Does exergaming drive future physical activity and sport intentions?

International audienc

Contribution of Exergaming Behaviour to Physical Activity: Toward Better Understanding the Role of Motivation

Physical activity (PA) is associated with numerous health benefits. Because PA patterns established early in life track into adulthood, it is important that children develop and sustain healthy PA habits. Current guidelines recommend that youth accumulate ≥ 60 minutes of moderate to vigorous intensity PA daily, but many youth do not attain this level. Evaluation of public health interventions that aim to promote PA provide little evidence of sustained positive effects over time. This could relate, at least in part, to interventions lacking a strong conceptual foundation and, in particular, to a lack of underpinnings that recognize the central role of motivation in PA. It is important that effective strategies to increase and sustain healthy PA levels in youth are identified. The Self-Determination Theory is used to explain why people adopt and maintain healthy PA behaviors and posits that sustained PA relates to natural or intrinsic tendencies or motivations to behave in healthy and effective ways. Positive PA experiences in school, at home and in community settings may foster an internal desire or motivation to sustain PA participation simply for its challenges or for enjoyment. Lack of sustained PA among youth could reflect a scarcity of enjoyable PA options that fit with the sophisticated technetronic expectations of youth today. PA interventions must “keep up with the times,” by acknowledging young peoples’ prevailing interests and by incorporating advancements in technology that heighten interest and motivation for PA. Exergaming, a type of non-sedentary videogame that requires players to be physically active in order to attain a series of incrementally challenging goals, is increasingly viewed as an enjoyable PA option among today’s technology-immersed youth. However, although critical to informing the design, implementation and sustainability of exergaming interventions, evidence on exergaming-related motivation, preferences, intentions and sustainability is lacking. Research in this domain is needed to ascertain whether exergaming interventions can help youth become and remain physically active, and which facets of exergaming hold the most promise in sustaining positive PA change. More specifically, using “gamified augmented reality” such as exergaming could help youth attain recommended PA levels and promote sustainable healthy behaviour, while at the same time contributing to enjoyment of PA. The three studies described in this thesis examine motivation and exergaming in-depth using SDT and its tenants as a theoretical guide and a common theme across studies. Thus, the role of motivation and intentions in exergaming behaviour and how they contribute to PA in the general population of youth is a key contribution of this dissertation. Study 1, a review of reviews on exergaming, provides background for the next two studies, each of which was conducted in population-based (as opposed to clinical or experimental) settings. Twenty-five reviews spanning 2009 to 2016 were retained, each of which incorporated between 5 and 100 articles. A positive relationship between exergaming and energy expenditure (EE) was well-documented, but whether exergaming increases PA or changes body composition was not established. There is however, evidence that exergaming (i.e., as a non-sedentary use of screens) is a healthy alternative to sedentary behaviour, that it improves cognitive function, that it is an interesting and enjoyable pastime in youth, that it shows promise as a PA option by adding variety and alternative PA forms in health and dietary interventions and finally that it is likely more health-promoting than traditional videogames because of higher EE and possibly improved physical fitness, body composition and cognitive health. However, more research and specifically, longitudinal studies are needed to assess whether exergaming can be sustained to obtain these benefits over time. Study 2 identified correlates of sustained exergaming. We reported that almost 50% of grade 9 students sustained exergaming for 2-3 years. Study results suggest that in non-clinical settings, exergaming may be a practical approach to help adolescents maintain PA during adolescence. Study 3 examined the psychometric properties of a new scale to assess reasons for exergaming (i.e., the Reasons to Exergame (RTEX) scale). This study also examined whether and how the scale relates to the timing, intensity and duration of past-month exergaming. RTEX items were developed in consultation with PA and exergaming experts and using key exergaming constructs, including PA, general interest in videogames and enjoyment of exergaming. RTEX was found to be a reliable and valid assessment of reasons to exergame. However, further studies should replicate these initial findings in larger, more diverse samples

Can exergaming improve mental health of university students?

The academic, financial, and social pressures that emerge when adults begin university may lead them to encounter mental health challenges (American College Health Association [ACHA], 2016). In Ontario, 46.2% of university/college students have reported ‘excessive’ stress whereas 64.5% report ‘overwhelming’ anxiety (ACHA, 2016). One approach that may be useful for enhancing mental health is exergaming which uses motion-sensor technology requiring players to move their bodies to complete the videogame sessions (Huang et al., 2017). However, studies focused on the effectiveness of exergaming for improving mental health of university students are scarce in number and limited in scope. The overall purpose of this dissertation was to examine the role of exergaming in relation to mental health reported by university students. In Study 1, a synthesis of published intervention research using exergaming to change well-being – a psychological concept affiliated with mental health – reported by adults was conducted. Results from Study 1 indicated that less than 50.0% of the coded studies - using either multi- or single-group (pre-post-test) research designs - reported enhanced well-being as a function of exergaming. In Study 2, the link between the amount and intensity of exergaming behaviour per week and mental health reported by university students was evaluated. Results from Study 2 indicated that university students who reported more frequent exergaming behaviour during a typical week displayed lower anxiety and stress plus higher flourishing and vitality. In Study 3, the contributions of exergaming to mental health of university students were investigated using an experimental research design that compared exergaming against other physical activity behaviours and self-management approaches. Results from Study 3 showed that ‘exergamers’ did not present higher or lower mental health scores compared against ‘traditional’ exercisers but displayed less stress and anxiety when compared against pet therapy, as well as, higher vitality plus lower stress and anxiety compared to ‘non-exercisers’. The results from these studies make it apparent that exergaming may not offer anything ‘unique’ as a stimulus beyond more traditional modes of exercise, but it fosters mental health of university students

Exploring user experience and technology acceptance for a fall prevention system: results from a randomized clinical trial and a living lab

Background: Falls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults’ motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults. Methods: In the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants. Results: Participants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain factors such as motivation, complexity or graphical design were different for gender and age. Conclusions: The results suggest that the iStoppFalls system has good usability, user experience and user acceptance. It will be important to take these along with factors such as motivation, gender and age into consideration when designing and further developing ICT-based fall prevention systems

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

Investigating the Finnish Elderly People’s Attitudes and Motivation towards Digital Game-Based Physical Exercises

Attitudes and motivation towards physical exercises play a vital role for elderly people’s adherence to exercise. In recent years, digital games have been used to enhance elderly people’s experiences in physical exercises. However, there is a limited number of studies regarding elderly people’s attitudes and motivation towards digital game-based exercises. In this study, we aim at investigating the Finnish elderly people’s attitudes towards physical and digital game-based exercises, as well as their motivation in the gameplay. Furthermore, we intend to investigate if digital games can be an alternative way of exercising for elderly people. We conducted a user experience test of the “Skiing Game” with 21 elderly participants in Finland. We applied both qualitative (e.g. interview) and quantitative (e.g. questionnaires) methods to collect data from the participants. Then, we analyzed the data by using SPSS and Nvivo. The findings show that the Finnish elderly people’s attitudes towards physical exercises are more positive than digital game-based exercises. However, their attitudes towards digital games have become more positive after the gameplay. Their in-game and post-game user experiences were moderately positive. Their motivation to play digital game-based exercises was moderately high after the gameplay. Their feedback towards the Skiing game was positive. They recommend that digital game-based exercises can be an effective way of exercising. Based on these findings, we recommend that digital games are promising to be used as an alternative way of exercising for the Finnish elderly people. The discussion in this study can help researchers gain insights about using digital games for promoting elderly people’s participation in physical exercises

Impact of Exergames on the Mental Health of Older Adults: A Systematic Review and GRADE Evidence Synthesis

Exergames, which combine digital games and physical exercise, have become a popular alternative to traditional exercise programs and are increasingly used in the health domains. This study aimed to provide a systematic review to synthesize existing studies on the use of exergames for the mental wellbeing of healthy older adults, aggregating the collected data to identify effect size. We performed a Systematic Review and Grading of Recommendations, Assessment, Development, and Assessment (GRADE) evidence synthesis. We performed the search in the following databases: MEDLINE®, CINAHL®, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, and Cochrane® Central Register of Controlled Trials from the first record until October 2021. Randomized controlled trials using exergames as an intervention were included. A total of 10 articles published between 2009 and 2021 were selected. Most studies used the Nintendo Wii® as the exergame in the intervention program. Interventions ranged from 6 to 12 weeks, with 8-week programs being most frequent. It was possible to observe a positive effect on mood, the reduction of apathy, anxiety and depression, self-esteem, and affection.info:eu-repo/semantics/publishedVersio