The use of interactive game technology to improve the physical health of the elderly : a serious game approach to reduce the risk of falling in older people
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The elderly population is growing dramatically both in Australia and globally. With age, the human body undergoes a series of changes that can lead to decline in mental and physical health. Decline in motor functions increases the risk of developing health problems such as postural instability, balance disorders or simply having a fall. Falling is the main cause of disability and fatality among the elderly. Statistics show that one in three older adults might experience a fall every year. This could be prevented with regular exercise. Exercises with a walking component have proven to reduce falls by 40%. However, compliance with physical activity is often poor due to the mode of delivery, which is often unattractive. One approach that might help alleviate this is the use of commercial video games to engage the elderly in physical exercise. However, this practice may have undesirable results as such games are not designed to provide therapeutic support for the elderly but instead to entertain a much younger audience. This thesis aims to solve the above problem through the use of interactive game technology by testing that optimal results for the health of the elderly come from the combination of three elements: • the integration of a formal method to assess progress towards and the achievement of the desired health outcomes, • inclusion of meaningful tasks aligned with the specific health objectives • an appropriate game design through the use of user-centred design methodologies. Firstly, literature in the area of video games with health purposes for the elderly is reviewed to develop a clear understanding of the health issues and the research opportunities in the area. Secondly, a series of game prototypes is built and tested to investigate whether off-the-shelf game technology can be used to reliably perform a clinical test for fall risk assessment. Then a game is developed that aims to reduce the risk of falling by training a set of specific cognitive and physical functions that have been shown to be associated with falling. This prototype, known as the StepKinnection game, integrates the concept of an appropriate game design for the elderly, inclusion of meaningful tasks and the collection of stepping performance data. Thirdly, a series of studies on independent-living people aged 65 years and over are conducted. These studies confirmed the ability to reliably perform a clinical test using off-the-shelf game technology, the acceptance and ease of use of the StepKinnection game, and the potential of StepKinnection to reduce the risk of falling in the elderly. Finally, an analytical framework is developed for designing interactive games with health purposes for the elderly. This framework aims to assist the development of games aligned to particular health outcomes. This framework emphasises the importance of aligning the game goals to the expected health outcomes as well as the continuous assessment of progress and effectiveness.
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