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GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS 
GameUp project is cofunded by the AAL Joint Programme (AAL...
Page 2 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
ARE SERIOUS GAMES PROMOTING 
MOBILITY AN ATTRACTI...
Page 3 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Context 
Percentage of the 
population over 65 in...
Page 4 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Recommendations 
• Adults > 65 should practice ae...
• Valens Rehabilitation Clinic had already positive experiences 
manipulation of the Nintendo Wii® console (Wollersheim et...
Page 6 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Study objectives 
• To determine whether elderly ...
Page 7 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Study design 
• single blind, randomized controll...
hampering the practice of 
computer-based games. 
Page 8 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS ...
Page 9 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Bias reduction 
• Stratification: participants ar...
Page 10 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Study flow 
Project Number: AAL-2011-4-090 AAL F...
Page 11 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Outcome measures 
1. Primary outcome: 
Intensity...
Page 12 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Measurement methods - 1 
• pro forma logbook 
Pr...
• Falls Efficacy Scale measures the subjective level of 
Page 13 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR C...
Page 14 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Measurement methods - 3 
• ActiGraph Mobility Tr...
Page 15 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Time flow of interventions 
Entry 
1 day 
after ...
Page 16 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Level 1 self-training 
• Berg Balance Scale scor...
Page 17 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Level 2 self-training 
• Berg Balance Scale scor...
Page 18 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Level 3 exercises 
• Berg Balance Scale score = ...
Page 19 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Discussion 
• To our knowledge this study is the...
Page 20 
GAME-BASED MOBILITY TRAINING AND MOTIVATION OF 
SENIOR CITIZENS 
Thank you very much 
for your attention 
Questio...
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are serious games promoting mobility an attractive alternative to conventional self-training for elderly people?

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Presentation of the use of exergames in rehabilitation

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are serious games promoting mobility an attractive alternative to conventional self-training for elderly people?

  1. 1. GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS GameUp project is cofunded by the AAL Joint Programme (AAL-2011-4-090) COFUNDING PARTNERS
  2. 2. Page 2 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS ARE SERIOUS GAMES PROMOTING MOBILITY AN ATTRACTIVE ALTERNATIVE TO CONVENTIONAL SELF-TRAINING FOR ELDERLY PEOPLE? VIVIANE HASSELMANN MAS PT, PETER OESCH, PhD PT Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  3. 3. Page 3 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Context Percentage of the population over 65 in Europe in 2010 Based on data from the CIA World Factbook. Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  4. 4. Page 4 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Recommendations • Adults > 65 should practice aerobic physical activity for at least 150 minutes of moderate intensity or 75 minutes of high intensity per week (WHO, 2010) However, the compliance of elderly people to execute self-exercise programs varies considerably. These programs are often • Self-training programs: prematurely stopped. – improve significantly physical capacities, likewise therapist-assisted sessions (Olney, Nymark et al., 2006). (Phillips, Schneider et al., 2004; Burdea, 2002; Robertson et al., 2010; Rego et al., 2010). – serve as a proven efficient and cost-effective mean for inpatient rehabilitation settings. Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  5. 5. • Valens Rehabilitation Clinic had already positive experiences manipulation of the Nintendo Wii® console (Wollersheim et al., 2010; Theng et Page 5 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Background with the use of serious games promoting mobility. • In a feasibility study, stroke patients were highly motivated to use Nintendo Wii® for training balance (Schnurr and Oesch, 2012). • However, some constraints and difficulties arose during the al., 2009; Anderson et al, 2010; Chao et al., 2013). Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  6. 6. Page 6 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Study objectives • To determine whether elderly people in rehabilitation setting show higher adherence to self-exercise programs when using computer-based games than when performing conventional exercises. • To analyze mobility improvement according to the mode of exercising. Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  7. 7. Page 7 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Study design • single blind, randomized controlled trial with two parallel-groups (conventional self-training exercises vs exergame self-training exercises). • double-site conducted study Valens Rehabilitation Clinics (Switzerland) O+Berri Instituto Vasco de Innovacion Sanitaria (Spain) Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  8. 8. hampering the practice of computer-based games. Page 8 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Participants’ inclusion Inclusion Criteria • + 65 years old. • Ability to walk independently over 20 meters, with or without walking aids. • Self-training prescribed by the doctor. • Informed signed consent form. Exclusion Criteria • Cognitive impairment (MMSE score <26). • Other limiting disorders Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  9. 9. Page 9 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Bias reduction • Stratification: participants are stratified in 4 groups according to their balance capacities (Berg Balance Score ≤ 44 or ≥ 45) and according to their computer skills (computer experience yes or no). • Randomization: Within the strata, patients are randomly assigned to one of the 2 groups (intervention vs control) with Microsoft Excel. • Single blinding: examiner is not informed of the group allocation. Independent dynamic mobility measurements. Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  10. 10. Page 10 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Study flow Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  11. 11. Page 11 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Outcome measures 1. Primary outcome: Intensity of the performed self-training program is collected in a logbook during the whole intervention phase. • frequency (quantity in number of sessions) • duration (time in minutes) of self- training sessions 2. Secondary outcomes: Mobility capacities are tested at pre- and post-intervention. • The Berg Balance Scale (BBS) • self-perceived Fall Efficacy Scale (FES-I) • ActiGraph Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  12. 12. Page 12 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Measurement methods - 1 • pro forma logbook Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  13. 13. • Falls Efficacy Scale measures the subjective level of Page 13 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Measurement methods - 2 • Berg Balance Scale measures the objective balance capabilities of the patient. It also serves as baseline for the exercise level. It tests the ability to keep balance in various standard activities (Berg et al., 1992). concern about falling during social and physical activities (Lomas-Vega et al., 2012; Dias et al., 2006). Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  14. 14. Page 14 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Measurement methods - 3 • ActiGraph Mobility Tracker assesses mobility by a tri-axial accelerometer measuring Local Dynamic Stability (Wollerheim et al., 2010). • It has been advocated as an early indicator of risk for falls (Hilfiker et al., 2013). Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  15. 15. Page 15 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Time flow of interventions Entry 1 day after entry 2 days for instructions Week 1 Week 2 1 2 3 4 5 6 7 8 9 10 End I 1 I 2 I 1 I 2 Test 1 T1 T2 Check inclusion criteria Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014 Test 2 Serious games promoting mobility Conventional self-training Logbook (from day 1 to day 10)
  16. 16. Page 16 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Level 1 self-training • Berg Balance Scale score < 45 • Exercises performed in sitting position Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  17. 17. Page 17 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Level 2 self-training • Berg Balance Scale score between 45 and 56 • Exercises performed in standing position Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  18. 18. Page 18 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Level 3 exercises • Berg Balance Scale score = 56 • Exercises performed in standing and walking Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  19. 19. Page 19 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Discussion • To our knowledge this study is the first to compare conventional self-training programs with serious games among elderly persons. • Results of this study will provide insight into the effectiveness of serious games promoting mobility and contribute to our understanding of the motivational potential of serious games in elderly people. Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014
  20. 20. Page 20 GAME-BASED MOBILITY TRAINING AND MOTIVATION OF SENIOR CITIZENS Thank you very much for your attention Questions? Project Number: AAL-2011-4-090 AAL Forum Bucarest September 2014

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