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

Younger adolescents’ perceptions of physical activity, exergaming, and virtual reality:qualitative intervention development study

Background. Novel strategies to promote physical activity (PA) in adolescence are required. The vEngage study aims to test whether a virtual reality (VR) exergaming intervention can engage younger adolescents (13-15 year old) with physical activity. Objective: This study aimed to gather adolescents’ views of using VR to encourage PA and identify the key features they would like to see in a VR exergaming intervention via interviews. Methods: Participants were recruited through two schools in London, UK. Semi-structured interviews were conducted with adolescents about their views on PA and what might work to increase PA, technology, knowledge and experience of VR, and desired features in a VR exergaming intervention. Data were analysed using Framework Analysis. Results: 31 13-15 year olds (58% female, 62% from non-white ethnicities) participated in this interview study. The vast majority had no awareness of government PA recommendations, but felt they should be more thoroughly informed. All participants were positive about the use of VR in PA promotion. Rewards, increasing challenges and a social/multiplayer aspect were identified by participants as crucial aspects to include in a VR exercise game. Barriers were related to cost of high-end systems. Being able to exercise at home was very appealing. VR exergaming was viewed as a way to overcome multiple perceived social and cultural barriers to PA, particularly for girls. Conclusions: Key elements that should be incorporated into a VR for health intervention were identified and described. These also included the use of rewards, novelty and enjoyment in immersive game play, multi-player options, real-world elements, as well as continual updates and new challenge levels. The use of VR to promote PA in adolescents is promising, but some barriers were raised

Activity-promoting gaming systems in exercise and rehabilitation

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation

A Systematic Review on the Cognitive Benefits and Neurophysiological Correlates of Exergaming in Healthy Older Adults

Human aging is associated with structural and functional brain deteriorations and a corresponding cognitive decline. Exergaming (i.e., physically active video-gaming) has been supposed to attenuate age-related brain deteriorations and may even improve cognitive functions in healthy older adults. Effects of exergaming, however, vary largely across studies. Moreover, the underlying neurophysiological mechanisms by which exergaming may affect cognitive and brain function are still poorly understood. Therefore, we systematically reviewed the effects of exergame interventions on cognitive outcomes and neurophysiological correlates in healthy older adults (>60 years). After screening 2709 studies (Cochrane Library, PsycINFO, Pubmed, Scopus), we found 15 eligible studies, four of which comprised neurophysiological measures. Most studies reported within group improvements in exergamers and favorable interaction effects compared to passive controls. Fewer studies found superior effects of exergaming over physically active control groups and, if so, solely for executive functions. Regarding individual cognitive domains, results showed no consistence. Positive effects on neurophysiological outcomes were present in all respective studies. In summary, exergaming seems to be equally or slightly more effective than other physical interventions on cognitive functions in healthy older adults. Tailored interventions using well-considered exergames and intervention designs, however, may result in more distinct effects on cognitive functions

Mobile exergaming in adolescents’ everyday life—contextual design of where, when, with whom, and how: the SmartLife case

Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential playing time, but need to be engaging and integrated in everyday life. The goal of the present study was to examine the context of gameplay for mobile exergaming in adolescents’ everyday life to inform game design and the integration of gameplay into everyday life. Eight focus groups were conducted with 49 Flemish adolescents (11 to 17 years of age). The focus groups were audiotaped, transcribed, and analyzed by means of thematic analysis via Nvivo 11 software (QSR International Pty Ltd., Victoria, Australia). The adolescents indicated leisure time and travel time to and from school as suitable timeframes for playing a mobile exergame. Outdoor gameplay should be restricted to the personal living environment of adolescents. Besides outdoor locations, the game should also be adaptable to at-home activities. Activities could vary from running outside to fitness exercises inside. Furthermore, the social context of the game was important, e.g., playing in teams or meeting at (virtual) meeting points. Physical activity tracking via smart clothing was identified as a motivator for gameplay. By means of this study, game developers may be better equipped to develop mobile exergames that embed gameplay in adolescents’ everyday life

Physical literacy: Importance, assessment and future directions

Physical literacy (PL) has become a major focus of physical education, physical activity and sports promotion worldwide. PL is a multifaceted conceptualisation of the skills required to fully realise potentials through embodied experience. Substantial financial investments in PL education by governments are underpinned by a wide range of anticipated benefits, including expectations of significant future savings to healthcare, improved physical and psychological well-being of the population, increased work-force productivity and raised levels of expertise in sport and exercise participation. However, disappointingly, scientific evidence showing the efficacy of PL interventions to successfully meet such high expectation is limited. We suggest that contradictions in research findings are due largely to limitations in movement assessment batteries and consequent discrepancies between measurements used to assess the immediate outcomes of PL programmes. Notably, there is no robust empirical tool for evidencing skill learning in the physical movement component of PL, education and this presents a serious limitation to the design of, and claims that can be made for, such interventions. Considering the parameters of proficient PL skills and the limitations of current evaluation instruments, possible future directions for developing empirical measures of PL movement skills are presented

Human gesture classification by brute-force machine learning for exergaming in physiotherapy

In this paper, a novel approach for human gesture classification on skeletal data is proposed for the application of exergaming in physiotherapy. Unlike existing methods, we propose to use a general classifier like Random Forests to recognize dynamic gestures. The temporal dimension is handled afterwards by majority voting in a sliding window over the consecutive predictions of the classifier. The gestures can have partially similar postures, such that the classifier will decide on the dissimilar postures. This brute-force classification strategy is permitted, because dynamic human gestures show sufficient dissimilar postures. Online continuous human gesture recognition can classify dynamic gestures in an early stage, which is a crucial advantage when controlling a game by automatic gesture recognition. Also, ground truth can be easily obtained, since all postures in a gesture get the same label, without any discretization into consecutive postures. This way, new gestures can be easily added, which is advantageous in adaptive game development. We evaluate our strategy by a leave-one-subject-out cross-validation on a self-captured stealth game gesture dataset and the publicly available Microsoft Research Cambridge-12 Kinect (MSRC-12) dataset. On the first dataset we achieve an excellent accuracy rate of 96.72%. Furthermore, we show that Random Forests perform better than Support Vector Machines. On the second dataset we achieve an accuracy rate of 98.37%, which is on average 3.57% better then existing methods