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Co-design, Social
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Progress - Exergaming

Publication - Exergaming

Contact - exergaming

Motivation for exercise and maintaining a stable level of activity is a vital component, but often it is the ‘Achilles heel’ of exercise and activity. Elements of competition, setting personal goals and social interaction are strong motivators to be active, both in the young and old, healthy or diseased. The connection between the older and the younger generations is not always easy due to lack of mutual interests, distances or busyness. Exercise is an important self-care behavior and is related to mortality in heart failure (HF). It is not always easy for patients to start exercising in the conventional ways (rehabilitation center, fitness club). Virtual reality might be a solution to increase exercise in the home environment. Virtual reality is a technology that allows the user to interact directly with a computer- simulated environment. The Wii, a video game console made by Nintendo, uses virtual reality where people of any age have the opportunity to exercise. It is conceivable that computer-based rehabilitation programs could be developed using current, widely available, affordable virtual reality platforms, such as the Nintendo Wii.

Aim: To determine the effectiveness of using a Wii game computer in older persons with HF to improve their exercise capacity, daily physical activity, decrease health care use and improve quality of life.

Method: This study contains two elements:

1. HF-Wii study

A multicenter RCT design with an intervention and a control group, in total, 300 persons with HF in Sweden and 300 patients from Italy, Israel and the Netherlands will be performed to test the effects of the Wii game computer to increase daily activity among older persons with HF. Persons with HF are randomized into attention control (control) or structured access to a Wii game computer (Wii). After 3 months we will analyze if the exercise capacity as determined by the six-minute walking test improved more in the Wii group compared to the control patient. We also will measure daily physical activity, health care use (hospitalizations, institutionalization in nursing homes) and quality of life.

2. The virtual national Swedish bowling competition

Using the format of the National Senior League, recreational competitions will be organized, starting on a local level. Teams consisting of four bowlers will be brought together and play one competition game a week in their own environment setting (e.g. sheltered living, retirement, community home). The setting will have access to a game computer and a virtual “coach” will be assigned to the setting to manage the play and post the scores on a gaming website. The website will contain all the participating teams, short descriptions of each player, competition schedule, the scores and standings. If the regional competition is a success, national and international bowling competitions will be organized.

Impact:  It is evident that our more traditional approaches to motivate people to stay active are not successful in all patients and therefore we have to look around and creatively use existing tools and interventions to apply in a ‘new’ population. This project will strengthened evidence base on the effects of using exergames in older cardiac patients. The intervention may improve physical function and independence in daily activities of patients with other long-term illnesses as well as the interaction between patients, their relatives and others, facilitating more inclusion in active society.

What is new:  Although gaming is extremely popular among the young, the potential has not been fully considered in older persons with long-term illness. A novel approach is to use a virtual medium to contact others and be active ‘together at distance’.