5 minute read
Exergaming A new approach to health and wellness
from In-SPHERE March 2024
by IN-SPHERE
At the intersection of technology and health, exergaming stands out as a promising way to promote physical activity while providing an engaging and entertaining experience. Two research studies have shed light on its potential to transform health outcomes, particularly in falls prevention for older adults and promoting physical activity during pregnancy.
Falls Prevention Study
Led by Dr Daina Sturnieks, Senior Research Scientist at NeuRA and Senior Lecturer at UNSW Medicine & Health, a five-year randomised controlled trial investigated whether exergaming could prevent falls in older individuals. With falls being a significant concern among the elderly, finding engaging ways to improve balance and reduce fall risk is crucial.
The study recruited 769 people aged 65 -95 years, living independently in the community. They were divided into three groups: two intervention arms, one involving balance challenge exercises and the other involving brain training exercises, and a control group. The primary outcome measured was the rate of falls over 12 months, while secondary outcomes focused on understanding the training effects on physical and cognitive functions.
“We designed this trial because we know you can prevent falls in people living in the community quite well with exercise, in particular with balance challenging exercises but the problem is the low adherence rate to many exercise programs,” explains Dr Sturnieks.
“So, we designed step training exergames as a fun exercise program that challenges balance and cognition and potentially prevents falls.”
Taking cues from the 1998 video arcade sensation Dance Dance Revolution, Daina’s research team devised smart±step, an innovative system comprising eight interactive games that can be played either in a seated position using a touchpad or by engaging with target panels on a mat.
“We aimed to make exercise enjoyable by gamifying the experience, which also allowed us to incorporate cognitive challenges aimed at training the cognitive functions associated with fall risk,” Dr Sturnieks added.
“Previous studies have demonstrated that cognitive training interventions can enhance physical functions like gait and mobility. However, no one had investigated whether cognitive training alone could prevent falls, which led to the inclusion of the second intervention arm.”
The results were promising, showing a significant reduction (26%) in the rate of falls in the exergame training group. Despite the brain training group not showing significant benefits on the primary outcome, subgroup analyses revealed promising results, particularly among individuals with a history of falls.
Statistics highlight the urgency of such interventions. In people aged 65 years, one in three will fall each year, while for those over 80, it increases to one in two falls annually. This demographic is particularly vulnerable, with a higher risk of injury, fractures, and even death resulting from falls.
“Falls are the leading cause of injury-related hospitalisations in older people and the leading cause of injury-related death in older people. We spend far more money in hospitals each year on falls than on motor vehicle injuries,” explains Dr Sturnieks.
“The fact that we have an ageing population means the issue of falls is getting worse.”
Dr Sturnieks has conducted other studies on using exergaming in diverse populations, including those with medical conditions such as MS and Parkinson’s disease. She is currently looking at how exergaming can be used to help people who have developed peripheral neuropathy after chemotherapy.
Implementing the system
The future implementation of the smart±step system for falls prevention holds great promise. Although the system is not yet available for commercial purchase, there is significant interest, with over 1000 individuals eager to acquire it. Additionally, one aged care provider has already installed the system in 25 facilities nationwide, indicating a growing recognition of the potential of interactive gaming technology in promoting health and wellness.
Improving physical activity in pregnant women by exergaming
In another study focusing on the feasibility of exergaming during pregnancy, UTS PhD candidate, Gemechu Kumera, explored its potential to promote physical activity among expectant mothers. With only three in 10 pregnant women in Australia meeting physical activity guidelines, finding ways to encourage exercise during pregnancy is crucial for women’s health. One such potential innovative approach may be exergames, emerging technologies designed to encourage physical activity in an engaging and entertaining manner, requiring physical activity as part of gameplay. With this in mind, the study aimed to evaluate the feasibility, potential efficacy and acceptability of home-based exergaming programs tailored for pregnant women.
The exergaming program was designed by a team with multidisciplinary expertise, in accordance with physical activity guidelines for pregnant women. The suitability and safety of exergame exercises for pregnant women was evaluated using an expert’s heuristic evaluation. Based on this initial exploratory work, the team developed exergame programs tailored specifically for pregnant women. A pre-post testing design was employed to investigate the feasibility and potential efficacy of the exergame programs. Thirteen women followed the exercise program from 16 weeks gestation to birth. A qualitative study was adopted to explore women’s views and experiences of exergaming during pregnancy at the end of the intervention (near birth).
“The study findings demonstrated that the exergaming program has the potential to increase physical activity levels in pregnant women safely,” said Gemechu.
Results also indicated that exergaming was enjoyable, motivating, and convenient for pregnant women, especially those with other children at home or facing inclement weather conditions. Qualitative feedback highlighted its potential to overcome barriers to exercise during pregnancy, making it a valuable tool for promoting maternal and foetal well-being.
As researchers continue to explore exergaming’s potential in diverse populations, the future of health and wellness looks increasingly intertwined with interactive gaming technology. With ongoing efforts to make exergaming more accessible, it holds promise for transforming how we approach physical activity and preventive healthcare.
Gemechu was supervised by the co-lead of SPHERE’s Maternal & Women’s Health Clinical Theme, A/Prof Deborah Fox, together with Prof Rob Duffield, Dr Jaime Garcia and Ms Justine Salisbury.
