The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study

Abstract BackgroundAging in older adults results in a decline in physical function and quality of daily life. Due to the COVID-19 pandemic, the exercise frequency among older adults decreased, further contributing to frailty. Traditional rehabilitation using repetitive movemen...

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Main Authors: Chien-Hsiang Chang, Chun-Chun Wei, Wei-Chih Lien, Tai-Hua Yang, Bo Liu, Yimo Lin, Poh Thong Tan, Yang-Cheng Lin
Format: Article
Language:English
Published: JMIR Publications 2025-01-01
Series:JMIR Serious Games
Online Access:https://games.jmir.org/2025/1/e50669
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author Chien-Hsiang Chang
Chun-Chun Wei
Wei-Chih Lien
Tai-Hua Yang
Bo Liu
Yimo Lin
Poh Thong Tan
Yang-Cheng Lin
author_facet Chien-Hsiang Chang
Chun-Chun Wei
Wei-Chih Lien
Tai-Hua Yang
Bo Liu
Yimo Lin
Poh Thong Tan
Yang-Cheng Lin
author_sort Chien-Hsiang Chang
collection DOAJ
description Abstract BackgroundAging in older adults results in a decline in physical function and quality of daily life. Due to the COVID-19 pandemic, the exercise frequency among older adults decreased, further contributing to frailty. Traditional rehabilitation using repetitive movements tends not to attract older adults to perform independently. ObjectiveIntelligent Rehabilitation Exergame System (IRES), a novel retro interactive exergame that incorporates real-time surface electromyography, was developed and evaluated. MethodsFrail older adults were invited to use the IRES for rehabilitation using lower limb training twice per week for 4 weeks. Participants were required to have no mobility or communication difficulties and be willing to complete the 4-week study. The enrolled cohort had baseline scores ranging from 1 to 5 on the Clinical Frailty Scale, as described by Rockwood et al. Three major lower limb movements (knee extension, plantar flexion, and dorsiflexion) were performed 20 times for each leg within 30 minutes. The surface electromyography collected and analyzed muscle potential signals for review by health care professionals to customize the protocol for the next training. The System Usability Scale (SUS) and Taiwanese version of the EuroQol-5 Dimensions (EQ-5D) were administered after completing the first (week 1, baseline) and last training (week 4, one-month follow-up) to evaluate the usability of the IRES and its effects on the quality of life of participants. ResultsA total of 49 frail older adults (mean age 74.6 years) were included in the analysis. The usability of the IRES improved according to the mean SUS score, from 82.09 (good) at baseline to 87.14 (good+) at 1-month follow-up. The willingness to use (t96Pt96Pt96Pt47Pt47Pt96P ConclusionsThe novel IRES proposed in this study received positive feedback from frail older adults. Integrating retro-style exergame training into rehabilitation not only improved their rehabilitation motivation but also increased their learning, system operability, and willingness to continue rehabilitation. The IRES provides an essential tool for the new eHealth care service in the post–COVID-19 era.
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spelling doaj-art-b8115bb48cd24be58ba2ccb551caddb42025-01-28T19:18:47ZengJMIR PublicationsJMIR Serious Games2291-92792025-01-0113e50669e5066910.2196/50669The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort StudyChien-Hsiang Changhttp://orcid.org/0000-0002-6337-5577Chun-Chun Weihttp://orcid.org/0009-0003-3752-9012Wei-Chih Lienhttp://orcid.org/0000-0002-7679-8042Tai-Hua Yanghttp://orcid.org/0000-0001-5068-2570Bo Liuhttp://orcid.org/0009-0004-5538-2891Yimo Linhttp://orcid.org/0009-0005-3315-7535Poh Thong Tanhttp://orcid.org/0009-0009-2035-6235Yang-Cheng Linhttp://orcid.org/0000-0002-2405-9176 Abstract BackgroundAging in older adults results in a decline in physical function and quality of daily life. Due to the COVID-19 pandemic, the exercise frequency among older adults decreased, further contributing to frailty. Traditional rehabilitation using repetitive movements tends not to attract older adults to perform independently. ObjectiveIntelligent Rehabilitation Exergame System (IRES), a novel retro interactive exergame that incorporates real-time surface electromyography, was developed and evaluated. MethodsFrail older adults were invited to use the IRES for rehabilitation using lower limb training twice per week for 4 weeks. Participants were required to have no mobility or communication difficulties and be willing to complete the 4-week study. The enrolled cohort had baseline scores ranging from 1 to 5 on the Clinical Frailty Scale, as described by Rockwood et al. Three major lower limb movements (knee extension, plantar flexion, and dorsiflexion) were performed 20 times for each leg within 30 minutes. The surface electromyography collected and analyzed muscle potential signals for review by health care professionals to customize the protocol for the next training. The System Usability Scale (SUS) and Taiwanese version of the EuroQol-5 Dimensions (EQ-5D) were administered after completing the first (week 1, baseline) and last training (week 4, one-month follow-up) to evaluate the usability of the IRES and its effects on the quality of life of participants. ResultsA total of 49 frail older adults (mean age 74.6 years) were included in the analysis. The usability of the IRES improved according to the mean SUS score, from 82.09 (good) at baseline to 87.14 (good+) at 1-month follow-up. The willingness to use (t96Pt96Pt96Pt47Pt47Pt96P ConclusionsThe novel IRES proposed in this study received positive feedback from frail older adults. Integrating retro-style exergame training into rehabilitation not only improved their rehabilitation motivation but also increased their learning, system operability, and willingness to continue rehabilitation. The IRES provides an essential tool for the new eHealth care service in the post–COVID-19 era.https://games.jmir.org/2025/1/e50669
spellingShingle Chien-Hsiang Chang
Chun-Chun Wei
Wei-Chih Lien
Tai-Hua Yang
Bo Liu
Yimo Lin
Poh Thong Tan
Yang-Cheng Lin
The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study
JMIR Serious Games
title The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study
title_full The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study
title_fullStr The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study
title_full_unstemmed The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study
title_short The Usability and Effect of a Novel Intelligent Rehabilitation Exergame System on Quality of Life in Frail Older Adults: Prospective Cohort Study
title_sort usability and effect of a novel intelligent rehabilitation exergame system on quality of life in frail older adults prospective cohort study
url https://games.jmir.org/2025/1/e50669
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