Abstract

BackgroundDeclines 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.ObjectiveThe 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.MethodsIn 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.ResultsThe 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.ConclusionsThese 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.

Highlights

  • Declines in multiple physiological systems with ageing contribute to balance and gait deficits, leading to an increased risk of fall [1]

  • The results showed that the average Physical Activity Enjoyment Scale (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

  • We aimed to develop and test the usability of a virtual, interactive game-based training system that is focused on simultaneously training the physical and cognitive function of community-dwelling older adults

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Summary

Introduction

Declines in multiple physiological systems with ageing contribute to balance and gait deficits, leading to an increased risk of fall [1]. Several investigators have consistently reported a strong positive effect of physical exercise on fall prevention among older adults [5,6,7,8,9]. Many examiners have demonstrated that cognitive training, which is an intervention program aimed at improving, maintaining, or restoring cognitive function via the repeated and structured practice of tasks, can improve balance and gait and reduce fall risk [14,15,16,17]. A growing number of investigators have documented the effects of combined physical-cognitive exercise training in a simultaneous form (dual-tasking) among older adults. 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

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