Motivation/ Background

Current research indicates that physical activity levels are low across various care settings/ facilities, with studies suggesting minimal variations in both volume and intensity of physical activity (Mc Ardle et al., 2021). On the other hand, insufficient physical activity and exercise training is associated with a more rapid decline in motor function and, in the long term, decline in activities of daily living  (Buchman et al., 2007). Depending on the age of care-receiving residents and the specialization of the facilities (i.e., assisted living, nursing homes, residential care), between 51% and 75% of residents have dementia (Schäufele et al., 2013). Studies suggest a potential necessity to tailor physical activity interventions to the specific needs and requirements of individuals with dementia. This could include modifying exercise intensity, frequency, or task selection based on the individual's baseline physical and/ or cognitive performance (Barisch-Fritz et al., 2022). Moreover, physical activity for older adults and the corresponding technology can enhance various additional benefits of sport such as emotional wellbeing (Gerling et al., 2012).

Study design/ approach

The exergame "Nintendo Ring Fit Adventure" offers the opportunity to combine individualizable conditions with an appealing game environment. Before a longer-term intervention study can be designed, it is critical to examine whether this exergame and its individualization function can be applied for providing nursing home residents access to physical activity and training. A first study showed that Nintendo Ring Fit Adventure is feasible to be used with community-dwelling older adults, and may be effective to enhance predictive balance tasks (Chan et al., 2023). To the best of our knowledge, no study has been conducted among nursing home residents.

In terms of technology acceptance, it is known that the use of technology by older people is influenced by lack of experience, fear and lack of understanding (Künemund, 2015). The specific needs and challenges of people in nursing homes in relation to the instruction and use of technology-assisted exercises have not been sufficiently considered. Therefore, together with the target group, we will also analyze how nursing home residents respond to the use of technology-assisted exercise.

Possible research questions

1. To what extent can the exergame Nintendo Ring Fit Adventure be individualized to the needs and requirements of nursing home residents?
2. How valid is the implemented individualization function compared to classic motor test procedures?
3. How are the different games perceived (player experiences) by nursing home residents?
4. To what extent are individual characteristics (e.g., cognitive status, motor impairments) related to the perception of the game?
5. How could the game be further adapted to the needs of the users from software/hardware perspective?
6. How do nursing home residents accept the instruction and use of technology-assisted exercise?
7. What virtues and benefits of physical activity do nursing home residents report when exercising with games like Nintendo Ring Fit Adventure?

References

Barisch-Fritz, B., Trautwein, S., Scharpf, A., Krell-Roesch, J., & Woll, A. (2022). Effects of a 16-Week Multimodal Exercise Program on Physical Performance in Individuals With Dementia: A Multicenter Randomized Controlled Trial. Journal of Geriatric Physical Therapy, 45(1), 3–24. https://doi.org/10.1519/JPT.0000000000000308

Buchman, A. S., Boyle, P. A., Wilson, R. S., Bienias, J. L., & Bennett, D. A. (2007). Physical activity and motor decline in older persons. Muscle & Nerve, 35(3), 354–362. https://doi.org/10.1002/mus.20702

Chan, W. L. S., Chan, C. W. L., Lam, F. M. H., Chan, H. H. W., Chan, K. C. K., Chan, J. S. K., Chan, O. L. W., & Cheung, D. S. K. (2023). Feasibility, safety, and effects of a Nintendo Ring Fit AdventureTM balance and strengthening exercise program in community‐dwelling older adults with a history of falls: A feasibility randomized controlled trial. Geriatrics & Gerontology International, ggi.14771. https://doi.org/10.1111/ggi.14771

Gerling, K., Livingston, I., Nacke, L., & Mandryk, R. (2012). Full-body motion-based game interactions for older adults. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (CHI '12), 1873-1882. https://doi.org/10.1145/2207676.2208324

Künemund, H. (2015). Chancen und Herausforderungen assistiver Technik. Nutzerbedarfe und Technikakzeptanz im Alter. TATuP - Zeitschrift für Technikfolgenabschätzung in Theorie und Praxis, 24(2), 28–35. https://doi.org/10.14512/tatup.24.2.28

Mc Ardle, R., Sverdrup, K., Del Din, S., Lord, S., Kerse, N., Rochester, L., & Taylor, L. (2021). Quantifying physical activity in aged residential care facilities: A structured review. Ageing Research Reviews, 67, 101298. https://doi.org/10.1016/j.arr.2021.101298

Schäufele, M., Köhler, L., Hendlmeier, I., Hoell, A., & Weyerer, S. (2013). Prävalenz von Demenzen und ärztliche Versorgung in deutschen Pflegeheimen: Eine bundesweite repräsentative Studie. Psychiatrische Praxis, 40(04), 200–206. https://doi.org/10.1055/s-0033-1343141