- Research Area:
- Pervasive Health
- In progress
- Project Leaders:
- Project Collaborators:
- Design Workshops: Older adults will be invited to collaborate with the researchers on the evaluation and design of concept exercise games.
- User Evaluations: The developed exergame system will be evaluated in small-scale user tests in community and day care centers.
- Home evaluation: This will include a parallel group randomized controlled trial with two groups of participants. Participants will use standard rehabilitation care and/ or the exergame system for 12 weeks in the home.
One of the most successful interventions for reducing the rate (and risk) of falls is the use of specially tailored exercises designed to improve strength and balance in older people. In the UK, the most commonly used exercise programmes used in community settings are based on the Otago Exercise Programme and the Falls Management Exercise Programme. The tailored exercises included in these programmes have been designed to target individual muscle groups to recover muscle strength and balance in older adults. Essentially the issue in practice is ensuring that the exercises are done regularly and with good movement quality. Certainly in the home setting, the use of home exercise booklets does not feasibly work, as motivation is very low. If exercise to improve strength and balance is to be effective there must, certainly in home dwelling older people, be a dose of at least 50 hours before which there is a definite effect on falls, rather than just an improvement in functional outcomes such as strength and balance which are known risk factors for falls. Therefore ways of making the exercises more fun, whilst also ensuring good movement quality are vital to ensure effectiveness.
Computer games and in particular serious games have received a high level of interest from researchers and health professionals alike. There are studies that have demonstrated the effectiveness of specially tailored exergames, for rehabilitation in stroke. However, there is a lack of evidence regarding the effectiveness of the use of such tailored exergames to aid the rehabilitation of fallers. To address this problem we designed and developed, in conjunction with elderly users at risk of falling, four exergames based on falls rehabilitation exercises (marching, side stepping, sit to stand and knee bends).
These games were then piloted for use in the home with a small number of fallers e.g. 8, over 12 weeks and it was found that the games encouraged greater adherence to the falls exercise programme compared to standard care. We had two groups use standard care (booklet and DVD) and a games group, the only group to maintain the prescribed number of exercise per week was the games group. Some games users performed well over the “prescribed” number of exercises as they enjoyed the games so much and in particular wanted to beat their scores. Their scores cannot increase unless they perform the movements with better movement quality and so this aids not only adherence but also correct movement technique. So, in home dwelling fallers, we have shown that the use of the exergames has increased adherence as well as significant gains in functional performance (Timed up and go, gait speed etc.).
These exergames require two sensors to be strapped to the person’s leg (to provide real time movement quality for the particular exercises) and all participants put these sensors on themselves and operated the computer system themselves with only minor problems (some were completely naïve to computers. The current project will trial a full set of 9 games in a large scale trial in collaboration with the falls service and community/ day care establishments.
Study design and methodology
The project will include a variety of mixed methods to satisfy the design, development and evaluation of the game system using a User-Centered Design process. The various methods to be employed will include:
Funder: Digital Health Institute
Project Duration: 12 months