Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy
Maroni, Nina Skjæret; Nawaz, Ather; Morat, Tobias; Schoene, Daniel; Helbostad, Jorunn L.; Vereijken, Beatrix
Peer reviewed, Journal article
Permanent lenke
http://hdl.handle.net/11250/2382093Utgivelsesdato
2015Metadata
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Originalversjon
International Journal of Medical Informatics 2015, 85(1):1-16 10.1016/j.ijmedinf.2015.10.008Sammendrag
Background: There has been a rapid increase in research on the use of virtual reality (VR) and gaming
technology as a complementary tool in exercise and rehabilitation in the elderly population.
Although a few recent studies have evaluated their efficacy, there is currently no in-depth
description and discussion of different game technologies, physical functions targeted, and safety
issues related to older adults playing exergames. Objectives: This integrative review provides an
overview of the technologies and games used, progression, safety measurements and associated
adverse events, adherence to exergaming, outcome measures used, and their effect on physical
function. Methods: We undertook systematic searches of SCOPUS and PubMed databases. Key
search terms included “game”, “exercise”, and “aged”, and were adapted to each database. To be
included, studies had to involve older adults aged 65 years or above, have a pre-post training or
intervention design, include ICT-implemented games with weight-bearing exercises, and have
outcome measures that included physical activity variables and/or clinical tests of physical function.
Results: Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and
intervention designs and mostly focused on community-dwelling healthy older adults. The majority
of the studies used commercially available gaming technologies that targeted a number of different
physical functions. Most studies reported that they had used some form of safety measure during
intervention. None of the studies reported serious adverse events. However, only 21 studies (35%)
reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only
seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical
measures of balance were the most frequently used outcome measures. PEDro scores indicated that
most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out
of 10. Several studies found positive effects of exergaming on balance and gait, while none reported
negative effects. Conclusion: Exergames show promise as an intervention to improve physical function in older adults, with few reported adverse events. As there is large variability between
studies in terms of intervention protocols and outcome measures, as well as several methodological
limitations, recommendations for both practice and further research are provided in order to
successfully establish exergames as an exercise and rehabilitation tool for older adults.