Understanding older adults’ perceptions of and attitudes towards exergames

Purpose Maintaining physical activity is a key component of successful aging and has benefits for both physical and cognitive functioning in the older adult population. One promising method for engaging in physical activity is through exergames, which are video games designed to promote exercise. Exergames have the potential to be used by a wide range of people, including older adults, in a variety of settings, such as at home, in community living environments, or senior centers. However, exergames have not been designed for older adults (e.g., with respect to their attitudes, needs). Thus, older adults may not adopt these systems if they perceive them as not useful or relevant to them. Method Twenty older adults (aged 60-79) interacted with two exergames, and were then interviewed about their perceptions of the system’s ease of use and usefulness, as well as their general attitudes towards the system. Results Participants identified the potential for exergames’ usefulness for various goals, such as to increase their physical activity. However, they also reported negative attitudes concerning the system, including perceiving barriers to system use. Overall, participants said they would use the system in the future and recommend it to other people at their age for improving health, despite these use challenges. Conclusion The older adults were open to adopting exergames, which could provide opportunities to increase physical activity. Given the participants’ overall positive perceptions of the usefulness of exergames, designers must address the perceived challenges of using these systems. Understanding barriers and facilitators for older adults’ use of exergames can guide design, training, and adoption of these systems

Motion-Based Video Games for Older Adults in Long-Term Care

Older adults in residential care often lead sedentary lifestyles despite physical and cognitive activities being crucial for their well-being. Care facilities face the challenge of encouraging their residents to participate in leisure activities, but as the impact of age-related changes grows, few activities remain accessible. Video games in general – and motion-based games in particular – hold the promise of providing mental, physical and social stimulation for older adults. However, the accessibility of commercially available games for older adults is not considered during the development process. Therefore, many older adults are unable to obtain any of the benefits. In my dissertation, this issue is addressed through the development of motion-based game controls that specifically address the needs of older adults. The first part of this thesis lays the foundation by providing an overview of motion-based game interaction for older adults. The second part demonstrates the general feasibility of motion-based game controls for older adults, develops full-body motion-based and wheelchair-based game controls, and provides guidelines for accessible motion-based game interaction for institutionalized older adults. The third part of this thesis builds on these results and presents two case studies. Motion-based controls are applied and further evaluated in game design projects addressing the special needs of older adults in long-term care, with the first case study focusing on long-term player engagement and the role of volunteers in care homes, and the second case study focusing on connecting older adults and caregivers through play. The results of this dissertation show that motion-based game controls can be designed to be accessible to institutionalized older adults. My work also shows that older adults enjoy engaging with motion-based games, and that such games have the potential of positively influencing them by providing a physically and mentally stimulating leisure activity. Furthermore, results from the case studies reveal the benefits and limitations of computer games in long-term care. Fostering inclusive efforts in game design and ensuring that motion-based video games are accessible to broad audiences is an important step toward allowing all players to obtain the full benefits of games, thereby contributing to the quality of life of diverse audiences

Information technology for active ageing: A review of theory and practice

Active Ageing aims to foster a physically, mentally and socially active lifestyle as a person ages. It is a complex, multi-faceted problem that involves a variety of different actors, such as policy makers, doctors, care givers, family members, friends and, of course, older adults. This review aims to understand the role of a new actor, which increasingly plays the role of enabler and facilitator, i.e., that of the technology provider. The review specifically focuses on Information Technology (IT), with a particular emphasis on software applications, and on how IT can prevent decline, compensate for lost capabilities, aid care, and enhance existing capabilities. The analysis confirms the crucial role of IT in Active Ageing, shows that Active Ageing requires a multidisciplinary approach, and identifies the need for better integration of hardware, software, the environment and the involved actors

Investigating the Value of Acceptance and Commitment Therapy and Nintendo Wii Physical Activity for Older Adults

There has been much debate on best practices for limiting negative outcomes associated with relocation, sedentary lifestyle, and social isolation after older adults relocate to a residential care facility. This thesis is an exploration of the novel intervention combining Acceptance and Commitment Therapy with Nintendo Wii gameplay that was designed to improve initiation and adherence to physical activity. Acceptance and Commitment Therapy is an empirically based psychological intervention that utilizes mindfulness and acceptance techniques along with values-based action to improve one’s perception of life worth. The primary aim for this thesis was to understand more about the experiences that older adults residing in a residential care facility have with this intervention. Four participants were observed during the intervention and interviewed after the intervention. Multiple forms of analyses were performed such as, inductive interview content analysis, inductive and deductive analysis of observational field notes, deductive analysis of interviews, and deductive analysis of inductive findings. Results revealed that Nintendo Wii gameplay provides a convenient outlet for physical activity where older adults can participate in activities they once enjoyed and individuals with minimal functionality have the capacity to successfully and safely play the Nintendo Wii. Further, older adults prefer to participate in physical activities that are fun and do not feel like exercise; and, participate in small groups rather than large groups. After the intervention only one participant perceived that participation lead to physical health improvements, however, all participants perceived that the intervention increased mental health and social functioning levels. Additionally, all participants understood and were in agreement with the principles of Acceptance and Commitment Therapy, which increased initiation and adherence to physical activity. The intervention featured in this study could be useful for these purposes with similar participants in residential care facilities, although additional research is necessary to corroborate the findings of this study and to continue developing new knowledge in this area

The Use of digital games to enhance the physical exercise activity of the elderly : a case of Finland

According to the World Health Organization (WHO), population ageing is a global phenomenon, which brings both challenges and opportunities for society. The current longer expected lifespan can create opportunities for the elderly to contribute in many ways to their families and communities. However, it greatly depends on their quality of life, which is affected by many factors, including physical and functional health, social well-being, and cognitive abilities. The WHO (2012) states that physical health is one of the indicators for the elderly’s quality of life, and it declines with increasing age. Participation in regular physical exercises can help the elderly improve their physical and mental health, and this has been aided by the use of modern technologies to promote the elderly’s physical and functional health. Of these latest technologies, digital games have shown promise to improve and enhance the elderly’s physical activities through fun and engaging gameplay. The literature highlights that some commercial games in the market (e.g. Microsoft Kinect- Sports and Nintendo Wii Sports games) have the potential to improve the elderly’s physical health such as gait, balance, and fall prevention. However, researchers argue that these commercial games are not designed specifically for the elderly and their physical exercise activities. They state that most commercial games are not user-friendly for the elderly whose functional and physical abilities are limited due to their advanced years. The literature points out that more studies need to be undertaken to understand the usability and usefulness of digital games for physical exercise activities so that game designers can create elderly-friendly digital games in the future. In Finland, the government has been focusing on promoting healthy ageing and increasing home care services for the elderly. In recent years, Finnish researchers have used digital games to promote older Finns’ healthy and active ageing. The existing literature, whilst showing the potential of digital games for elderly Finns’ physical health, also acknowledges further research is needed particularly in the context of Finland. Thus, in this study, we aimed at investigating digital games to specifically assess their applications for older Finns’ physical activities, focusing on the quality of users’ experiences, and their reported ease of use and perceived usefulness. We used the mixed methods approach, which applies both qualitative and quantitative research methods. The study design included four stages: requirements gathering, analysis and design, prototyping, and evaluation. Firstly, we conducted pre-studies to elicit users’ requirements. This was followed by the analysis of the resulting data to identify trends and patterns, which fuelled ideas in the brainstorming game design and development phases. The final product was a digital game-based physical exercise called the Skiing Game. We then evaluated the Skiing Game in Finland with 21 elderly Finns (M=7, F=14, Average Age =76). By using questionnaires, observation, and interviews, we investigated user experiences, focusing on the game’s usability, and usefulness for enhancing the physical activity and wellbeing of the elderly. We also conducted a comparative test of the Skiing Game in Japan with 24 elderly Japanese participants (M=12, F=12, Average Age = 72) to further understand non-Finnish elderly users’ experiences. The findings from the usability study of the Skiing Game in Finland demonstrated that elderly Finns had a positive experience in the gameplay, and their motivation was noticeably high. It also confirmed that elderly Finns have a genuine interest in digital game-based exercises and strong intentions to play digital games as a form of physical exercise in the future. Although prior to the study most of them had negative views and misconceptions about digital games, after the gameplay their attitudes were decidedly positive. They acknowledged that whilst playing digital games could be an alternative way of exercising for them their use would primarily be when they don’t have access to their usual non-digital physical exercise. The Japanese usability of the Skiing Game showed that the elderly Japanese people also had positive user experiences in playing digital games, and also intend to use them in the future. Similarly, after playing the game they reported that their attitudes towards digital games become positive, and indicated playing digital games could be an alternative way of exercising. Although the comparison of the two studies suggests that the elderly Finns had relatively more positive experiences whilst playing the Skiing Game, compared to their Japanese counterparts, in general, both groups had a positive experience in the gameplay and showed interest in digital games as an alternative exercise. Based on the usability lessons learned from these two studies, recommendations for practitioners and designers regarding improvements in game design and development are made in this report. Implementing these modifications into future designs and further development of digital games for the elderly will improve their commercial viability and user uptake. The findings from this study can provide valuable insights, particularly for Finnish policymakers and healthcare practitioners who are keen to introduce digital games into the aged-care sector in Finland. The studies have also provided valuable insights into the optimal methods for introducing Finnish digital games to international markets, in particular, digital games tailored specifically for the physical exercise needs and motivations of the elderly. By taking into consideration the limitations of the study, we provide our future studies and further improvements of the game to be conducted

DYSGRAPHY AS DYSHARMONY OF BODY MOVEMENT. NEW SCENARIOS BETWEEN TRADITION AND TECHNOLOGY

Diversi studi dimostrano come grazie al movimento si instaurino rapporti con l’ambiente e come questa relazione sia determinante nel processo di apprendimento di ogni individuo. Il corpo è il primo mezzo con cui l’individuo sperimenta l’ambiente, è il primo canale di comunicazione fra lui e gli altri e continuerà ad essere l’intermediario privilegiato nella relazione con gli altri, tra il mondo interno e quello esterno a sé (Federici, Valentini, Tonini Cardinali, 2008, p.85). Il presente articolo nasce dall’esigenza di descrivere una proposta di intervento che prevede l’integrazione del metodo Terzi con gli exergames, con lo scopo di potenziare le abilità visuo-spaziali e favorire il miglioramento delle abilità di scrittura nei bambini disgrafici. In particolare, obiettivo del lavoro è stato sperimentare la valenza di prassi didattiche incentrate su un uso consapevole e intenzionale del corpo e delle sue potenzialità motorie al fine di prospettare possibili percorsi didattici che utilizzino il movimento nei processi di apprendimento della scrittura.Various studies show how movement establishes relationships with the environment and how this relationship is decisive in the learning process of each individual. The body is the first means by which the individual experiences the environment, it is the first channel of communication between him and others and will continue to be the privileged intermediary in the relationship with others, between the inner and outer world (Federici, Valentini, Tonini Cardinali, 2008, p.85). The present article stems from the need to describe an intervention proposal that provides for the integration of the Terzi method with exergames, with the aim of enhancing visual-spatial skills and promoting the improvement of writing skills in children with dysgraphia. In particular, the aim of the work was to test the value of didactic practices centred on a conscious and intentional use of the body and its motor potential in order to propose possible didactic paths that use movement in the learning process of writing

The effect of video gaming on physical activity among nursing home residents

There are approximately 1.5 million residents living in nursing homes in the United States. For those living in this environment, opportunities to participate in health promoting behaviors, such as physical activity, have been limited (Kayser-Jones, 2009). The use of video game technology is now being used related to health and health benefits with older adults (Primack et al., 2012). Because there have been limited research studies conducted in long-term care environments related to physical activity and health promotion, current research is needed to further explore these phenomena. The purposes of this study were as follows: (1) to describe the use of video game technology, specifically the Nintendo Wii, with older adults living in long term care facilities; (2) to determine if there is a relationship among personal factors, perceived barriers, perceived benefits, perceived self-efficacy, and physical activity; and (3) to examine the effects of this video game technology perceived barriers, perceived benefits, and perceived self-efficacy for physical activity using a 6-week intervention with nursing home residents. Pender’s Promotion Model was used as a guiding framework for this study. Twenty-four participants, primarily Caucasian (n=20, 83.3%) women (n=16, 66.7%) were recruited from four nursing homes in and around central North Carolina. Prior to the start of the intervention, data were collected by face to face interviews on current self-reported level of physical activity and prior use of a technological device, as well as other pre-intervention measures. The majority of the sample reported being very physically active and had prior experience using a technological device. The intervention period lasted for 6 weeks, meeting twice per week for 45 minute sessions. The sessions included a 15 minute educational component followed by 30 minutes of Nintendo Wii game play. From the data gathered prior to the intervention, it was ascertained that the majority of the study participants reported currently engaging in physical activity (87.4%). Many of the participants (83.3%) reported prior use of a technological device, with the computer being the most commonly reported. Using the scores from the multiple regression analysis (F (6, 22) = 2.49, p =.07, R2 = .48, R2Adjusted = .29) revealed no significant predictors of physical activity at posttest. Paired t-tests revealed no significant change in key variables between before and after intervention. Although the study the findings were not statistically significant, the intervention provided some useful clinical information that can be used in the development of future physical activity programs for residents in long-term care facilities. The use of video games with older adults is a feasible, inexpensive method to assist them in physical activity maintenance. Initiating interventions that are tailored to older adults, focused on health promoting behaviors such as physical activity, within long-term care facilities can help reduce to maintain the functional ability of residents in long-term care