JMIR Publications

ABSTRACT

Background:

Elderly people often do not meet the recommended levels of exercise required to reduce functional decline. Social interaction is mentioned by these people as a reason for joining group-based exercises, which does not occur when exercising alone. In this perspective, exergames can be used as a motivational resource. However, most of the exergames available are generic and obtained from commercial sources, usually not specifically designed or adapted for the elderly.

Objective:

First, we intended to co-design and develop a new exergame alongside elderly participants to tailor the game mechanics and optimize their adherence and enjoyment for exercise. Afterward, we tested the participant's functional capacity, motivation, and adherence to the exergaming program while comparing these scores between those who played alone and those who played with peers.

Methods:

We conducted a co-design process to develop a new exergame adapted to the elderly. For user testing, 23 participants were divided into two groups to play individually (Alone Group) or competing in pairs (With Peers Group). They played the game twice a week, resulting in 21 exergaming sessions. We assessed the participants' General Physical Fitness Index before and after the intervention. We also applied questionnaires about the gaming experience and exercise adherence with its motivators and barriers.

Results:

We introduced a new bowling exergame for Xbox with a Kinect motion sensor that can be played in a single or multi-player mode. After the exergaming sessions, both groups showed a statistically significant improvement in functional capacity. Participants recognized the benefits and expressed enthusiasm towards the exergame. Considering adherence to physical exercise, both groups had improvements and showed interest in playing together. Still, when analyzing the post-test between groups, the With Peers Group had better outcomes than the Alone Group.

Conclusions:

The findings suggest that the developed exergame is effective in improving functional capacity and adherence to physical exercise of the elderly, with even better results for those who played with peers. Besides leading to more appropriate products, a co-design approach may positively influence the motivation and adherence of participants to elicit better health outcomes.