Digital Gaming Intervention for Older People in Long-term Care

Effectiveness of Digital Gaming Intervention With Yetitablet for Older Peoples' Functioning and Activity in Long-term Care Environment - Quasi-experimental Study

Older people in long-term care (LTC) are often less physically active than their community-dwelling peers. Low physical activity level is associated with more symptoms of anxiety and depression as well as with lower physical performance. This weakens coping with daily activities and increases the care costs. Earlier research have found that playing digital games that require physical activity affects positively functioning of older people. Playing can increase physical activity, improve balance and walking speed, lift the mood and create opportunities for social interaction. The effects of digital gaming, especially on objectively measured physical activity and social functioning, are still unclear.

The aim of this study is to evaluate effectiveness of digital gaming intervention with Yetitablet to physical, psychological and social functioning and activity of older people in long-term care environment.

This study investigates the effectiveness of the Yetitablet in improving the functioning of older people. Yetitablet is an assistive technology device developed for special groups. Yetitablet is a large interactive touchscreen tablet with 55" screen and with Android operating system and it includes numerous applications. Yetitablet has mobile stand on wheels, which allows the screen to be raised and lowered, as well as tilted as needed, all the way to a desk position. Applications can be downloaded to the device from the Google Play Store, and it also has its own game applications, such as darts, table hockey and memory game. These games can be played individually or in group. There is no previous scientific research on the effectiveness of the Yetitablet on the functioning and activity of older people in long-term care settings.

Study Overview

• Status: Enrolling by invitation
• Conditions: Aging; Depressive Symptoms; Sedentary Behavior; Loneliness; Physical Inactivity; Social Isolation
• Intervention / Treatment: Device: Yetitablet gaming

Detailed Description

Sample size calculation was completed based on an effect size of 0.3 (power = 0.80; α= 0.05). Assuming a 25% attrition rate, a total of 70 residents will be recruited (35 people in a control group and 35 people in the intervention group). Participants will be recruited from LTC facilities for older people in the region of Oulu in northern Finland. Facilities will be selected by purposeful sampling. Participants will be selected by personnel of the facilities purposefully based on the inclusion criteria.

After being informed about the study all suitable residents willing to participate in this study will undergo baseline functional testing on week 0. Same functional measurements will be conducted after three month intervention period. Baseline physical activity will be measured by activity tracker during one week before intervention and during the intervention (3 months). In addition, approximately 10-15 LTC facility personnel will be recruited for semi-structured group interviews to understand more of the effects of Yetitablet to psychological and social functioning as well as social activity of LTC residents. The interviews will also clarify the staff's experiences of using the Yetitablet and its suitability for the everyday life of the facility.

• Study Type: Interventional
• Enrollment (Estimated): 70
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Saara Kukkohovi, MSc; Phone Number: +358504420666; Email: saara.kukkohovi@oulu.fi
• Study Contact Backup: Name: Satu Elo, PhD; Email: satu.elo@oamk.fi

Study Locations

• Finland
  • Oulu, Finland, 90220
    • University of Oulu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• lives in a long-term care facility for older people participating in the study
• has sufficient cognitive ability to understand the purpose of the study
• is able to walk (with or without walking aid) the distance required by physical functioning tests (10m)
• no illness restricting light exercise
• no serious, acute illness
• sufficient cognitive skills to understand game instructions
• sufficient functionality of the upper limbs to use the touch screen

Exclusion Criteria:

• unable to move independently even with walking aid
• severe memory disorder or other acute illness
• unable to understand game instructions, or able to concentrate on playing games for the required time
• too weak vision to play games
• unable to use upper limbs to play
• simultaneously receiving some other treatment that differs from usual treatment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Yetitablet group; Older adults in the experimental group will participate in a 12-week, 3 times per week, 30-60 minutes per session (recommendation) gaming session with Yetitablet in their home facility. Games will be played in group of 3-5 people with participants taking turns. Gaming sessions are supervised by research assistant or facility personnel.	Device: Yetitablet gaming; Playing digital games like bowling, memory games, coordination games ect. with the Yetitablet.
No Intervention: Control group; Participants in control group will continue their normal daily activities in their home facility. No intervention is provided to control group (passive control group).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in the Timed Up and Go test (TUG) at week 12	Change in mean scores on the Timed-up-and-Go test (Completion time in seconds, faster performance indicate better functioning).	Baseline and week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in the Revised Index for Social Engagement (RISE) at week 12	Change in mean RISE points (range 0-6, higher points indicate more social engagement).	Baseline and week 12
Change from baseline in weekly time spent in light to vigorous physical activity	Physical activity (weekly time spent in light to vigorous physical activity) measured with wrist-worn physical activity monitor continuously over the 3-month trial	13 weeks
Change in mood before and after every gaming session	Change in mean face scale scores (range 1-5, higher scores indicate better mood).	Every gaming session during three month long intervention
Change from baseline in hand grip strength at week 12	Change in hand grip strength in both hands measured with dynamometer	Baseline and week 12
Change from baseline in the Short Physical Performance Battery (SPPB) at week 12	Change in mean scores on the SPPB test (higher scores indicate better functioning).	Baseline and week 12

Collaborators and Investigators

• Sponsor: University of Oulu
• Investigators: Study Director: Satu Elo, PhD, Oulu University of Applied Sciences

Publications and helpful links

General Publications

• Jantunen H, Wasenius N, Salonen MK, Perala MM, Osmond C, Kautiainen H, Simonen M, Pohjolainen P, Kajantie E, Rantanen T, von Bonsdorff MB, Eriksson JG. Objectively measured physical activity and physical performance in old age. Age Ageing. 2017 Mar 1;46(2):232-237. doi: 10.1093/ageing/afw194.
• de Oliveira LDSSCB, Souza EC, Rodrigues RAS, Fett CA, Piva AB. The effects of physical activity on anxiety, depression, and quality of life in elderly people living in the community. Trends Psychiatry Psychother. 2019 Jan-Mar;41(1):36-42. doi: 10.1590/2237-6089-2017-0129. Epub 2019 Feb 4.
• van Santen J, Droes RM, Holstege M, Henkemans OB, van Rijn A, de Vries R, van Straten A, Meiland F. Effects of Exergaming in People with Dementia: Results of a Systematic Literature Review. J Alzheimers Dis. 2018;63(2):741-760. doi: 10.3233/JAD-170667.

Study record dates

Study Major Dates

• Study Start (Actual): September 13, 2023
• Primary Completion (Estimated): March 1, 2024
• Study Completion (Estimated): March 1, 2024

Study Registration Dates

• First Submitted: August 9, 2023
• First Submitted That Met QC Criteria: August 30, 2023
• First Posted (Actual): August 31, 2023

Study Record Updates

• Last Update Posted (Estimated): November 16, 2023
• Last Update Submitted That Met QC Criteria: November 13, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: physical activity; social functioning; aging; older people; physical functioning; long-term care; digital games; psychological functioning
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: 49/2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No