Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review

Miller, Kimberly J.; Adair, Brooke; Pearce, Alan J.; Said, Catherine M; Ozanne, Elizabeth; Morris, Meg E.

doi:10.1093/ageing/aft194

Cited by 211 publications

(148 citation statements)

References 21 publications

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“…Conversely, Hall et al 5 proposed future studies should consider ''more robust and rigorous research designs are needed to increase validity and reliability of results'' (p. 1). Although Miller et al 3 echoed the recommendation of Hall et al, 5 they also proposed three key points, including ''The current evidence for the effectiveness of home-based VR/gaming for improving health-related domains in older adults is relatively weak with a high risk of bias and therefore insufficient to provide sound recommendations for clinical practice, strong retention and adherence with exercise, and the need for assistance, training and monitoring to ensure safety was identified and future studies should not only address the effectiveness of VR/gaming exercise programs for particular older populations, but also the feasibility issues specific to the implementation in a home environment using more rigorous research designs'' (p. 194). 5 As life expectancy continues to increase, new and innovative research is needed to explore digital game use by the oldest old.…”

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“…3 Research focusing on the application, feasibility, and effectiveness of virtual reality (VR) digital gaming systems to manage or improve the effects of physical and mental impairment and limitations in community settings found insufficient evidence to validate the feasibility and effectiveness of such an approach. Conversely, one of the limitations from these studies is the lack of physical recommendations as noted by these authors.…”

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confidence: 99%

“…Conversely, one of the limitations from these studies is the lack of physical recommendations as noted by these authors. 3 For example, Miller et al 3 found that ''evidence to date supporting the feasibility and effectiveness of VR/gaming systems undertaken for enabling physical activity in a home setting to address impairments, activity limitations and participation in people aged over 45 years old is relatively weak with a high risk of bias in this emerging area, and, therefore, insufficient to provide sound recommendations for clinical practice' ' (p. 193).…”

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“…Furthermore, Miller et al 3 proposed that future studies should use a more rigorous study design and data collection methods. This recommendation is based on findings of their review identifying several ''feasibility issues and inconsistences relating to: recruitment, retention, target and recorded dosage of exercises, adherence, training, assistance, safety, cost, acceptability and take-up of technologies' ' (p. 193) within the existing knowledge base.…”

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confidence: 99%

“…The importance of identifying suitable game technologies to improve the health and well-being of older people has been highlighted in several reviews, [2][3][4][5] and several areas requiring further exploration have been identified. These areas include the need for a physical, cognitive, and social classification system specifically aimed at games for health while considering the implementation of longitudinal studies to ascertain the effects of videogames on participants, 2 and Bleakley et al 4 provided 15 recommendations that related to the exploration of technologies across the selection/inclusion criteria, methodology, intervention, comparison group, outcomes, and follow-up, while also proposing the recommendation of tailoring the respective study to the participants and considering participant safety, engagement/motivation, and enjoyment.…”

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confidence: 99%

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A Scoping Review of Digital Gaming Research Involving Older Adults Aged 85 and Older

Marston

Freeman

Bishop

et al. 2016

Games for Health Journal

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Background: Interest in the use of digital game technologies by older adults is growing across disciplines from health and gerontology to computer science and game studies. The objective of this scoping review was to examine research evidence involving the oldest old (persons 85 years of age or greater) and digital game technology. Materials and Methods: PubMed, CINHAL, and Scopus were searched, and 46 articles were included in this review. Results: Results highlighted that 60 percent of articles were published in gerontological journals, whereas only 8.7 percent were published in computer science journals. No studies focused directly on the oldest old population. Few studies included sample sizes greater than 100 participants. Seven primary and 34 secondary themes were identified, of which Hardware Technology and Assessment were the most common. Conclusions: Existing evidence demonstrates the paucity of studies engaging older adults 85 years of age and above regarding the use of digital gaming and highlights a new understudied cohort for further research focus. Recommendations for future research include intentional recruitment and proportionate representation of participants q85 years of age, large sample sizes, and explicit mention of specific numbers of participants q85 years of age, which are necessary to advance knowledge in this area. Integrating a rigorous and robust mixedmethods approach including theoretical perspectives would lend itself to further in-depth understanding and knowledge generation in this field.

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A Scoping Review of Digital Gaming Research Involving Older Adults Aged 85 and Older

Marston

Freeman

Bishop

et al. 2016

Games for Health Journal

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Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map

Welch,

Ghogomu,

Barbeau

et al. 2023

Campbell Systematic Reviews

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BackgroundSocial isolation and loneliness are more common in older adults and are associated with a serious impact on their well‐being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID‐19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID‐19 restrictions.ObjectivesTo map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings.Search MethodsWe searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos.Selection CriteriaTitles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria.Data Collection and AnalysisWe developed and pilot tested a data extraction code set in Eppi‐Reviewer and data were individually extracted and coded based on an intervention‐outcome framework which was also used to define the dimensions of the evidence and gap map.Main ResultsWe included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID‐19 pandemic. The evidence is unevenly distributed with clusters predominantly in high‐income countries and none in low‐income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at‐risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS‐Plus categories.Authors' ConclusionsThe restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high‐quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.

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Effects of virtual reality on moods in community older adults. A multicenter randomized controlled trial

Chan

Wong

et al. 2020

Int J Geriat Psychiatry

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IntroductionVirtual reality (VR) technology is a potential method to use in cognitive intervention, but the use of VR in cognitive stimulation intervention for older adults has not been investigated. Therefore, the aim of this study was to investigate the mood change of older adults after participating in the VR cognitive stimulation activity.MethodsThis is a multicenter randomized controlled, cross‐over trial. The intervention was a VR cognitive stimulation activity, and the control was a paper‐and‐pencil activity. The participants were older adults with age over 60 and recruited in the elderly community centers. The Positive and Negative Affect Score (PANAS) was used to measure mood change. Mean difference (MD) with 95% confidence interval (95% CI) was calculated. The Simulator sickness questionnaire was used to measure adverse events.ResultsA total of 236 participants from 19 community centers were recruited. After the VR activity, the participants had a significant increase in total PANAS positive affect score (MD = 2.09, 95% CI = 0.69 to 3.49), and a significant reduction in total negative affect score (MD = −1.99, 95% CI = −2.55 to −1.43). The reduction in negative affect score was significantly larger in VR activity than paper‐and‐pencil activity (MD = −0.48, 95% CI = −0.98 to 0.00). Besides, only three participants reported severe advance events after VR activity.ConclusionsThe use of VR technology is well accepted by older adults. Therefore, the use of VR technology through smartphone and a mobile app can be a potential method for future cognitive training interventions.

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Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review

Cited by 211 publications

References 21 publications

A Scoping Review of Digital Gaming Research Involving Older Adults Aged 85 and Older

A Scoping Review of Digital Gaming Research Involving Older Adults Aged 85 and Older

Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map

Effects of virtual reality on moods in community older adults. A multicenter randomized controlled trial

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