Accepted for/Published in: JMIR Serious Games
Date Submitted: Apr 3, 2024
Date Accepted: Sep 23, 2024
Home-Based, Low-intensity, Gamification-Based Interactive Physical-Cognitive Training for Older Adults Using the ADDIE Model: Design, Development, and Evaluation of User Experience
ABSTRACT
Background:
The decline in physical function, coupled with cognitive function, is an inevitable process for older adults, leading to an increased risk of falls. Promising evidence suggests that combined physical-cognitive exercise has shown beneficial effect in improving both physical and cognitive health. While moderate-to-high exercise intensity is commonly recommended, it might be impractical for older adults facing physical limitations or contraindications. Thus, low-intensity exercise is a viable option. The main barriers to engaging in exercise in older adults include transportation, time, motivation, and enjoyment. To overcome these challenges, a home-based, gamification-based training system may provide an effective approach to enhance exercise adherence.
Objective:
To develop and evaluate the usability of a low-intensity, gamification-based interactive, combined physical-cognitive exercise for older adults in a home-based setting.
Methods:
The prototype of a game-based physical-cognitive exercise was created following the ADDIE model (i.e., analysis, design, development, implementation, and evaluation) and assessed for the usability of a system and satisfaction in older adults. Fifteen older adults engaged in the game-based physical-cognitive exercise at home for 60 minutes/day, 3 days/week for 4 weeks. The usability of the game-based training system was evaluated using the System Usability Scale (SUS) after completion of a 4-week training. As for satisfaction, the 8-item Physical Activity Enjoyment Scale (PACES) questionnaire was used to assess participants’ enjoyment level before and after 4-week training. Descriptive statistics were employed to illustrate the SUS score. A Wilcoxon signed-rank test was used to compare the PACES scores between baseline and the end of the 4-week period, with significance set at P < .05.
Results:
As for experts' consensus, the game-based training consisted of 3 games: Ocean Diver, Road Runner, and Moving and Memorizing, and 3 levels of difficulty: beginner, intermediate, and advanced. A computer vision-based system was selected as the delivery platform for home setting. The total SUS score for all participants was 87.22 ± 5.76, indicating the user’s perception of the usability of a system ranging from good to excellent. At the end of the 4-week training, the total PACES score was significantly greater than the baseline score, suggesting an improvement in enjoyment (pre-test score = 44.93 ± 3.99 versus post-test score = 50.53 ± 4.70, P = .001).
Conclusions:
A prototype of low-intensity, gamification-based interactive physical-cognitive training using the ADDIE model was a usable and practical approach for a home-based setting, as well as enhancing older adults’ enjoyment and motivation. The effectiveness of gamification-based training for improving both physical and cognitive health in older adults is still warranted. Clinical Trial: -
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