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

Combining explicit and implicit measures to study the effects of persuasive games

Understanding how games influence players is an integral part of persuasive game design. However, evaluating player attitudes to determine the success of a persuasive game can be difficult, e.g., if games deal with sensitive topics that invite socially desirable answers to explicit measures such as questionnaires. In this paper, we discuss the application of an implicit measure – the Implicit Association Test – to support explicit data, and to help game designers and games user researchers better understand the effects of persuasive games on player attitudes

Tailoring persuasive health games to gamer type

Persuasive games are an effective approach for motivating health behavior, and recent years have seen an increase in games designed for changing human behaviors or attitudes. However, these games are limited in two major ways: first, they are not based on theories of what motivates healthy behavior change. This makes it difficult to evaluate why a persuasive approach works. Second, most persuasive games treat players as a monolithic group. As an attempt to resolve these weaknesses, we conducted a large-scale survey of 642 gamers' eating habits and their associated determinants of healthy behavior to understand how health behavior relates to gamer type. We developed seven different models of healthy eating behavior for the gamer types identified by BrainHex. We then explored the differences between the models and created two approaches for effective persuasive game design based on our results. The first is a one-size-fits-all approach that will motivate the majority of the population, while not demotivating any players. The second is a personalized approach that will best motivate a particular type of gamer. Finally, to make our approaches actionable in persuasive game design, we map common game mechanics to the determinants of healthy behavior

Is movement better? Comparing sedentary and motion-based game controls for older adults

Providing cognitive and physical stimulation for older adults is critical for their well-being. Video games offer the opportunity of engaging seniors, and research has shown a variety of positive effects of motion-based video games for older adults. However, little is known about the suitability of motion-based game controls for older adults and how their use is affected by age-related changes. In this paper, we present a study evaluating sedentary and motion-based game controls with a focus on differences between younger and older adults. Our results show that older adults can apply motion-based game controls efficiently, and that they enjoy motion-based interaction. We present design implications based on our study, and demonstrate how our findings can be applied both to motion-based game design and to general interaction design for older adults. Copyright held by authors

Designing video games for older adults and caregivers

Providing care for older adults is a challenging task, particularly when close family members are involved: instead of spending quality time with the other person, caregiving relationships often focus on daily needs of the older adult, leaving little room for persons to communicate outside the caregiving context. In this paper, we examine the design of interactive technologies to support caregiving relationships through play. We present an exploratory study where ten caregiving dyads played cooperative motion-based video games, and follow up with two case studies to analyze how video game play affects older adults and family caregivers. Our results show that playing games generally represents an enjoyable activity for older adults and caregivers that can be integrated into the caregiving context. Based on our findings, we highlight design opportunities, and outline core challenges that need to be addressed to design accessible games that provide positive shared experiences for a wide range of caregiving dyads

KINECTWheels: wheelchair-accessible motion-based game interaction

The increasing popularity of full-body motion-based video games creates new challenges for game accessibility research. Many games strongly focus on able-bodied persons and require players to move around freely. To address this problem, we introduce KINECTWheels, a toolkit that facilitates the integration of wheelchair-based game input. Our library can help game designers to integrate wheelchair input at the development stage, and it can be configured to trigger keystroke events to make off-the-shelf PC games wheelchair-accessible

The effects of graphical fidelity on player experience

Graphical assets in video games have become increasingly complex over the years, but little is known about their effect on player experience (PX). In this paper, we present results of a controlled study with 48 participants comparing how abstract and stylized graphics influence player experience in casual games. Our results show that high-fidelity graphics result in a more positive impression of the game. However, we also show that many effects are only present in the game with a more challenging mechanic. This shows that casual games can be compelling and enjoyable to play despite simplistic graphics, suggesting that small game developers and researchers need not focus on elaborate visuals to engage players. Copyright © 2013 ACM

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

Designing wheelchair-based movement games

People using wheelchairs have access to fewer sports and other physically stimulating leisure activities than nondisabled persons, and often lead sedentary lifestyles that negatively influence their health. While motion- based video games have demonstrated great potential of encouraging physical activity among nondisabled players, the accessibility of motion-based games is limited for persons with mobility disabilities, thus also limiting access to the potential health benefits of playing these games. In our work, we address this issue through the design of wheelchair-accessible motion-based game controls. We present KINECTWheels, a toolkit designed to integrate wheelchair movements into motion-based games. Building on the toolkit, we developed Cupcake Heaven, a wheelchair-based video game designed for older adults using wheelchairs, and we created Wheelchair Revolution, a motion-based dance game that is accessible to both persons using wheelchairs and nondisabled players. Evaluation results show that KINECTWheels can be applied to make motion-based games wheelchair-accessible, and that wheelchair-based games engage broad audiences in physically stimulating play. Through the application of the wheelchair as an enabling technology in games, our work has the potential of encouraging players of all ages to develop a positive relationship with their wheelchair