Design of Exergames for Older Adults
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This document discusses the design of exergames to promote physical activity for older adults. It describes four iterations of an action research study to test exergame designs with older adult participants. The goal was to design games that adapt to participants' varying physical capabilities and promote social engagement. Key lessons learned include the need to classify players based on physical abilities and adapt gameplay accordingly, use cooperative rather than competitive gameplay, and design for spectators to encourage participation. Future work involves further refining classification of players and developing prototype exergames that apply these design principles.
![Characteristics of Healthy Elder
They natural decay, diseases and
physical dependence do not lead to a
major impediments to perform daily life
activities
Great heterogeneity in functional
condition among peers
Functional decay often is accelerated
as result of depressive states and
sedentary lifestyle.
Muscular disuse slows the
neuromuscular response, reduces
strength in movement and loss of balance.
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Design of Exergames for Older Adults
- 1. Design of Exergames with the Collaborative Participation of Older Adults
- 2. Characteristics of Healthy Elder They natural decay, diseases and physical dependence do not lead to a major impediments to perform daily life activities Great heterogeneity in functional condition among peers Functional decay often is accelerated as result of depressive states and sedentary lifestyle. Muscular disuse slows the neuromuscular response, reduces strength in movement and loss of balance. [1]
- 3. General Characteristics of the Elderly PHYSICAL ASPECTS PSYCHOLOGICAL-AFFECTIVE ASPECTS (Alba et al, 2001; Glanz et al, 2008; Wilson-Escalante et al,2009; INGER,2010) 3
- 4. Social interaction among elder’s gamers Metaphors Roles emerged from game structure Rhetoric Roles brought into the game from outside Friendship Fellowship [2,3,6,7,8,9]
- 5. Methodology
- 6. Requirements analysis Summary: The exercise -Should not cause harm or pain -The exertion must be controlled -It has to produce a benefit, avoiding fatigue -It must be based on physical capacity -There should be a design of an exercise baseline -There should be goals and progress differentiated by level of capacity
- 7. Preferences and issues (older adults)
- 9. Iteration 1. Social Behavior Observe gamer’s engagement and classify them based on their level of participation Some elders have tendency to isolate themselves Group support is not enough to engage all participants Easy metaphors facilitate elder effectiveness Peer’s effectiveness is perceived as “easy to play” More movement increases social participation Replace pictorial instructions with mimics of movements Promote that more skilled games helps to less skilled ones. Integrate observers to playground area. Entrance Action planning Intervention Evaluation
- 10. Iteration 2. Exertion perceived Analyze motion promoted in game interface and provide with new facilitators movements to gamer Provide facilitators movements to less skilled gamers increase movement level in games selected Human instructing increases the number of active gamers. Few active gamers were highly participatory. Physical limitations implies more time to control the gameplay Designed facilitators movements, modify playground area to teach these movements and promote coach figure Entrance Action planning Intervention Evaluation
- 11. Iteration 3. Effectiveness Classify gamers’ motion capacity using enabled elements in game design and adequate the gameplay based on the classification Is necessary re build metaphors using a rhetoric adequate for each level of motion capacity. There was no more passive players. The group’s clustering helps to identify adequate motion, risk and tiredness during game time. However some gamer seems ashamed with their low performances Evaluated the functional capacity using joint’s arcs of motion and a simple test of balance. The group was clustered in four subgroups and for each cluster were re expressed the movements Entrance Action planning Intervention Evaluation
- 12. Iteration 4. Social Game Include new warm up session Use simple casual games to improve performances Provide continuous feedback about bad practices Change peer to peer challenges by group challenges. Use cooperative play rather than competition. Leveling gamers lets hide low performances Highly engaged group with exergames. Efficacy in game improves social interaction. The gamers feels more confident with their motion. Leveling scores using handicaps. Replace individual scores for group scores. Use a cooperative gameplay rather individual competition Diagnosis Action planning Intervention Evaluation
- 13. Adaptability
- 14. Conclusions • We presented a long-term case study applying the Action Research methodology • The exergames’ design makes compete all gamers under the same conditions supposing than all gamer all needs is time and practice • The gesture detection needs to take into account the gamer mobility capacity classification and adapt the gameplay to this context • Cooperative gameplay and a the design oriented to spectator increases the game engagement
- 15. Future work • Define a player classification based on joint’s arcs of movements, a simple balance test and speed of neuromuscular response • Design gameplay adaptability and develop a prototype of an exergame for older adults using this classification • Establish design principles for cooperative play and observer-oriented design of exergames
- 16. Thanks for your attention
- 17. References • [1] C. Hall, L. Brody, Terapheutic exercise moving toward function • Editorial Paidotribo, 2006. • [2] J. Madrigal, Benefits in the quality of life of women between 50 and 81 years of age participating in a group physical recreation program in Journal Education, 34(2), pp. 111- 132, July-December 2010. • [3] D.A. Leiberman, B. Chamberlin, E. Medina, The Power of Play: Innovations in Getting Active Summit 2011: A Science Panel Proceedings Report From the American Heart Association. Circulation.;123:1–10, 2011. • [4] J. Garcia, K. Felix, E. Lawrence, Serious Games to Improve the Physical Health of the Elderly: A Categorization Scheme. CENTRIC 2011; The Fourth International Conference on Advances in Human oriented and Personalized Mechanisms, Technologies, and Services, • pp. 64-71, October 2011. • [5] T. Campbell, B. Ngo, J. Fogarty, Game Design Principles in Every Fitness Applications. CSCW2008 Proceedings of the 2008 ACM conference on Computer Supported Cooperative Work, pp. 249-252, • 2008. • [6] A. Voida, S. Greenberg, Wii All Play: The Console as a Computational Meeting Place. CHI 2009 New gaming expiriences, pp. 1559-1568, April 2009. • [7] D. Harley, G. Fitspatrick, L. Axelrod, G. White, G. Mc Allister, Making the Wii at Home: Game Play by Older People in Sheltered Housing. USAB’10 Proceedings of the 6th international conference on HCI in work and learning, life and leisure: workgroup humancomputer interaction and usability engineering, pp. 156-176, 2010 • [8] E. Brox, L. Fernandez-Luque, T. Tøllefsen, Healthy Gaming – Video Game Design to promote Health. Appl Clin Inf 2011; 2: 128–142, 2011. http://dx.doi.org/10.4338/ACI- 2010-10-R-0060 • [9] R. Koster, A Theory of Fun for Game Design. Scottsdale: Paraglyph. 2004. • [17] R. Davison, M. Martinsons, Principles of canonical research in Journal Information Systems, 6, January 2004.
Notes de l'éditeur
- My name is…. I present the paper entitled …
- This is a Human Computer Interaction study ... aimed to identify principles of design for older adult´s exergames, videogames that promotes…, and provide element that lets a collaborative work among player-game-medical specialist…. In this sense the exergame must be able to adapt its movement interaction to provide an adequate benefit for the older adult gamer. Without the direct intervention from therapist whilst are played… Besides preserving the fun elements in game for an older adult gamer… And providing a benefit for them.
- Alba plantea que debido a los cambios en la vejez se promueve una inseguridad en el movimiento esta inseguridad lleva al desuso y deterioro de cierta parte del cuerpo, Wilson-Escalante proporciona evidencia que la pérdida de la actividad física recreativa produce estados depresivos no patológicos. Condición que finalmente incide en enfermedades, depresión y aislamiento social. lo que establece la relevancia de promover la reactivación física del adulto mayor y proveerle de herramientas que faciliten este proceso. (20 segs.) (0:00:56)
- From HCI perspective .. Exergames are designed using rhetorics and metaphors to express motion promoted and relate it with well known elements for the gamer… Outcome of use these elements … the exergame promotes that the gamer plays roles inside the game … These roles emerged form movement interface itself and are used to promoted and exertion whilst other brought into the game are less utilized in game interaction.
- In our methodology we divided the study in 3 phases, In the first one we … In the second And in the third we applied Action Methodology to answer our research questions and solve user’s specific problem playing exergames
- In the first phase we conducted 18 long interviews with specialists. We used a semi structured interview containing 61 questions that gave us a perspective of all the elements to take into account from specialist perspective Using grounded theory we obtained all the considerations about the use of exergames with older adults and summarized in the topics shown in the slide.
- In the second phase we designed a first intervention with healthy older adults that never has played videogames before and using exergames specially selected for them taking into account all the specialist considerations. We found The way that the movement is expressed can be frightening for the elderly … This respond more to a design tendency than a physical problems to play The observer role is relevant and must be included in someway in the game interaction The exergames have a lack of elements to evaluate how the gamer mobility capacity really affects the interaction with the game There are physical problems to solve but this problematic subsist even with low
- Action Research is incremental iterative spiral process used from used in academic improvement research. We applied Action Research in its canonical form. Action Research is defined as a iterative spiral process, where researchers and users works together identifying and diagnosing several generic problems (entrance). Based on this diagnosis the actions and interventions are planned, implemented and evaluated. In this way the outcome in the last iteration is a new entrance for the next, in this way at the end of this process the researcher is closer to have a good view of relevant elements for his research and solutions for several users’ problems.
- The third phase had a duration of 6 months. In the first iteration was addressed the problem that some elders have the tendency to insolate themselves After differentiate among active and less active players, we can observe how training the gamers using pictorial instructions was a barrier for everyone, then we decided replace this method for mimic instruction and include observers in the playground. easy metaphors facilitate gamer engagement with the game but the way that is expressed the movement inhibit some participants even when they feel that is easy to play And in the other hand high intensity games increases the social interaction substantially So is necessary found ways to maintain the intensity in the game without intimidate the gamer.
- We decide use more demanding exergames to increase the social interaction We include the coach role, making that less skilled gamers helped to more skilled ones. We found that the exergames are designed supposing that any gamer increases his abilities just with time and practice. Is not necessarily true, because the movement interface promotes that gamer makes movements causing the opposite effect A role played for the therapist is provide adequate movement, in our intervention we use the facilitators movements, those that the gamer use to achieve his performance. However, virtually no elements are considered from the context of mobility capacity and no adaptations are made during play time to adapt the gameplay to gamer’s characteristics. In some cases the way that the movement is expressed (the rhetoric) implies efforts beyond older adult´s mobility capacity, and even in low intensity exergames the older adult require a longer time to get control over the gameplay. The problem is the exergames gives a continuous negative feedback about gamer’s performance along this time.
- For the third iteration we found that although all the older adults in the group were evaluated as healthy elders, there was significantly differences in mobility capacity, especially in lower limbs. Two evaluations were performed using the Kinect sensor: measurement of the joint’s active arcs of movement and a simple balance test. With these outcomes we clustered the group in 4 subgroups identifying real or own perceived limitations. For each of these subgroups the movement was redesigned taking into account their specific characteristics. For instance, the running rhetoric were re-expressed as a kind of march for G1 (more skilled gamers); for G2 we reduce the intensity in the march and with a lower rise of knees; for G3 we focus the gamer attention to rise his ankles; and finally for G4 we asked move the body center of mass from one leg to another. Applying these modifications all of them started to play.
- We observed that less skilled gamers look ashamed with their performances. we change the individual challenges by cooperative gameplay, implementing new ways to evaluate the performances. The medical specialist provide lines of exercise for each level of capacity, that were used to adequate the movement and improve the gamers efficiency. These same elements were used by the therapist to improve some physical aspects whilst the exergames were played, we adequate a new section where the specialist provide continuous feedback for each player.
- Based in these results we propose a model of adaptability based on 4 principles. Morphofunctional: the exergame requires identify mobility capacity and adapt the gameplay to it. The measurement of joint’s arcs and the practice of a simple test of balance provide good insights. A line of exercise must be provided for each level of mobility taking into account that a lower neuromuscular response requires reduce intensity of motion, a low speed, and adequate metaphors and feedback. Effectiveness: elders requires a longer time to engage with the game. Provide tips to increase the game effectiveness, design a user interaction taking into account the observer too. Include new elements like mimic demonstration and coach role inside the game design. Unlike others kind of gamers the older adult requires focus their attention in effective movements, use simple metaphors and improve feedback including other senses besides visual interaction. Risk-Tiredness high intensity exercise is not adequate in an exergame for older adults. Think in an effort centered in maintain the capacity to perform the daily life activities. Use casual games to retrain, encapsulate group interactions in short turns of 1-2 minutes by gamer , and give chance to socialize among turns. Think that the mobility capacity play the role of a threshold and have no sense encourage the gamer to increase the intensity of movement beyond that limit, for an older adult the effort to realize some movement may represent big exertion whilst for another not. Use the classification of gamers during playing time to control this elements. Think that this circumstances tend to decline not to improve with the time. Think that these games improve the social interaction then prefer design oriented to group interaction and include cooperative gameplay. Design scores and turns to play for a group interaction.