User-centred design of an active computer gaming system for strength and balance exercises for older adults
Open accessAbstract
Purpose: Active computer gaming (ACG) is a way for older people to participate in strength and balance exercise. Involving older adults in the development of a bespoke ACG system may optimise its usability and acceptability. The purpose of this paper is to employ user-centred design to develop an ACG system to deliver strength and balance exercises, and to explore its safety, usability and acceptability in older adults. Design/methodology/approach: This paper describes user involvement from an early stage, and its influence on the development of the system to deliver strength and balance exercise suitable for display on a flat screen or using an Oculus Rift virtual reality (VR) headset. It describes user testing of this ACG system in older adults. Findings: Service users were involved at two points in the development process. Their feedback was used to modify the ACG system prior to user testing of a prototype of the ACG system by n=9 older adults. Results indicated the safety, usability and acceptability of the system, with a strong preference for the screen display. Research limitations/implications: The sample size for user testing was small; however, it is considered to have provided sufficient information to inform the further development of the system. Practical implications: Findings from user testing were used to modify the ACG system. This paper identified that future research could explore the influence of repeated use on the usability and acceptability of ACG in older adults. Originality/value: There is limited information on the usability and acceptability VR headsets in this population.
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Participants in 11/13 of the studies reported issues with the HMD, including that it was too heavy, caused general discomfort, caused disorientation and imbalance, and caused feelings of being trapped, confined, afraid, or anxious.
“Participants in 11/13 of the studies reported issues with the HMD, including that it was too heavy [9,44,45,48,50]; caused general discomfort [9,15,16,44,50]; caused disorientation and imbalance [44,46]; and caused feelings of being trapped, confined [45], afraid, or anxious [16,45].”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
The Results (p. 6) report that participants felt disorientated with the VR headset and needed slightly more hand support in that condition; the Discussion (p. 7) also reports disorientation. The paper does not say participants reported imbalance caused by the headset. The 11/13 count and the other listed complaints are not attributed specifically to this source in the citing sentence. (LLM, conf=0.83)
Experimental — accuracy not yet measured11/13 of the studies described feedback on the content presented, with participants preferring still content to moving content, preferring familiar content similar to past experiences, showing a strong preference for tailoring content to their own interests, enjoying the adaptive nature of the content, suggesting more diversity in content, and giving only a few negative comments about content.
“A total of 11/13 of the studies described feedback on the content presented, specifically the various objects and scenes inside the virtual environment and participants’ experiences navigating them [9,14-16,44,46-48,50-52]. Participants preferred still content to moving content [44,51] and preferred content that was familiar [52], in particular, content similar to past experiences in real life [44”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredOlder adults found it dangerous to use an HMD on their own as they were unaware of their physical surroundings when wearing it, and would like to have someone present to reassure them that they were safe.
“it was clear that older adults found it dangerous to use an HMD on their own as they were unaware of their physical surroundings when wearing it [9,46] and would like to have someone present to reassure them that they were safe [46].”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
The Results (p. 6) say close supervision was required for safety, particularly with the VR headset. The Discussion (p. 7) reports disorientation and suggests that loss of visual feedback from the surroundings may affect older adults’ experience. The paper does not say participants described using the headset alone as dangerous or asked for someone present to reassure them. (LLM, conf=0.84)
Experimental — accuracy not yet measured10/13 of the studies reported participants' experiences and perceptions of presence and immersion in IVR, with participants reporting that the feeling of presence made the experience feel more real and allowed them to engage with objects as if they were really present, 3/13 explicitly reporting enjoying the experience of presence, and 1/13 reporting some feelings of anxiety and nervousness because
“A total of 10/13 of the studies reported participants’ experiences and perceptions of presence and immersion in IVR [9,14-16,46,48-52]. Participants reported that the feeling of presence made the experience feel more real [15] and allowed them to engage with objects in the virtual environment as if they were really present [9]. Participants from 3/13 of the studies explicitly reported enjoying the”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
The Results (p. 6) report participants’ experiences with a VR headset, including disorientation and a preference for the screen version, so this paper supports its inclusion among studies reporting perceptions of immersive VR. It does not report that a feeling of presence let participants engage with virtual objects as if they were real, nor does it link enjoyment or anxiety to presence. The Introduction (p. 2) describes a more realistic environment only as a possibility. (LLM, conf=0.82)
Experimental — accuracy not yet measuredFeedback provided by participants during and after use was mostly positive, with participants excited and curious about IVR, some saying it was a technology missing from their life, novelty identified as a distinct pattern usually referring to unique features and positive experiences, and a number of negative responses including preference for technologies without HMD, having enough devices, and
“Feedback provided by participants during and after use was mostly positive [9,14,16,46,48,49,51]. Authors from 1/13 of the studies reported that participants were excited and curious about IVR and were keen to learn about its potential benefits [14]. A participant from another study went as far as to say that it was a technology that had been missing from their life [9]. Novelty experienced in IVR”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
Split into 3 atoms — 1 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
There was a temporal pattern in older adults' perceptions of IVR across stages of use, illustrating the importance of users' preconceptions and how they can differ from actual experience, with a generally negative impression before use changing to a generally positive impression after use.
“There was a temporal pattern identified in the data that consisted of older adults’ perceptions of IVR across stages of IVR use (perceptions of IVR [9,14-16,44-52]). It began with older adults’ perceptions of IVR before use, followed by their perceptions during and immediately after use. This pattern illustrates the importance of users’ preconceptions of a given technology and how they can differ”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredConflicting participant experiences were present across the synthesis, including differences in experiences of dizziness and nausea, wearing the HMD, and sitting while using IVR.
“Conflicting participant experiences were present across the synthesis. These conflicts included differences in older adults’ experiences of dizziness and nausea [14,44], wearing the HMD [9,14,15,44,46,48,50,51], and sitting while using IVR [15,44,50].”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
The Results (p. 6) report that participants felt disorientated while wearing the VR headset and preferred the screen, supporting a difference in headset experiences. The paper does not report nausea or participants’ experiences of sitting while using immersive VR; its user-testing exercises required standing (User testing methods, p. 5). (LLM, conf=0.86)
Experimental — accuracy not yet measuredDifficulties with the HMD being too small to wear with glasses were described.
“Difficulties with the HMD being too small to wear with glasses were also described [14,44,46,48,50,51].”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [46]
The Results (p. 6) describe disorientation and lower usability with the VR headset, but do not describe a fit problem involving glasses. Searches for glasses, spectacles, and headset size found no passage addressing that specific difficulty. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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“Of the 10 studies that reported the participants’ place of residence, participants from 5 (50%) studies identified as community-dwelling adults [14,16,44,47,50], and participants from 5 (50%) studies reported living in some form of residential aged-care facility [9,15,45,46,50].”
BackgroundInfluential
- Authors
- Howes, S. C., Charles, D., Pedlow, K., Wilson, I., Holmes, D., & McDonough, S.
- Affiliations
- University of Ulster (GB)
- Venue
- Journal of Enabling Technologies
- Publisher
- Emerald
- Published
- 2019-06-17
- Volume
- 13
- Issue
- 2
- Pages
- 101-111
- ISSN
- 2398-6263 (ISSN-L)
- OpenAlex
- W2966402035
- Cited by
- 18
- References
- 37
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 8 · 2021: 5
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- green
- pure.qub.ac.uk
- Licence
- Locations
- Journal of Enabling Technologies (publishedVersion)
- Research Portal (Queen's University Belfast) (acceptedVersion, other-oa)
- Ulster University Research Portal (Ulster University) (submittedVersion, other-oa)
- Topics
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Keywords
- older adults, resistance training, balance training, virtual reality, Oculus Rift, user-centered design, usability, acceptability, safety, user involvement in development
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