An Interactive Physical-Cognitive Game-Based Training System Using Kinect for Older Adults: Development and Usability Study

Abstract

Background Declines in physical and cognitive functions are recognized as important risk factors for falls in older adults. Promising evidence suggests that interactive game-based systems that allow simultaneous physical and cognitive exercise are a potential approach to enhance exercise adherence and reduce fall risk in older adults. However, a limited number of studies have reported the development of a combined physical-cognitive game-based training system for fall risk reduction in older adults. Objective The aim of this study is to develop and evaluate the usability of an interactive physical-cognitive game-based training system (game-based exercise) for older adults. Methods In the development phase (Part I), a game-based exercise prototype was created by integrating knowledge and a literature review as well as brainstorming with experts on effective fall prevention exercise for older adults. The output was a game-based exercise prototype that covers crucial physical and cognitive components related to falls. In the usability testing (Part II), 5 games (ie, Fruits Hunter, Where Am I?, Whack a Mole, Sky Falls, and Crossing Poison River) with three difficulty levels (ie, beginner, intermediate, and advanced levels) were tested in 5 older adults (mean age 70.40 years, SD 5.41 years). After completing the games, participants rated their enjoyment level while engaging with the games using the Physical Activity Enjoyment Scale (PACES) and commented on the games. Descriptive statistics were used to describe the participants’ characteristics and PACES scores. Results The results showed that the average PACES score was 123 out of 126 points overall and between 6.66 and 7.00 for each item, indicating a high level of enjoyment. Positive feedback, such as praise for the well-designed interactions and user-friendly interfaces, was also provided. Conclusions These findings suggest that it is promising to implement an interactive, physical-cognitive game-based exercise in older adults. The effectiveness of a game-based exercise program for fall risk reduction has yet to be determined.

Development and initial validation of the German version of the Exergame Enjoyment Questionnaire (EEQ-G)

“…The occurrence of a ceiling effect in the sub-score ‘intrinsic motivation’ of the BREQ might be explained by a possible selection bias in the recruitment process (see section ‘Discussion–Limitations’). Comparing our PACES data with the literature, such high PACES values are not atypical for exergame studies with HOA, where mean scores of 64% [ 32 ], 65% [ 35 ], between 80–90% [ 30 , 31 ] or above 90% [ 29 , 33 ] of the maximum score have been reported (compared to an average score of 96.3% of the maximum score in this study). Data of the EEQ-G was less skewed (skewness of– 0.998 and– 0.370 for the ‘preferred’ and ‘unpreferred’ condition, respectively) and none of the participants reached the maximal rating (the highest of all ratings was 93 out of 100), indicating an advantage for the EEQ-G compared to the PACES when applied for measuring exergaming enjoyment in HOA.…”

Children’s Influence on Their Parents’ Satisfaction with Physical Activity in Nature: An Exploratory Study

“…Moreover, age showed no relationship with the dimensions and total score of the scales when evaluated. Finally, the ceiling effect observed in questionnaire responses has also been highlighted in previous studies, such as that of Kamnardsiri et al [ 43 ], in assessing the enjoyment of an interactive game in older adults. Likewise, Ryuh et al [ 44 ] observed this effect when promoting PA through exergaming in people with intellectual disabilities.…”

The potential competency outcome of vigorous brain training game in the elderly: A systematic review

“…This literature review showed that positive effects were found in the elderly who underwent the computer/mobile phone‐based brain training game program. Some studies reported benefits not just in the psychological dimension, but also in the physical dimension 22 . The variation in the studies depended on the type of brain training game provided, the measurement tools used, and the baseline brain competency (the level of decline in brain memory function) of the subjects.…”

“…Beyond control participants, the NeuroRacer group continued to exhibit lower multitasking costs, and midline frontal theta power, a neural marker of cognitive control, continued to exhibit increased activity. Kamnardsiri et al 22 5 An exercise prototype based on a game was developed in the development phase (Part I) by combining expertise, conducting literature research, and consulting experts on fall prevention exercise for older individuals. The result was a game-based training prototype that addresses important physical and mental aspects of falls.…”