Custom-designed motion-based games for older adults: a review of literature in human-computer interaction

Many older adults, particularly persons living in senior residences and care homes, lead sedentary lifestyles, which reduces their life expectancy. Motion-based video games encourage physical activity and might be an opportunity for these adults to remain active and engaged; however, research efforts in the field have frequently focused on younger audiences and little is known about the requirements and benefits of motion-based games for elderly players. In this paper, we present an overview of motion-based video games and other interactive technologies for older adults. First, we summarize existing approaches towards the definition of motion-based video games – often referred to as exergames – and suggest a categorization of motion-based applications into active video games, exergames, and augmented sports. Second, we use this scheme to classify case studies addressing design efforts particularly directed towards older adults. Third, we analyze these case studies with a focus on potential target audiences, benefits, challenges in their deployment, and future design opportunities to investigate whether motion-based video games can be applied to encourage physical activity among older adults. In this context, special attention is paid to evaluation routines and their implications regarding the deployment of such games in the daily lives of older adults. The results show that many case studies examine isolated aspects of motion-based game design for older adults, and despite the broad range of issues in motion-based interaction for older adults covered by the sum of all research projects, there appears to be a disconnect between laboratory-based research and the deployment of motion-based video games in the daily lives of senior citizens. Our literature review suggests that despite research results suggesting various benefits of motion-based play for older adults, most work in the field of game design for senior citizens has focused on the implementation of accessible user interfaces, and that little is known about the long-term deployment of video games for this audience, which is a crucial step if these games are to be implemented in activity programs of senior residences, care homes, or in therapy

Pass the Ball: Enforced Turn-Taking in Activity Tracking

We have developed a mobile application called Pass The Ball that enables users to track, reflect on, and discuss physical activity with others. We followed an iterative design process, trialling a first version of the app with 20 people and a second version with 31. The trials were conducted in the wild, on users' own devices. The second version of the app enforced a turn-taking system that meant only one member of a group of users could track their activity at any one time. This constrained tracking at the individual level, but more successfully led users to communicate and interact with each other. We discuss the second trial with reference to two concepts: social-relatedness and individual-competence. We discuss six key lessons from the trial, and identify two high-level design implications: attend to "practices" of tracking; and look within and beyond "collaboration" and "competition" in the design of activity trackers

Wearable Computing for Health and Fitness: Exploring the Relationship between Data and Human Behaviour

Health and fitness wearable technology has recently advanced, making it easier for an individual to monitor their behaviours. Previously self generated data interacts with the user to motivate positive behaviour change, but issues arise when relating this to long term mention of wearable devices. Previous studies within this area are discussed. We also consider a new approach where data is used to support instead of motivate, through monitoring and logging to encourage reflection. Based on issues highlighted, we then make recommendations on the direction in which future work could be most beneficial

Development and preliminary evaluation of a novel low cost VR-based upper limb stroke rehabilitation platform using Wii technology.

Abstract Purpose: This paper proposes a novel system (using the Nintendo Wii remote) that offers customised, non-immersive, virtual reality-based, upper-limb stroke rehabilitation and reports on promising preliminary findings with stroke survivors. Method: The system novelty lies in the high accuracy of the full kinematic tracking of the upper limb movement in real-time, offering strong personal connection between the stroke survivor and a virtual character when executing therapist prescribed adjustable exercises/games. It allows the therapist to monitor patient performance and to individually calibrate the system in terms of range of movement, speed and duration. Results: The system was tested for acceptability with three stroke survivors with differing levels of disability. Participants reported an overwhelming connection with the system and avatar. A two-week, single case study with a long-term stroke survivor showed positive changes in all four outcome measures employed, with the participant reporting better wrist control and greater functional use. Activities, which were deemed too challenging or too easy were associated with lower scores of enjoyment/motivation, highlighting the need for activities to be individually calibrated. Conclusions: Given the preliminary findings, it would be beneficial to extend the case study in terms of duration and participants and to conduct an acceptability and feasibility study with community dwelling survivors. Implications for Rehabilitation Low-cost, off-the-shelf game sensors, such as the Nintendo Wii remote, are acceptable by stroke survivors as an add-on to upper limb stroke rehabilitation but have to be bespoked to provide high-fidelity and real-time kinematic tracking of the arm movement. Providing therapists with real-time and remote monitoring of the quality of the movement and not just the amount of practice, is imperative and most critical for getting a better understanding of each patient and administering the right amount and type of exercise. The ability to translate therapeutic arm movement into individually calibrated exercises and games, allows accommodation of the wide range of movement difficulties seen after stroke and the ability to adjust these activities (in terms of speed, range of movement and duration) will aid motivation and adherence - key issues in rehabilitation. With increasing pressures on resources and the move to more community-based rehabilitation, the proposed system has the potential for promoting the intensity of practice necessary for recovery in both community and acute settings.The National Health Service (NHS) London Regional Innovation Fund

Full-body motion-based game interaction for older adults

Older adults in nursing homes often lead sedentary lifestyles, which reduces their life expectancy. Full-body motion-control games provide an opportunity for these adults to remain active and engaged; these games are not designed with age-related impairments in mind, which prevents the games from being leveraged to increase the activity levels of older adults. In this paper, we present two studies aimed at developing game design guidelines for full-body motion controls for older adults experiencing age-related changes and impairments. Our studies also demonstrate how full-body motion-control games can accommodate a variety of user abilities, have a positive effect on mood and, by extension, the emotional well-being of older adults. Based on our studies, we present seven guidelines for the design of full-body interaction in games. The guidelines are designed to foster safe physical activity among older adults, thereby increasing their quality of life. Copyright 2012 ACM

Using motivation derived from computer gaming in the context of computer based instruction

This paper was originally presented at the IEEE Technically Sponsored SAI Computing Conference 2016, London, 13-15 July 2016. Abstract— this paper explores how to exploit game based motivation as a way to promote engagement in computer-based instruction, and in particular in online learning interaction. The paper explores the human psychology of gaming and how this can be applied to learning, the computer mechanics of media presentation, affordances and possibilities, and the emerging interaction of playing games and how this itself can provide a pedagogical scaffolding to learning. In doing so the paper focuses on four aspects of Game Based Motivation and how it may be used; (i) the game player’s perception; (ii) the game designers’ model of how to motivate; (iii) team aspects and social interaction as a motivating factor; (iv) psychological models of motivation. This includes the increasing social nature of computer interaction. The paper concludes with a manifesto for exploiting game based motivation in learning

Design Strategies for Playful Technologies to Support Light-intensity Physical Activity in the Workplace

Moderate to vigorous intensity physical activity has an established preventative role in obesity, cardiovascular disease, and diabetes. However recent evidence suggests that sitting time affects health negatively independent of whether adults meet prescribed physical activity guidelines. Since many of us spend long hours daily sitting in front of a host of electronic screens, this is cause for concern. In this paper, we describe a set of three prototype digital games created for encouraging light-intensity physical activity during short breaks at work. The design of these kinds of games is a complex process that must consider motivation strategies, interaction methodology, usability and ludic aspects. We present design guidelines for technologies that encourage physical activity in the workplace that we derived from a user evaluation using the prototypes. Although the design guidelines can be seen as general principles, we conclude that they have to be considered differently for different workplace cultures and workspaces. Our study was conducted with users who have some experience playing casual games on their mobile devices and were able and willing to increase their physical activity.Comment: 11 pages, 5 figures. Video: http://living.media.mit.edu/projects/see-saw

Visual complexity, player experience, performance and physical exertion in motion-based games for older adults

Motion-based video games can have a variety of benefits for the players and are increasingly applied in physical therapy, rehabilitation and prevention for older adults. However, little is known about how this audience experiences playing such games, how the player experience affects the way older adults interact with motion-based games, and how this can relate to therapy goals. In our work, we decompose the player experience of older adults engaging with motion-based games, focusing on the effects of manipulations of the game representation through the visual channel (visual complexity), since it is the primary interaction modality of most games and since vision impairments are common amongst older adults. We examine the effects of different levels of visual complexity on player experience, performance, and exertion in a study with fifteen participants. Our results show that visual complexity affects the way games are perceived in two ways: First, while older adults do have preferences in terms of visual complexity of video games, notable effects were only measurable following drastic variations. Second, perceived exertion shifts depending on the degree of visual complexity. These findings can help inform the design of motion-based games for therapy and rehabilitation for older adults

Questioning, exploring, narrating and playing in the control room to maintain system safety

Systems whose design is primarily aimed at ensuring efficient, effective and safe working, such as control rooms, have traditionally been evaluated in terms of criteria that correspond directly to those values: functional correctness, time to complete tasks, etc. This paper reports on a study of control room working that identified other factors that contributed directly to overall system safety. These factors included the ability of staff to manage uncertainty, to learn in an exploratory way, to reflect on their actions, and to engage in problem-solving that has many of the hallmarks of playing puzzles which, in turn, supports exploratory learning. These factors, while currently difficult to measure or explicitly design for, must be recognized and valued in design

Understanding Engagement within the Context of a Safety Critical Game

One of the most frequent arguments for deploying serious games is that they provide an engaging format for student learning. However, engagement is often equated with enjoyment, which may not be the most relevant conceptualization in safety-critical settings, such as law enforcement and healthcare. In these contexts, the term ‘serious’ does not only relate to the non-entertainment purpose of the game but also the environment simulated by the game. In addition, a lack of engagement in a safety critical training setting can have serious ethical implications, leading to significant real-world impacts. However, evaluations of safety-critical games (SCGs) rarely provide an in-depth consideration of player experience. Thus, in relation to simulation game-based training, we are left without a clear understanding of what sort of experience players are having, what factors influence their engagement and how their engagement relates to learning. In order to address these issues, this paper reports on the mixed-method evaluation of a SCG that was developed to support police training. The findings indicate that engagement is supported by the experience situational relevance, due to the player’s experience of real-world authenticity, targeted feedback mechanisms and learning challenges