Persuasive technologies like exergames combine physical activity (PA) and exercise. Full-body movement exergames lead to behaviour change such as overcoming sedentariness and repeating activities, increased engagement, and participation in physical activity on the part of older adults’ due to gesture-based interactions (Mandryk, Gerling, & Stanley, 2014). Gestures for selection and moving a cursor on the screen in place of mouse actions helped older adults in simplifying certain actions, encouraging physical activity and allowing for easier repetition of actions. The attitudes of older adults towards gesture-based interaction have changed, because of the presence of new products like the Nintendo Wii Remote and the Microsoft Xbox Kinect sensor. The performance and acceptance of freehand gestures through a variety of techniques were investigated in a study of 24 older adults that particularly looked at performance issues of several implemented freehand gesture techniques related to the control of a TV menu (Bobeth, Schmehl, Kruijff, Deutsch, & Tscheligi, 2012). This study explored gesture-based TV control methods instead of a standard hand-held remote to investigate controlling the TV through gestures as a form of physical activity. Transferring tracked hand movements to control a cursor on a TV was shown to be a positive approach for older adults (Bobeth et al., 2012). However, we still do not know whether full-body gestures as a way of interaction would increase the cognitive load on older adults because they would have to remember more items. In digital games, we need to prioritize capability before mechanics to make games more accessible to a larger audience, including older adults (Gerling, Livingston, Nacke, & Mandryk, 2012). Meanwhile, robot games encouraging older adults to imitate movements of a mobile robot have developed into a persuasive tool for promoting PA among older adults (Hansen, 2011). This study investigated the learning of a robot and its adaptability to older adult players with differing degrees of challenged mobility. Changes in the interactions between older adults and the mobile robot, the former using required assistive tools such as crutches, wheelchairs, or walkers also provided information on play styles. Adaptable gameplay and controls, as well as adjustable calibration parameters in digital games for physical therapy, were found to be critical in developing games for older adults with motor disabilities (Geurts et al., 2011).
Improved sense of physical, social and psychological well-being in older women resulted from the use of Nintendo Wii video games because of increased confidence in using technology, the benefits of improved connectedness with family members, and positive changes to their self-image (Wollersheim et al., 2010). Feedback on gesture-based games features higher ratings for physical well-being among older adults because of the intuitiveness of the games, the ease of the gestures themselves, and the increased movement demanded by the games (Rice et al., 2011). Studies using Nintendo Wii Fit Balance Board games indicated improvements in balance among older adults (Young, Ferguson, Brault, & Craig, 2010). The independently created SilverBalance exertion game using the Nintendo Wii Fit Balance Board reported positive engagement and enjoyment amongst older adults because of improvements in self-efficacy and the perception of the game’s user-friendliness (Gerling, Schild, & Masuch, 2011).
Encouraging older adults to participate in physical activity through persuasive technology interventions provides the additional benefit of being able to track user activity. One study showed that overcoming sedentary lifestyles can be achieved through systems like UbiFit Garden (Consolvo et al., 2008) where the authors used on-body sensing and machine learning to track physical activity. The authors incorporated rewards and tracking functions to encourage older adults to participate in physical activity. A separate study (Albaina, Visser, van der Mast, & Vastenburg, 2009), used Flowie, a persuasive virtual coaching game, to encourage physical activity in the elderly by encouraging them to walk using motivational cues. Other researchers (Fan, Forlizzi, & Dey, 2012) found that overcoming barriers to physical activity through technology interventions must support the needs of older adults. The authors identified awareness of personal limitations, social motivation, establishing and adapting to routines, and finding enjoyable activities to be four consistent themes that technology interventions could address to help older adults overcome barriers to physical activity. SilverPromenade, a custom-video game which simulated real-life activities indicated that the simplicity of games and interactions are key drivers when designing for cognitive and physical limitations of older adults (Gerling, Schulte, Smeddinck, & Masuch, 2012). One study found that social exergaming was an effective strategy to engage older adults in physical activity, and helped to reduce loneliness by promoting social interaction (Brox, Fernandez-Luque, Evertsen, & González-Hernández, 2011).
By the same token, persuasive technology games can be used as interventions to treat cognitive challenges therapeutically. Some of the many examples of this genre are games for people with dementia (Astell, 2010), games to enhance brain fitness in senior citizens (Baecker et al., 2010), games used to understand social disengagement (Bassuk, Glass, & Berkman, 1999), and games used to improve social interactions (Casey, Kirman, & Rowland, 2007). Exergames which combines PA and gaming technology (Juho Hamari & Koivisto, 2015; Kappen, Mirza-Babaei, & Nacke, 2017), a form of persuasive technology (Chen, King, & Hekler, 2014; J Hamari, Koivisto, & Pakkanen, 2014) also helped with temporary improvements in concentration (Gao & Mandryk, 2012). While the above have contributed to behaviour change strategies in influencing older adult’s PA, I examined gamified PA interventions from the standpoint of Theory of Planned Behaviour (Ajzen, 2015; Motalebi, Iranagh, Abdollahi, & Lim, 2014) and SDT (Ryan & Deci, 2000) to deconstruct the gamification layer in the design of these technology artifacts. The next section discusses the theoretical construct of gamification and associated terminologies.
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