Facilitating these constructs for home-based physical activity interventions could be efficacious for promoting physical activity.
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Affiliation(s)
- Navin Kaushal
- School of Health & Human Sciences, Department of Health Sciences, Indiana University, Indianapolis, IN 47405, USA
| | - NiCole Keith
- School of Health & Human Sciences, Department of Kinesiology, Indiana University, Indianapolis, IN 47405, USA;
| | - Susan Aguiñaga
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61820, USA;
| | - Martin S. Hagger
- Psychological Sciences, University of California, Merced, CA 95343, USA;
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
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28
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Blasco-Lafarga C, Cordellat A, Forte A, Roldán A, Monteagudo P. Short and Long-Term Trainability in Older Adults: Training and Detraining Following Two Years of Multicomponent Cognitive-Physical Exercise Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165984. [PMID: 32824709 PMCID: PMC7460235 DOI: 10.3390/ijerph17165984] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/21/2022]
Abstract
Despite the benefits of multicomponent physical–cognitive training programs (MCCogTPs), lower training intensities in the concurrent approach, and bigger heterogeneity with aging, suggest the need for long-term analyses, with special attention to training and detraining in older adults. The present study aims to examine these training/detraining effects in a two year MCCogTP, looking for specific dynamics in the trainability of their physical and cognitive capacities. The intervention was divided into four periods: T1, T2 (8 months of training each), and D1, D2 (3.5 months of detraining plus 0.5 of testing each). Twenty-five healthy seniors (70.82 ± 5.18 years) comprised the final sample and were assessed for cardiovascular fitness (6-minutes walking test), lower-limbs strength (30-seconds chair-stand test) and agility (8-feet timed up-and-go test). Inhibition (Stroop test) was considered for executive function. Physical and cognitive status improved significantly (p < 0.05) throughout the two years, with larger enhancements for physical function (mainly strength and agility). Strength and cardiovascular fitness were more sensitive to detraining, whilst agility proved to have larger training retentions. Inhibition followed an initial similar trend, but it was the only variable to improve along D2 (d = 0.52), and changes were not significant within periods. Notwithstanding aging, and the exercise cessation in D2, physical and cognitive status remained enhanced two years later compared to baseline, except for lower-limb strength. According to these results, basic physical capacities are very sensitive to training/detraining, deserving continuous attention (especially strength). Both reducing detraining periods and complementary resistance training should be considered. Additionally, physical enhancements following MCcogTPs may help cognition maintenance during detraining.
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Affiliation(s)
- Cristina Blasco-Lafarga
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain; (C.B.-L.); (A.R.)
- Sport Performance & Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain;
| | - Ana Cordellat
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain; (C.B.-L.); (A.R.)
- Sport Performance & Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain;
- Correspondence:
| | - Anabel Forte
- Statistics and Operational Research Department, University of Valencia, 46100 Burjassot, Valencia, Spain;
| | - Ainoa Roldán
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain; (C.B.-L.); (A.R.)
- Sport Performance & Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain;
| | - Pablo Monteagudo
- Sport Performance & Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain;
- Education and Specific Didactics Department, Jaume I University, 12071 Castellon, Spain
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29
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Thomas TH, Sivakumar V, Babichenko D, Grieve VLB, Klem ML. Mapping Behavioral Health Serious Game Interventions for Adults With Chronic Illness: Scoping Review. JMIR Serious Games 2020; 8:e18687. [PMID: 32729836 PMCID: PMC7426803 DOI: 10.2196/18687] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Serious games for health are increasingly being used to address health outcomes in patients with chronic illnesses. These studies vary in their study designs, patient populations, frameworks, outcome variables, and degree of specificity of the serious game intervention. OBJECTIVE This scoping review aims to clarify the conceptual features of the existing research related to serious games designed to improve cognitive and behavioral outcomes in adults with chronic illness. METHODS We applied the Preferred Reporting Items of Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR) methodology, including an a priori research question. We searched 4 electronic databases to identify articles published through November 2019. Inclusion criteria encompassed (1) adults 18 years or older; (2) patients with a diagnosis of chronic illness; (3) a serious game intervention; and (4) defined patient outcomes that assess patients' behavioral, cognitive, or health outcomes. RESULTS Of the 3305 articles identified, 38 were included in the review. We charted and analyzed the theoretical frameworks, key concepts, and outcome variables of these studies with summaries of features across articles. The majority of studies used a randomized controlled trial design (23/38, 61%), included a custom serious game intervention (22/38, 58%), and lacked a theoretical framework (25/38, 66%). Common outcome variables included quality of life (16/38, 42%), mood (15/38, 39%), cognitive function (13/38, 34%), symptoms (12/38, 32%), and physical activity (9/38, 24%). Key differences between studies included whether or not serious games aimed to train versus teach patients, be widely accessible versus tailored interventions, or replace versus complement current treatments. CONCLUSIONS This scoping review defines the current landscape of research in serious games for health research targeting behavioral and cognitive outcomes in adults with chronic disease. Studies have addressed a variety of patient populations and diverse patient outcomes. Researchers wanting to build on the current research should integrate theoretical frameworks into the design of the intervention and trial to more clearly articulate the active ingredients and mechanisms of serious games.
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Affiliation(s)
| | - Varshini Sivakumar
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dmitriy Babichenko
- School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
| | - Victoria L B Grieve
- Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mary Lou Klem
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, United States
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30
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Buyl R, Beogo I, Fobelets M, Deletroz C, Van Landuyt P, Dequanter S, Gorus E, Bourbonnais A, Giguère A, Lechasseur K, Gagnon MP. e-Health interventions for healthy aging: a systematic review. Syst Rev 2020; 9:128. [PMID: 32493515 PMCID: PMC7271471 DOI: 10.1186/s13643-020-01385-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Healthy aging (HA) is a contemporary challenge for population health worldwide. Electronic health (e-Health) interventions have the potential to support empowerment and education of adults aged 50 and over. OBJECTIVES To summarize evidence on the effectiveness of e-Health interventions on HA and explore how specific e-Health interventions and their characteristics effectively impact HA. METHODS A systematic review was conducted based on the Cochrane Collaboration methods including any experimental study design published in French, Dutch, Spanish, and English from 2000 to 2018. RESULTS Fourteen studies comparing various e-Health interventions to multiple components controls were included. The target population, type of interventions, and outcomes measured were very heterogeneous across studies; thus, a meta-analysis was not possible. However, effect estimates indicate that e-Health interventions could improve physical activity. Positive effects were also found for other healthy behaviors (e.g., healthy eating), psychological outcomes (e.g., memory), and clinical parameters (e.g., blood pressure). Given the low certainty of the evidence related to most outcomes, these results should be interpreted cautiously. CONCLUSIONS This systematic review found limited evidence supporting the effectiveness of e-Health interventions, although the majority of studies show positive effects of these interventions for improving physical activity in older adults. Thus, better quality evidence is needed regarding the effects of e-Health on the physiological, psychological, and social dimensions of HA. SYSTEMATIC REVIEW REGISTRATION The review protocol was registered in PROSPERO (registration number: CRD42016033163).
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Affiliation(s)
- Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Idrissa Beogo
- École des sciences infirmières et des études de la santé/School of Nursing and Health Studies, Université de Saint-Boniface, Winnipeg, Manitoba Canada
| | - Maaike Fobelets
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Carole Deletroz
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, CH-1011 Lausanne, Switzerland
| | - Philip Van Landuyt
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Samantha Dequanter
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ellen Gorus
- Faculty of Medicine and Pharmacy, Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, Quebec Canada
- Research Center of the Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, Quebec Canada
| | - Anik Giguère
- Faculty of Medicine, Université Laval, Quebec, Canada
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
| | - Kathleen Lechasseur
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
| | - Marie-Pierre Gagnon
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
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Dobbins S, Hubbard E, Flentje A, Dawson-Rose C, Leutwyler H. Play provides social connection for older adults with serious mental illness: A grounded theory analysis of a 10-week exergame intervention. Aging Ment Health 2020; 24:596-603. [PMID: 30586998 PMCID: PMC6597314 DOI: 10.1080/13607863.2018.1544218] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/30/2018] [Indexed: 12/16/2022]
Abstract
Introduction: The number of older adults with serious mental illness (SMI) is predicted to reach 15 million by 2030. Social isolation is known to contribute to morbidity and mortality, and those with SMI experience more social isolation than older adults in the general population. Social isolation in these older adults is complex and involves factors including organic psychopathology, effects of medications and/or other substances, medical co-morbidity, disability, and social stigma. The burgeoning field of inquiry of exergames, which are video games with gestural interfaces, for older adults has found that they are safe, effective, enjoyable, and may decrease social isolation. This qualitative study was conducted to gain insight into the effects of group exergame play on the psychosocial wellbeing of older adults with SMI.Methods: We explored the psychosocial effects of a 10-week group exergame program for 16 older adults with SMI using grounded theory methodology within a symbolic interactionist framework.Results: Participants experienced positive social contact, engaged in social attunement, and expressed motivation to take risks and face problem-solving and physical challenges. Two interrelated concepts emerged from the integrated data: Social connectedness and competence. The theoretical construct that was abducted from these concepts was that play and playfulness were the vehicle for many interacting social processes to take place.Conclusion: Group play through exergames for older adults with SMI may promote recovery and healthy aging by increasing social integration, improving self-efficacy, and promoting physical health through exercise.
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Affiliation(s)
- Sarah Dobbins
- Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Erin Hubbard
- Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Annesa Flentje
- Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Carol Dawson-Rose
- Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Heather Leutwyler
- Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA
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Khalili-Mahani N, Assadi A, Li K, Mirgholami M, Rivard ME, Benali H, Sawchuk K, De Schutter B. Reflective and Reflexive Stress Responses of Older Adults to Three Gaming Experiences In Relation to Their Cognitive Abilities: Mixed Methods Crossover Study. JMIR Ment Health 2020; 7:e12388. [PMID: 32213474 PMCID: PMC7146255 DOI: 10.2196/12388] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/20/2019] [Accepted: 12/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The gamification of digital health provisions for older adults (eg, for rehabilitation) is a growing trend; however, many older adults are not familiar with digital games. This lack of experience could cause stress and thus impede participants' motivations to adopt these technologies. OBJECTIVE This crossover longitudinal multifactorial study aimed to examine the interactions between game difficulty, appraisal, cognitive ability, and physiological and cognitive responses that indicate game stress using the Affective Game Planning for Health Applications framework. METHODS A total of 18 volunteers (mean age 71 years, SD 4.5; 12 women) completed a three-session study to evaluate different genres of games in increasing order of difficulty (S1-BrainGame, S2-CarRace, and S3-Exergame). Each session included an identical sequence of activities (t1-Baseline, t2-Picture encode, t3-Play, t4-Stroop test, t5-Play, and t6-Picture recall), a repeated sampling of salivary cortisol, and time-tagged ambulatory data from a wrist-worn device. Generalized estimating equations were used to investigate the effect of session×activity or session×activity×cognitive ability on physiology and cognitive performance. Scores derived from the Montreal Cognitive Assessment (MoCA) test were used to define cognitive ability (MoCA-high: MoCA>27, n=11/18). Kruskal-Wallis tests were used to test session or session×group effects on the scores of the postgame appraisal questionnaire. RESULTS Session×activity effects were significant on all ambulatory measures (χ210>20; P<.001) other than cortisol (P=.37). Compared with S1 and S2, S3 was associated with approximately 10 bpm higher heart rate (P<.001) and approximately 5 muS higher electrodermal activity (P<.001), which were both independent of the movement caused by the exergame. Compared with S1, we measured a moderate but statistically significant drop in the rate of hits in immediate recall and rate of delayed recall in S3. The low-MoCA group did not differ from the high-MoCA group in general characteristics (age, general self-efficacy, and perceived stress) but was more likely to agree with statements such as digital games are too hard to learn. In addition, the low-MoCA group was more likely to dislike the gaming experience and find it useless, uninteresting, and visually more intense (χ21>4; P<.04). Group differences in ambulatory signals did not reach statistical significance; however, the rate of cortisol decline with respect to the baseline was significantly larger in the low-MoCA group. CONCLUSIONS Our results show that the experience of playing digital games was not stressful for our participants. Comparatively, the neurophysiological effects of exergame were more pronounced in the low-MoCA group, suggesting greater potential of this genre of games for cognitive and physical stimulation by gamified interventions; however, the need for enjoyment of this type of challenging game must be addressed.
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Affiliation(s)
- Najmeh Khalili-Mahani
- PERFORM Centre, Concordia University, Montreal, QC, Canada.,McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Atousa Assadi
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Kate Li
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | | | | | - Habib Benali
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Kim Sawchuk
- Department of Communications, Concordia University, Montreal, QC, Canada
| | - Bob De Schutter
- Armstrong Institute for Interactive Media Studies, Miami University, Oxford, OH, United States
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Effects of Playful Exercise of Older Adults on Balance and Physical Activity: a Randomized Controlled Trial. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09273-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractThere is evidence that one of the most important approaches to improving the healthy ageing of older adults is for them to carry out daily physical activity. However, motivation to engage in physical activity is often low in old age. This study investigated the potential of engaging older adults in playful exercise to increase physical activity and balance. A randomised control trial (RCT) was performed with 26 independently living older adults (initially 38, but 12 were lost to illness or death during the course of the project), mean age 83.54 (SD: 7.12), 19 women. Participants were randomly allocated to intervention (n = 16) or control (n = 12) (originally 19 in each group). The intervention consisted of playful exercise on Moto tiles 6 * 2 min twice a week over 10 weeks, while control group participants engaged in normal daily activities.The intervention group participants improved functional balance (Berg’s Balance Score) by an average of 5.02 points, and the control group by 2.58 points (p = 0.11). No between-group difference was observed in physical activities outside exercise sessions (p = 0.82). The difference in gain of balance as measured by BBS was below statistical significance, as a result of the sample size being too small. However, trial results suggest that older pre-frail and frail adults who engage in a moderate playful exercise programme over at least 10 weeks may potentially experience a modest gain in balance. Moreover, the playful exercise created a joyous social atmosphere among the participants who spontaneously remarked that the play sessions were much more fun than their standard light exercise programme of one hour twice a week. This motivational outcome is important for adherence to any exercise programme and indeed for general well-being.
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Older Adults' Perceptions of the Usefulness of Technologies for Engaging in Physical Activity: Using Focus Groups to Explore Physical Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041144. [PMID: 32053937 PMCID: PMC7068313 DOI: 10.3390/ijerph17041144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/08/2020] [Accepted: 02/09/2020] [Indexed: 02/06/2023]
Abstract
Insufficient physical activity (PA) levels observed among older adults remain extremely high and pose a danger to developing and maintaining their physical literacy (PL). Each person’s level of PL partly depends on their physical and cognitive skills, confidence level, and degree of motivation to practice PA daily. New technologies, such as exergames and wearable fitness trackers, may enable older adults to increase their PL, stimulating uptake and ongoing PA participation. Objective: This focus group study aims to describe older adults’ perceptions of the use of technologies to engage in physical exercise programs. Methods: Fifteen participants were randomly selected from a sample of 40 older adults who completed a randomized controlled trial that investigated the benefits of using technology in the context of group-based exercise programs. Separate post-intervention focus groups were performed with an exergaming group, a conventional physical training group, and a no training group (control). Data were mapped onto constructs from the four domains of PL: affective, physical, cognitive, and behavioral. Results: Generally, participants expressed positive perceptions about the benefits of using technology to engage in PA. These positive feelings outweighed the costs and the lack of familiarization with technology. Common themes for the three groups emerged from the discussions and included familiarization with technology, using fitness tracker to monitor PA, previous exposure to technology, and interaction with peers, staff members, and relatives. In particular, participants from the exergaming group explored the ideas of training their cognitive skills while using the exergame accessories, exercising in an alternative way, competitive versus cooperative play, changes in sense of humor, skill transferability from game to real environment, progressions of the exercise intensities, and the potential use of exergames for rehabilitation. Conclusions: Participants in this study reported positive perceptions about implementing technology into exercise. Emphasizing the benefits of using technology in group-based exercise programs may increase older adults’ PL levels and their future technology adoption. The potential implementation of technology into conventional exercise programs should focus on older adults’ lifelong values, biopsychosocial conditions, and the possibility of reducing age-related risk of injuries and chronic diseases.
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Andrade A, Correia CK, Coimbra DR. The Psychological Effects of Exergames for Children and Adolescents with Obesity: A Systematic Review and Meta-Analysis. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 22:724-735. [PMID: 31697604 DOI: 10.1089/cyber.2019.0341] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The systematic review and meta-analysis were conducted to analyze the psychological effects of exergames for children and adolescents with overweight or obesity. In August 2018, the electronic databases searched were PubMed, Scopus, Web of Science, SPORTDiscus, Science Direct, CINAHL, and PsycINFO. The eligibility criteria were defined according to the population, intervention, comparison, outcome, and study design. In relation to the population, only studies with children or adolescents with overweight or obesity and without any other comorbidities were analyzed. Only publications in English were considered. Nine studies were selected. The comparisons identified were in relation to weight, type of activity, and play style versus control and preintervention. The magnitude of effect size suggests that the practice of exergaming has a small effect on psychological outcomes. Furthermore, cooperative games produced greater attraction to the game (g = 4.71, 95% confidence interval [CI] = 3.23-6.19) and greater intrinsic motivation (g = 5.29; 95% CI = 3.68-6.90). It was verified that self-esteem (standard mean difference [SMD] = 0.37; 95% CI = 0.09-0.66), and self-efficacy (SMD = 0.42; 95% CI = 0.06-0.79) improved after playing an exergame. This systematic review and meta-analysis suggest that exergames may be effective in improving psychological aspects of children and adolescents with overweight or obesity. Given the limited number of studies, it is essential to increase scientific research in this area.
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Affiliation(s)
- Alexandro Andrade
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University, Florianópolis, Brazil
| | - Clara Knierim Correia
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University, Florianópolis, Brazil
| | - Danilo Reis Coimbra
- Laboratory of Psychology of Sport and Exercise, Department of Physical Education, Center of Health Sciences and Sports, Santa Catarina State University, Florianópolis, Brazil
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36
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Fang Q, Ghanouni P, Anderson SE, Touchett H, Shirley R, Fang F, Fang C. Effects of Exergaming on Balance of Healthy Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Games Health J 2020; 9:11-23. [PMID: 31800322 DOI: 10.1089/g4h.2019.0016] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Balance is critical for older adults to perform daily activities. However, age-related declines in balance increase the risk of falls and severe injuries, such as bone fractures and head injuries. Exergames have been widely applied to improve health-related outcomes in older adults. This meta-analysis aims to quantify the effects of exergaming interventions on balance performance in healthy older adults. A literature search was performed using PubMed, ScienceDirect, SPORTDiscus, COCHRANE, EBSCO, and EMBASE. A total of 16 experimental studies met inclusion criteria for a full-text review. Data synthesis examined balance functions, including static, dynamic, proactive, and perceived balance abilities when performing daily activities. Intervention protocols of the reviewed studies included an average of two to three 40-minute exergaming sessions per week for 8 weeks. A random effects model identified significant effects in favor of the exergaming group, with moderate effect size in dynamic balance (Hedges' g = 0.36, 95% CI = 0.26-1.30, P < 0.001), and perceived balance (Hedges' g = 0.31, 95% CI = 0.04-0.58, P = 0.02); and considerable effect size in Chair Stand Test (Hedges' g = 0.78, 95% CI = 0.26-1.30, P = 0.003), and balance test batteries (Hedges' g = 0.72, 95% CI = 0.42-1.02, P < 0.001). No significant effect was found in the static balance (Hedges' g = 0.22, 95% CI = -0.31 to 0.76, P = 0.42), or proactive balance (Hedges' g = 0.54, 95% CI = -0.12 to 1.20, P = 0.11). Meta-analysis identified exergaming-associated benefits in older adults' balance function and confidence. This finding supports the feasibility of exergaming as a supplementary approach to improve balance for healthy older adults. Health professionals may optimize treatment effect by integrating exergaming sessions into a traditional balance exercise program.
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Affiliation(s)
- Qun Fang
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - Parisa Ghanouni
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia
| | - Sarah E Anderson
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
| | - Hilary Touchett
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas
| | - Rebekah Shirley
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - Fang Fang
- Rehabilitation Center, Qing Dao Fu Wai Hospital, Qingdao, China
| | - Chao Fang
- Department of Pharmacology, the Fourth Military Medical University, Xi'an, China
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37
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Bergschöld JM, Neven L, Peine A. DIY gerontechnology: circumventing mismatched technologies and bureaucratic procedure by creating care technologies of one's own. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:232-246. [PMID: 31663618 DOI: 10.1111/1467-9566.13012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study analyses 'Do-It-Yourself' (DIY) gerontechnologies and shows that they can be viable and valuable alternatives to 'ready-made' gerontechnologies. Using the concept of innosumption, we analyze the work of care workers in gerontechnology showrooms in Norway. We show how and why care workers will sometimes advice older adults to assemble DIY-gerontechnologies. Such DIY-gerontechnologies are not high-tech solutions made by technology producers, but creative solutions that older adults' suit to their specific needs and assemble for themselves from mundane objects that are available in shops. So far, analyses of the design, implementation and use of gerontechnologies have almost exclusively focused on professionally designed and produced 'ready-made' gerontechnologies. But for various reasons, ready-made gerontechnologies often do not fit in well with the lives of older people. In such cases, care workers guide older people to the innosumption of DIY-gerontechnologies that offer workable solutions that are useful, quickly implemented, easily understandable and often cheap. We show that and how the existence of DIY-gerontechnologies questions the reasons behind the strong and widely accepted assumption that only high-tech innovations are a proper solution to the needs of older people.
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Affiliation(s)
- Jenny M Bergschöld
- Institute for Interdisciplinary Studies of Culture, NTNU, Trondheim, Norway
- Smart Sensor Systems, SINTEF Digital, Oslo, Norway
| | - Louis Neven
- Active Ageing Research Group, Avans University of Applied Sciences, Breda, The Netherlands
| | - Alexander Peine
- Copernicus Institute of Sustainable Development, Utrecht University, Utrecht, The Netherlands
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38
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Subramanian S, Dahl Y, Skjæret Maroni N, Vereijken B, Svanæs D. Assessing Motivational Differences Between Young and Older Adults When Playing an Exergame. Games Health J 2020; 9:24-30. [DOI: 10.1089/g4h.2019.0082] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sruti Subramanian
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yngve Dahl
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nina Skjæret Maroni
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dag Svanæs
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
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39
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Adcock M, Fankhauser M, Post J, Lutz K, Zizlsperger L, Luft AR, Guimarães V, Schättin A, de Bruin ED. Effects of an In-home Multicomponent Exergame Training on Physical Functions, Cognition, and Brain Volume of Older Adults: A Randomized Controlled Trial. Front Med (Lausanne) 2020; 6:321. [PMID: 32047751 PMCID: PMC6997483 DOI: 10.3389/fmed.2019.00321] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
Aging is associated with a decline in physical functions, cognition and brain structure. Considering that human life is based on an inseparable physical-cognitive interplay, combined physical-cognitive training through exergames is a promising approach to counteract age-related impairments. The aim of this study was to assess the effects of an in-home multicomponent exergame training on [i] physical and cognitive functions and [ii] brain volume of older adults compared to a usual care control group. Thirty-seven healthy and independently living older adults aged 65 years and older were randomly assigned to an intervention (exergame training) or a control (usual care) group. Over 16 weeks, the participants of the intervention group absolved three home-based exergame sessions per week (à 30–40 min) including Tai Chi-inspired exercises, dancing and step-based cognitive games. The control participants continued with their normal daily living. Pre- and post-measurements included assessments of physical (gait parameters, functional muscle strength, balance, aerobic endurance) and cognitive (processing speed, short-term attention span, working memory, inhibition, mental flexibility) functions. T1-weighted magnetic resonance imaging was conducted to assess brain volume. Thirty-one participants (mean age = 73.9 ± 6.4 years, range = 65–90 years, 16 female) completed the study. Inhibition and working memory significantly improved post-intervention in favor of the intervention group [inhibition: F(1) = 2.537, p = 0.046, np2 = 0.11, working memory: F(1) = 5.872, p = 0.015, np2 = 0.02]. Two measures of short-term attentional span showed improvements after training in favor of the control group [F(1) = 4.309, p = 0.038, np2 = 0.03, F(1) = 8.504, p = 0.004, np2 = 0.04]. No significant training effects were evident for physical functions or brain volume. Both groups exhibited a significant decrease in gray matter volume of frontal areas and the hippocampus over time. The findings indicate a positive influence of exergame training on executive functioning. No improvements in physical functions or brain volume were evident in this study. Better adapted individualized training challenge and a longer training period are suggested. Further studies are needed that assess training-related structural brain plasticity and its effect on performance, daily life functioning and healthy aging.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Mélanie Fankhauser
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Jennifer Post
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Kai Lutz
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | | | - Andreas R Luft
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland.,Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
| | | | - Alexandra Schättin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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40
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Adcock M, Thalmann M, Schättin A, Gennaro F, de Bruin ED. A Pilot Study of an In-Home Multicomponent Exergame Training for Older Adults: Feasibility, Usability and Pre-Post Evaluation. Front Aging Neurosci 2019; 11:304. [PMID: 31824295 PMCID: PMC6882741 DOI: 10.3389/fnagi.2019.00304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with sensory, motor and cognitive impairments that may lead to reduced daily life functioning including gait disturbances, falls, injuries and mobility restrictions. A strong need exists for implementing effective evidence-based interventions for healthy aging. Therefore, the aim of this study was to (i) evaluate the feasibility and usability of an in-home multicomponent exergame training and (ii) explore its effects on physical functions, cognition and cortical activity. Twenty-one healthy and independently living older adults were included (11 female, 74.4 ± 7.0 years, range: 65-92 years) and performed 24 trainings sessions (each 40 min) over eight weeks. The first part was conducted in a living lab (home-like laboratory environment), the second part at participants' home. The multicomponent exergame included Tai Chi-inspired exercises, dance movements and step-based cognitive games to train strength, balance and cognition. Attendance and attrition rates were calculated and safety during training was evaluated to determine feasibility. Participants rated the usability of the exergame (System Usability Scale) and reported on their game experience (Game Experience Questionnaire). Physical and cognitive functions and cortical activity (resting state electroencephalopathy) were assessed pre and post intervention. Results showed a high training attendance rate for the living lab and the home-based setting (91.7 and 91.0%, respectively) with a rather high attrition rate (28.6%, six drop-outs). Half of the drop-out reasons were related to personal or health issues. System usability was rated acceptable with a mean score of 70.6/100. Affective game experience was rated favorable. Significant improvements were found for minimal toe clearance, short-term attentional span, and information processing speed (p < 0.05). No significant pre-post differences were found for cortical activity. To summarize, the exergame is generally feasible and usable for healthy older adults applied in an in-home setting and provides an overall positive emotional game experience. Nevertheless, flawless technical functionality should be a mandatory consideration. Additionally, the training might have potential positive influence on specific functions in older adults. However, the efficacy has to be evaluated in a future randomized controlled trial assessing the behavioral and neuroplastic changes in a larger population after a longer training period.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Melanie Thalmann
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Alexandra Schättin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Federico Gennaro
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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41
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Muñoz JE, Gonçalves A, Rúbio Gouveia É, Cameirão MS, Bermúdez I Badia S. Lessons Learned from Gamifying Functional Fitness Training Through Human-Centered Design Methods in Older Adults. Games Health J 2019; 8:387-406. [PMID: 31368834 DOI: 10.1089/g4h.2018.0028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The design of meaningful and enjoyable Exergames for fitness training in older adults possesses critical challenges in matching user's needs and motivators with game elements. These challenges are often due to the lack of knowledge of seniors' game preferences and technology literacy as well as a poor involvement of the target population in the design process. Objective: This research aims at describing a detailed and scrutinized use case of applying human-centered design methodologies in the gamification of fitness training routines and illustrates how to incorporate seniors' feedback in the game design pipeline. Materials and Methods: We focus on how to use the insights from human-centered inquiries to improve in-game elements, such as mechanics or esthetics, and how to iterate the game design process based on playtesting sessions in the field. Results: We present a set of four Exergames created to train the critical functional fitness areas of older adults. We show how through rapid prototyping methods and multidisciplinary research, Exergames can be rigorously designed and developed to match individual physical capabilities. Moreover, we propose a set of guidelines for the design of context-aware Exergames based on the lessons learned. Conclusion: We highlight the process followed; it depicts 19 weeks of various activities delivering particular and actionable items that can be used as a checklist for future games for health design projects.
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Affiliation(s)
- John Edison Muñoz
- Department of System Design and Engineering, University of Waterloo, Ontario, Canada
| | - Afonso Gonçalves
- Madeira Interactive Technologies Institute (M-iti) and Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Élvio Rúbio Gouveia
- Madeira Interactive Technologies Institute (M-iti) and Faculdade de Ciências Sociais, Universidade da Madeira, Funchal, Portugal
| | - Mónica S Cameirão
- Madeira Interactive Technologies Institute (M-iti) and Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Sergi Bermúdez I Badia
- Madeira Interactive Technologies Institute (M-iti) and Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
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42
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Santos LHDO, Okamoto K, Funghetto SS, Cavalli AS, Hiragi S, Yamamoto G, Sugiyama O, Castanho CD, Aoyama T, Kuroda T. Effects of Social Interaction Mechanics in Pervasive Games on the Physical Activity Levels of Older Adults: Quasi-Experimental Study. JMIR Serious Games 2019; 7:e13962. [PMID: 31333202 PMCID: PMC6681637 DOI: 10.2196/13962] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/29/2019] [Accepted: 07/07/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The novel genre of pervasive games, which aim to create more fun and engaging experiences by promoting deeper immersion, could be a powerful strategy to stimulate physical activity among older adults. To use these games more effectively, it is necessary to understand how different design elements affect player behavior. OBJECTIVE The aim was to vary a specific design element of pervasive games for older adults, namely social interaction, to test the effect on levels of physical activity. METHODS Over 4 weeks, two variations of the same pervasive game were compared: social interaction for the test group and no social interaction for the control group. In both versions, players had to walk to physical locations and collect virtual cards, but the social interaction version allowed people to collaborate to obtain more cards. Weekly step counts were used to evaluate the effect on each group, and the number of places visited was used as an indicator of play activity. RESULTS A total of 32 participants were recruited (no social interaction=15, social interaction=17); 18 remained until the end of the study (no social interaction=7, social interaction=11). Step counts during the first week were used as the baseline (no social interaction: mean 17,099.4, SE 3906.5; social interaction: mean 17,981.9, SE 2171.1). For the following weeks, changes to individual baseline were as follows for no social interaction (absolute/proportional): 383.8 (SE 563.8)/1.1% (SE 4.3%), 435.9 (SE 574.5)/2.2% (SE 4.6%), and -106.1 (SE 979.9)/-2.6% (SE 8.1%) for weeks 2, 3, and 4, respectively. For social interaction they were 3841.9 (SE 1425.4)/21.7% (SE 5.1%), 2270.6 (SE 947.1)/16.5% (SE 4.4%), and 2443.4 (SE 982.6)/17.9% (SE 4.7%) for weeks 2, 3, and 4, respectively. Analysis of group effect was significant (absolute change: η2=.19, P=.01; proportional change: η2=.27, P=.009). Correlation between the proportional change and the play activity was significant (r=.34, 95% CI 0.08 to 0.56), whereas for absolute change it was not. CONCLUSIONS Social interaction design elements of the pervasive game may have some positive effects on the promotion of physical activity, although other factors might also have influenced this effect. TRIAL REGISTRATION Japan Medical Association Clinical Trial Registration Number JMA-IIA00314; https://dbcentre3.jmacct.med.or.jp/JMACTR/App/JMACTRS06/JMACTRS06.aspx?seqno=7274 (Archived by WebCite at http://www.webcitation.org/761a6MVAy).
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Affiliation(s)
| | - Kazuya Okamoto
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | | | | | - Shusuke Hiragi
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Goshiro Yamamoto
- Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Osamu Sugiyama
- Preemptive Medicine & Lifestyle-Related Disease Research Center, Kyoto University Hospital, Kyoto, Japan
| | | | - Tomoki Aoyama
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Kuroda
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
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43
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Reis E, Postolache G, Teixeira L, Arriaga P, Lima ML, Postolache O. Exergames for motor rehabilitation in older adults: an umbrella review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1639012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Eduardo Reis
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Gabriela Postolache
- Researcher at Instituto de Telecomunicaçőes, Avenida Rovisco Pais 1, Lisbon, Portugal
| | - Luís Teixeira
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
- Champalimaud Foundation, Lisbon, Portugal
| | - Patrícia Arriaga
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Maria Luísa Lima
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Octavian Postolache
- CIS-IUL/ISCTE-Instituto Universitário de Lisboa, Lisbon, Portugal
- Instituto de Telecomunicações, Lisbon, Portugal
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Martín-Martínez JP, Villafaina S, Collado-Mateo D, Pérez-Gómez J, Gusi N. Effects of 24-week exergame intervention on physical function under single- and dual-task conditions in fibromyalgia: A randomized controlled trial. Scand J Med Sci Sports 2019; 29:1610-1617. [PMID: 31206782 DOI: 10.1111/sms.13502] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/09/2019] [Accepted: 06/07/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the effects of 24-week exergame intervention in the physical fitness of women with fibromyalgia in both single- and dual-task conditions. DESIGN Single-blinded, randomized controlled trial. SETTING University facilities. PARTICIPANTS Fifty-five women with fibromyalgia, recruited from the local fibromyalgia association, were randomly assigned to one of the two groups: exercise group and control group. INTERVENTION The exercise group completed 24 weeks of supervised and group-based exergame protocol, divided into two sessions of 60 minutes. The intervention was focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength. MAIN OUTCOME MEASURES The strength of the upper limbs was measured using the arm curl test. The mobility skill was assessed through the timed-up and go test, and the flexibility of both upper and lower limbs was measured using the back scratch and the sit and reach tests, respectively. RESULTS Fifty participants completed the study. In the single-task condition, exergame intervention led to significantly higher effects in the arm curl test (P = 0.008), sit and reach test (P = 0.033), and timed-up and go test (P = 0.021). Moreover, under dual-task condition, exergames led to significant effects in all the physical fitness tests (arm curl test, timed-up and go test, back scratch test, and sit and reach test) compared to the control group. CONCLUSIONS Exergame is an effective tool to improve the physical fitness in women with fibromyalgia under single or dual-task conditions.
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Affiliation(s)
| | | | - Daniel Collado-Mateo
- Faculty of Sport Science, University of Extremadura, Caceres, Spain.,Facultad de Educación, Universidad Autonoma de Chile, Talca, Chile
| | | | - Narcis Gusi
- Faculty of Sport Science, University of Extremadura, Caceres, Spain
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45
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Santos LH, Okamoto K, Hiragi S, Yamamoto G, Sugiyama O, Aoyama T, Kuroda T. Pervasive game design to evaluate social interaction effects on levels of physical activity among older adults. J Rehabil Assist Technol Eng 2019; 6:2055668319844443. [PMID: 31285836 PMCID: PMC6600479 DOI: 10.1177/2055668319844443] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/15/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction Promoting active lifestyles among older adults can bring drastic benefits for
their quality of life. The innovative mechanics of pervasive games – that
mix real and virtual worlds – can further engage and motivate elderly people
into that goal. Using social interaction as a study case, we designed and
evaluated the feasibility of a pervasive game to investigate how game design
elements can affect the levels of physical activity of older adults. Methods A mobile, location-based pervasive game was developed, and a study with
community dwelling elderly volunteers from Kyoto, Japan was performed to
evaluate its feasibility as an experiment system. Results Participants reported that the theme and visual style of the game was
adequate, and that game rules and goals could be easily understood. The game
was considered enjoyably challenging and engaging. Further analysis showed
that next iterations of the system must pay special attention to the level
of complexity of controls, and that new ways to connect players when there
are few people playing or when they are too far apart are necessary. Conclusions The design allowed to test for variations on pervasive mechanics and was
effective to engage elderly people, encouraging further investigation.
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Affiliation(s)
| | - Kazuya Okamoto
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Shusuke Hiragi
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Goshiro Yamamoto
- Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Osamu Sugiyama
- Preemptive Medicine & Lifestyle-Related Disease Research Center, Kyoto University Hospital, Kyoto, Japan
| | - Tomoki Aoyama
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Kuroda
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.,Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
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46
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Renaud L, Sauv L, Kaufman D, Dupl A E. [The evaluation of an on-line educational game to improve seniors’ quality of life]. SANTE PUBLIQUE 2019; 30:799-810. [PMID: 30990268 DOI: 10.3917/spub.187.0799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This article describes and evaluates the educational online game Pour bien vivre, vivons sainement !, which aims to increase players' knowledge about physical aspects of health (nutrition, physical activity, sleep and fatigue), to reduce the risk situations, to highlight the importance of social interactions with family members and friends and to increase emotional well-being. In this exploratory study, the impact of the game on the quality of life was measured for 56 players aged between 50 and 90 who completed pre/post questionnaires. The results show an improvement in their perceivded physical well-being, social welfare and psychological well-being. The game is beneficial to both men and women. Regardless of age, the digital game improves their perception of quality of life. In addition, the older you are, the more one considers the online game strengthens social connections. Finally, the players more experienced in the use of technology, benefit more from online playing.
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47
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Fang Q, Aiken CA, Fang C, Pan Z. Effects of Exergaming on Physical and Cognitive Functions in Individuals with Autism Spectrum Disorder: A Systematic Review. Games Health J 2019; 8:74-84. [DOI: 10.1089/g4h.2018.0032] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Qun Fang
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - Christopher A. Aiken
- Department of Kinesiology & Dance, New Mexico State University, Las Cruces, New Mexico
| | - Chao Fang
- Department of Pharmacology, School of Pharmacy, Institute of Neurosciences, the Fourth Military Medical University, Xi'an, China
- F. M. Kirby Neurobiology Center, Harvard Medical School, Boston, Massachusetts
| | - Zhujun Pan
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
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Silva PA, Cochrane A, Farrell H. The Effectiveness of Technology-Mediated Dance Interventions and Their Impact on Psychosocial Factors in Older Adults: A Systematic Review and Meta-Analysis. Games Health J 2018; 7:347-361. [PMID: 30044127 DOI: 10.1089/g4h.2017.0197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
| | - Andy Cochrane
- Andy Cochrane, School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Helen Farrell
- Helen Farrell, Maynooth Library, Maynooth University, Maynooth, Ireland
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49
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Exergame Experience of Young and Old Individuals Under Different Difficulty Adjustment Methods. COMPUTERS 2018. [DOI: 10.3390/computers7040059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this work, we compare the exergaming experience of young and old individuals under four difficulty adjustment methods. Physical inactivity is a leading cause of numerous health conditions including heart diseases, diabetes, cancer, and reduced life expectancy. Committing to regular physical exercise is a simple non-pharmaceutical preventive measure for maintaining good health and sustaining quality of life. Incorporating exercise into games, studies frequently used exergames as an intervention tool over the last decades to improve physical functions and to increase adherence to exercise. While task difficulty optimization is crucial to exergame design, researchers consistently overlooked age as an element which can significantly influence the nature of end results. We use the Flow State Scale to analyze the mental state of young and old individuals to compare constant difficulty with ramping, performance-based, and biofeedback-based difficulty adjustments. Our results indicate that old individuals are less likely to experience flow compared to young under the same difficulty adjustment methods. Further investigation revealed that old individuals are likely to experience flow under ramping and biofeedback-based difficulty adjustments whereas performance-based adjustments were only feasible for young.
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50
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Nguyen HV, Huang HC, Wong MK, Yang YH, Huang TL, Teng CI. Moderator Roles of Optimism and Weight Control on the Impact of Playing Exergames on Happiness: The Perspective of Social Cognitive Theory Using a Randomized Controlled Trial. Games Health J 2018; 7:246-252. [DOI: 10.1089/g4h.2017.0165] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Huynh Van Nguyen
- Graduate Institute of Business and Management, Chang Gung University, Taoyuan, Taiwan
| | - Han-Chung Huang
- Graduate Institute of Business and Management, Chang Gung University, Taoyuan, Taiwan
| | - May-Kuen Wong
- Department of Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Hui Yang
- Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
| | - Tzu-Ling Huang
- Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Ching-I Teng
- Graduate Institute of Business and Management, Chang Gung University, Taoyuan, Taiwan
- Department of Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Business and Management, Ming Chi University of Technology, New Taipei City, Taiwan
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