JMIR Publications

ABSTRACT

Background:

In aging societies, dementia risk increases with advancing age, increasing the incidence of dementia-related degenerative diseases and other complications, especially fall risk. Dementia also escalates the care burden, impacting patients, their families, social welfare institutions, and the social structure and medical system.

Objective:

In elderly dementia, traditional card recognition rehabilitation (TCRR) does not effectively increase one’s autonomy. Therefore, from the usability perspective, we used the Tetris game as a reference to develop an interactive somatosensory game with nostalgic style for elderly rehabilitation with mild cognitive impairment (MCI). Through intuitive gesture-controlled interactive games, we evaluated subjective feelings concerning somatosensory game integration in rehabilitation to explore whether the novel method could improve the willingness to use and motivation for rehabilitation among elders with MCI.

Methods:

Fifteen elders with MCI (7 males and 8 females with an average age of 78.4) underwent two experiments for 15 mins. During experiment 1, traditional card recognition rehabilitation (TCRR) was performed (about 1 min), followed by completing the questionnaire of system usability scale (SUS) (about 5 mins). After 3–5 mins, the second experiment, i.e., an interactive somatosensory game rehabilitation (ISGR), was conducted (also about 1 min), followed by completing another SUS (about 5 mins). We utilized SUS to explore differences in impacts of TCRR and ISGR on willingness to use among elders with MCI. In addition, we further investigate whether the factor of sex or prior rehabilitation experience would affect the rehabilitation willingness or not.

Results:

The novel ISGR made the elderly feel interested and improved their willingness for continuous rehabilitation. Furthermore, its scores of “Willingness to Use” (t=-8.27, p=0.00<0.05), “Easy to Use” (t=-3.17, p=0.00<0.05), “System Integration” (t=-5.07, p=0.00<0.05), and “Easy to Learn” (t=-2.81, p=0.01<0.05) were better than TCRR. The somatosensory game was easier to learn and master for females than for males (t=2.71, p=0.02<0.05). The somatosensory game was easier to use (t=-2.50, p=0.02<0.05) and learn (t=-3.33, p=0.00<0.05) for those without prior rehabilitation experience. The result indicates that elders who have no rehabilitation experience were easier to use and simpler to learn the ISGR than TCRR.

Conclusions:

Regardless of prior rehabilitation experience, the ISGR developed in this study was easy to learn and effective in continuously improving willingness to use. Furthermore, adoption of a nostalgic game design style served the function of cognitive training and escalated interest in rehabilitation. The ISGR also improved user stickiness by introducing different game scenarios and difficulties, increasing long-term interest and motivation for rehabilitation. For future research on adoption of interactive somatosensory games in rehabilitation, additional rehabilitation movements can be developed to benefit the elderly with MCI.