Abstract
In recent years, with the rise of the ageing population worldwide, the health of the elderly has attracted increasing attention. This study explored existing extended reality (XR) game applications aiming at physical exercise for the elderly. Through the review of 1847 papers from the Scopus database, 17 articles were included. Based on these papers, we explored the existing contributions of exercise XR games for the elderly, the development opportunities and challenges of such games, and their special considerations in adapting to the characteristics and requirements of the target user. The results were organized into several perspectives: publication information and keywords, immersive technologies and game concepts, teamwork and social games, evaluation, opportunities and challenges, and adapting designs. We found the elderly interested in and accepted using XR games. The reported research results proved positive effects on such games’ physical and mental health. XR exercise games for the elderly should considerately adapt to the elder’s cognition, behaviour, and demand. Although problems existed, such as simulator sickness, safety risks, device problems, and cost, there were opportunities and space for research and future developments. Researchers and developers could refer to this paper for XR exercise games for the elderly and create or enhance future XR applications by learning from existing work.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Arlati, S., et al.: A social virtual reality-based application for the physical and cognitive training of the elderly at home. Sensors 19(2), 261 (2019)
Arns, L.L., Cerney, M.M.: The relationship between age and incidence of cybersickness among immersive environment users. In: 2005 IEEE Proceedings of Virtual Reality, VR 2005, pp. 267–268. IEEE (2005)
Bellei, E.A., Biduski, D., Lisboa, H.R.K., De Marchi, A.C.B.: Development and assessment of a mobile health application for monitoring the linkage among treatment factors of type 1 diabetes mellitus. Telemed. e-Health 26(2), 205–217 (2020)
Biduski, D., Bellei, E.A., Rodriguez, J.P.M., Zaina, L.A.M., De Marchi, A.C.B.: Assessing long-term user experience on a mobile health application through an in-app embedded conversation-based questionnaire. Comput. Hum. Behav. 104, 106169 (2020)
Bruun-Pedersen, J.R., Serafin, S., Kofoed, L.B.: Motivating elderly to exercise-recreational virtual environment for indoor biking. In: 2016 IEEE International Conference on Serious Games and Applications for Health (SeGAH), pp. 1–9. IEEE (2016)
Buckers, T., Gong, B., Eisemann, E., Lukosch, S.: VRabl: stimulating physical activities through a multiplayer augmented reality sports game. In: Proceedings of the First Superhuman Sports Design Challenge: First International Symposium on Amplifying Capabilities and Competing in Mixed Realities, pp. 1–5 (2018)
Cadore, E.L., et al.: Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age 36(2), 773–785 (2014)
Campbell, E., et al.: The effect of exercise on quality of life and activities of daily life in frail older adults: a systematic review of randomised control trials. Exp. Gerontol. 111287 (2021)
Campbell, T., Ngo, B., Fogarty, J.: Game design principles in everyday fitness applications. In: Proceedings of the 2008 ACM Conference on Computer Supported Cooperative Work, CSCW 2008, pp. 249–252. Association for Computing Machinery, New York (2008). https://doi.org/10.1145/1460563.1460603
Campo-Prieto, P., Cancela, J.M., Rodríguez-Fuentes, G.: Immersive virtual reality as physical therapy in older adults: present or future (systematic review). Virtual Reality 1–17 (2021)
Ceccacci, S., Germani, M., Mengoni, M.: User centred approach for home environment designing. In: Proceedings of the 5th International Conference on PErvasive Technologies Related to Assistive Environments, pp. 1–8 (2012)
Chau, P.H., et al.: Feasibility, acceptability, and efficacy of virtual reality training for older adults and people with disabilities: single-arm pre-post study. J. Med. Internet Res. 23(5), e27640 (2021)
Colcombe, S.J., et al.: Aerobic fitness reduces brain tissue loss in aging humans. J. Gerontol. A Biol. Sci. Med. Sci. 58(2), M176–M180 (2003)
Colder Carras, M., et al.: Commercial video games as therapy: a new research agenda to unlock the potential of a global pastime. Front. Psych. 8, 300 (2018)
Çöltekin, A., et al.: Extended reality in spatial sciences: a review of research challenges and future directions. ISPRS Int. J. Geo Inf. 9(7), 439 (2020)
Daskalopoulou, C., Stubbs, B., Kralj, C., Koukounari, A., Prince, M., Prina, A.M.: Physical activity and healthy ageing: a systematic review and meta-analysis of longitudinal cohort studies. Ageing Res. Rev. 38, 6–17 (2017)
Dent, E., Kowal, P., Hoogendijk, E.O.: Frailty measurement in research and clinical practice: a review. Eur. J. Intern. Med. 31, 3–10 (2016)
Deterding, S., Dixon, D., Khaled, R., Nacke, L.: From game design elements to gamefulness: defining “gamification”. In: Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments, pp. 9–15 (2011)
Devereux, N., Ellis, G., Dobie, L., Baughan, P., Monaghan, T.: Testing a proactive approach to frailty identification: the electronic frailty index. BMJ Open Qual. 8(3), e000682 (2019)
Djaouti, D., Alvarez, J., Jessel, J.P.: Classifying serious games: the G/P/S model (PDF) (2015). http://www.ludoscience.com/files/ressources/classifying_serious_games.pdf. Accessed 05 Jan 2019
Ferreira, M., Kowal, P.: A minimum data set on ageing and older persons in sub-Saharan Africa: process and outcome. Afr. Popul. Stud. 21(1) (2006)
Fu, Y., Hu, Y., Sundstedt, V.: A systematic literature review of virtual, augmented, and mixed reality game applications in healthcare. ACM Trans. Comput. Healthc. (HEALTH) 3(2), 1–27 (2022)
Fu, Y., Hu, Y., Sundstedt, V., Fagerstrom, C.: A survey of possibilities and challenges with AR/VR/MR and gamification usage in healthcare. In: 14th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC)/14th International Conference on Bio-inspired Systems and Signal Processing (BIOSIGNALS)/14th International Conference on Biomedical Electronics and Devices (BIODEVICES), pp. 733–740. SciTePress (2021)
Fu, Y., Hu, Y., Sundstedt, V., Forsell, Y.: A review of extended reality exercise games for elderly. In: 15th International Conference on Health Informatics (HEALTHINF) held as part of 15th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC), Virtual, Online, 09–11 February 2022, pp. 201–210. No. 15th International Conference on Health Informatics (HEALTHINF) held as part of 15th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC), SciTePress (2021)
Fu, Y., Hu, Y., Sundstedt, V., Forsell, Y.: Conceptual design of an extended reality exercise game for the elderly. Appl. Sci. 12(13), 6436 (2022)
Fu, Y., Hu, Y., Sundstedt, V., Forsell, Y.: A review of extended reality exercise games for elderly. In: Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies - HEALTHINF, pp. 201–210. INSTICC, SciTePress (2022). https://doi.org/10.5220/0010907800003123
Goršič, M., Cikajlo, I., Novak, D.: Competitive and cooperative arm rehabilitation games played by a patient and unimpaired person: effects on motivation and exercise intensity. J. Neuroeng. Rehabil. 14(1), 1–18 (2017)
Grani, F., Bruun-Pedersen, J.R.: Giro: better biking in virtual reality. In: 2017 IEEE 3rd Workshop on Everyday Virtual Reality (WEVR), pp. 1–5. IEEE (2017)
Hauk, N., Hüffmeier, J., Krumm, S.: Ready to be a silver surfer? A meta-analysis on the relationship between chronological age and technology acceptance. Comput. Hum. Behav. 84, 304–319 (2018)
Henrique, P.P., Colussi, E.L., De Marchi, A.C.: Effects of exergame on patients’ balance and upper limb motor function after stroke: a randomized controlled trial. J. Stroke Cerebrovasc. Dis. 28(8), 2351–2357 (2019)
Ijaz, K., Wang, Y., Milne, D., Calvo, R.A.: VR-rides: interactive VR games for health. In: Marsh, T., Ma, M., Oliveira, M.F., Baalsrud Hauge, J., Göbel, S. (eds.) JCSG 2016. LNCS, vol. 9894, pp. 289–292. Springer, Cham (2016). https://doi.org/10.1007/978-3-319-45841-0_33
Inokuchi, S., Matsusaka, N., Hayashi, T., Shindo, H.: Feasibility and effectiveness of a nurse-led community exercise programme for prevention of falls among frail elderly people: a multi-centre controlled trial. J. Rehabil. Med. 39(6), 479–485 (2007)
Jeon, S., Kim, J.: Effects of augmented-reality-based exercise on muscle parameters, physical performance, and exercise self-efficacy for older adults. Int. J. Environ. Res. Public Health 17(9), 3260 (2020)
Júnior, J.L.A.D.S., et al.: A bowling exergame to improve functional capacity in older adults: co-design, development, and testing to compare the progress of playing alone versus playing with peers. JMIR Ser. Games 9(1), e23423 (2021)
Juul, J.: Half-Real: Video Games Between Real Rules and Fictional Worlds. MIT Press, Cambridge (2011)
Karaosmanoglu, S., Kruse, L., Rings, S., Steinicke, F.: Canoe VR: an immersive exergame to support cognitive and physical exercises of older adults. In: CHI Conference on Human Factors in Computing Systems Extended Abstracts, pp. 1–7 (2022)
Keele, S., et al.: Guidelines for performing systematic literature reviews in software engineering. Technical report, Ver. 2.3 EBSE Technical Report. EBSE (2007)
Kowal, P., Dowd, J.E.: Definition of an older person. proposed working definition of an older person in Africa for the MDS project. World Health Organization, Geneva (2001). https://doi.org/10.13140/2.1.5188.9286
Lee, N., Choi, W., Lee, S.: Development of an 360-degree virtual reality video-based immersive cycle training system for physical enhancement in older adults: a feasibility study. BMC Geriatr. 21(1) (2021). https://doi.org/10.1186/s12877-021-02263-1
Lee, N., Choi, W., Lee, S.: Development of an 360-degree virtual reality video-based immersive cycle training system for physical enhancement in older adults: a feasibility study. BMC Geriatr. 21(1), 1–10 (2021)
Lee, Y., Kozar, K.A., Larsen, K.R.: The technology acceptance model: past, present, and future. Commun. Assoc. Inf. Syst. 12(1), 50 (2003)
Leonardi, C., Mennecozzi, C., Not, E., Pianesi, F., Zancanaro, M.: Designing a familiar technology for elderly people. Gerontechnology 7(2), 151 (2008)
Li, T., et al.: Cognitive training can reduce the rate of cognitive aging: a neuroimaging cohort study. BMC Geriatr. 16(1), 1–12 (2016)
Li, X., Niksirat, K.S., Chen, S., Weng, D., Sarcar, S., Ren, X.: The impact of a multitasking-based virtual reality motion video game on the cognitive and physical abilities of older adults. Sustainability 12(21), 9106 (2020)
Lindsay-Smith, G., Eime, R., O’Sullivan, G., Harvey, J., van Uffelen, J.G.: A mixed-methods case study exploring the impact of participation in community activity groups for older adults on physical activity, health and wellbeing. BMC Geriatr. 19(1), 1–15 (2019)
Mehra, S., et al.: Attitudes of older adults in a group-based exercise program toward a blended intervention; a focus-group study. Front. Psychol. 7, 1827 (2016)
Milgram, P., Kishino, F.: A taxonomy of mixed reality visual displays. IEICE Trans. Inf. Syst. 77(12), 1321–1329 (1994)
Miller, K.J., Adair, B.S., Pearce, A.J., Said, C.M., Ozanne, E., Morris, M.M.: Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review. Age Ageing 43(2), 188–195 (2014)
Moschny, A., Platen, P., Klaaßen-Mielke, R., Trampisch, U., Hinrichs, T.: Barriers to physical activity in older adults in Germany: a cross-sectional study. Int. J. Behav. Nutr. Phys. Act. 8(1), 1–10 (2011)
Muñoz, G.F., Cardenas, R.A.M., Pla, F.: A kinect-based interactive system for home-assisted active aging. Sensors 21(2), 417 (2021)
Nishchyk, A., Geentjens, W., Medina, A., Klein, M., Chen, W.: An augmented reality game for helping elderly to perform physical exercises at home. In: Miesenberger, K., Manduchi, R., Covarrubias Rodriguez, M., Peňáz, P. (eds.) ICCHP 2020. LNCS, vol. 12376, pp. 233–241. Springer, Cham (2020). https://doi.org/10.1007/978-3-030-58796-3_28
Pedroli, E., et al.: Characteristics, usability, and users experience of a system combining cognitive and physical therapy in a virtual environment: positive bike. Sensors 18(7), 2343 (2018)
PERKINSCOIE, Association, X.: 2021 augmented and virtual reality survey report (2021)
Pisan, Y., Marin, J.G., Navarro, K.F.: Improving lives: using Microsoft kinect to predict the loss of balance for elderly users under cognitive load. In: Proceedings of The 9th Australasian Conference on Interactive Entertainment: Matters of Life and Death, pp. 1–4 (2013)
Rebenitsch, L., Owen, C.: Review on cybersickness in applications and visual displays. Virtual Reality 20(2), 101–125 (2016). https://doi.org/10.1007/s10055-016-0285-9
Sakhare, A.R., Yang, V., Stradford, J., Tsang, I., Ravichandran, R., Pa, J.: Cycling and spatial navigation in an enriched, immersive 3D virtual park environment: a feasibility study in younger and older adults. Front. Aging Neurosci. 11, 218 (2019)
Sauvé, L., Renaud, L., Kaufman, D., Dupláa, E.: Can digital games help seniors improve their quality of life? pp. 179–192 (2017). https://doi.org/10.1007/978-3-319-63184-4_10
Shah, S.H.H., Hameed, I.A., Karlsen, A.S.T., Solberg, M.: Towards a social VR-based exergame for elderly users: an exploratory study of acceptance, experiences and design principles. In: Chen, J.Y.C., Fragomeni, G. (eds.) HCII 2022. LNCS, vol. 13317, pp. 495–504. Springer, Cham (2022). https://doi.org/10.1007/978-3-031-05939-1_34
Slater, M., Sanchez-Vives, M.V.: Enhancing our lives with immersive virtual reality. Front. Robot. AI 3, 74 (2016)
Taylor, L., Kerse, N., Klenk, J., Borotkanics, R., Maddison, R.: Exergames to improve the mobility of long-term care residents: a cluster randomized controlled trial. Games Health J. 7(1), 37–42 (2018)
Valenzuela, M., Sachdev, P.: Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am. J. Geriatr. Psychiatry 17(3), 179–187 (2009)
Watanabe, Y., Tanimoto, M., Ohgane, A., Sanada, K., Miyachi, M., Ishii, N.: Increased muscle size and strength from slow-movement, low-intensity resistance exercise and tonic force generation. J. Aging Phys. Act. 21(1), 71–84 (2013)
WHO: Active ageing a policy framework (2002)
WHO: Ageing and health (2019)
Wilkinson, P.: A brief history of serious games. Entertainment computing and serious games, pp. 17–41 (2016)
Yu Fu, Yan Hu, V.S.: A survey on AR/VR games for mental and physical public health. In: eTELEMED 2021, The Thirteenth International Conference on eHealth, Telemedicine, and Social Medicine. ThinkMind (2021)
Zhang, H., Shen, Z., Lin, J., Chen, Y., Miao, Y.: Familiarity design in exercise games for elderly. Int. J. Inf. Technol. 22, 1–19 (2016)
Acknowledgement
This research was funded partly by the Knowledge Foundation, Sweden, through the Human-Centered Intelligent Realities (HINTS) Profile Project (contract 20220068).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Fu, Y., Hu, Y., Sundstedt, V., Forsell, Y. (2023). A Systematic Literature Review of Extended Reality Exercise Games for the Elderly. In: Roque, A.C.A., et al. Biomedical Engineering Systems and Technologies. BIOSTEC 2022. Communications in Computer and Information Science, vol 1814. Springer, Cham. https://doi.org/10.1007/978-3-031-38854-5_17
Download citation
DOI: https://doi.org/10.1007/978-3-031-38854-5_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-38853-8
Online ISBN: 978-3-031-38854-5
eBook Packages: Computer ScienceComputer Science (R0)