The effects of exergaming on pain, postural control, technology acceptance and flow experience in older people with chronic musculoskeletal pain: a randomised controlled trial

Jae-Llane Ditchburn, Paul van Schaik, John Dixon, Alasdair MacSween, Denis Martin, Jae-Llane Ditchburn, Paul van Schaik, John Dixon, Alasdair MacSween, Denis Martin

Abstract

Background: Older people with chronic musculoskeletal pain are at risk of falls. This study aimed to investigate the effects of exergaming on pain and postural control in older people with chronic musculoskeletal pain. Secondary outcomes were technology acceptance, flow experience, perceived physical exertion, expended mental effort and heart rate.

Methods: Fifty four older adults (age: 71 ± 5 years) with chronic musculoskeletal pain were randomised into 2 groups. Group 1 received exergaming training using the Interactive Rehabilitation and Exercise System (IREX®). Group 2 undertook traditional gym-based exercise (TGB). Both groups completed twice weekly 40-min exercise sessions for 6 weeks. Perceived pain was measured using a numeric pain rating scale and the Multidimensional Affect and Pain Survey questionnaire. Postural control was measured as sway using a Kistler™ force platform. Technology acceptance was measured with the Unified Theory of Acceptance and Use of Technology questionnaire and flow experience with the Flow State Scale. Physiological measures of perceived physical exertion, expended mental effort and heart rate were recorded during all sessions.

Results: The exergaming group demonstrated significant reductions in pain intensity and thermal pain including a near significant approach in physical engagement in comparison to TGB group. Although no intervention effects on postural control were found, the exergaming group showed significant improvements in three sway measures (AP SD, ML SD and AP range) over time whereas significant improvements in ML range were found in the TGB group. Relating to technology acceptance, significant intervention effects on social influence and behavioural intention were found in the TGB group instead, although both groups demonstrated increases of acceptance over time. Regarding flow experience, concentration at task was significantly influenced in the TGB group and significant increases in flow variables over time were observed in both groups. Significant increases over time in perceived physical exertion and expended mental effort were found in both groups.

Conclusion: Our findings support the potential of exergaming to alleviate pain and improve balance in older people with chronic musculoskeletal pain. Both forms of exercise are acceptable, intrinsically motivating and show evidence of benefit to older people with chronic musculoskeletal pain.

Trial registration: ClinicalTrials.gov Identifier: NCT04029285 (retrospectively registered, July 23, 2019).

Keywords: Aged; Aged 80 and over; Exercise therapy; Exergaming; Flow state experience; Heart rate; Musculoskeletal Pain; Postural balance; Technology acceptance.

Conflict of interest statement

Competing interestsOne of the authors, JD is a member of the Editorial Board (Section Editor for Surgery, traumatology, and rehabilitation). The other authors (JLD, PvS, AM and DM) have none to declare.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram illustrating recruitment of participants into the study

References

    1. Dahlhamer J, Lucas J, Zelaya C, Nahin R, Mackey S, DeBar L, et al. Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Morb Mortal Wkly Rep. 2018;67:1001. doi: 10.15585/mmwr.mm6736a2.
    1. Brown ST, Kirkpatrick MK, Swanson MS, McKenzie IL. Pain experience in the elderly. Pain Manag Nurs. 2011;12:190–196. doi: 10.1016/j.pmn.2010.05.004.
    1. Helme RD, Gibson SJ. Pain in older people. In: Crombie IK, editor. Epidemiology of pain. Seattle: IASP Press; 1999. pp. 103–112.
    1. Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the: International Classification Of Diseases: (:ICD-11:). Pain 2019; 160:19–27.
    1. Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization study in primary care. JAMA. 1998;280:147–151. doi: 10.1001/jama.280.2.147.
    1. Mobily PR, Herr KA, Clark MK, Wallace RB. An epidemiologic analysis of pain in the elderly: the Iowa 65 rural health study. J Aging Health. 1994;6:139–154. doi: 10.1177/089826439400600201.
    1. Blyth FM, Cumming R, Mitchell P, Wang JJ. Pain and falls in older people. Eur J Pain. 2007;11:564–571. doi: 10.1016/j.ejpain.2006.08.001.
    1. Hicks C, Levinger P, Menant JC, Lord SR, Sachdev PS, Brodaty H, et al. Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people. BMC Geriatr. 2020;20:1–8. doi: 10.1186/s12877-020-1487-2.
    1. Patel KV, Phelan EA, Leveille SG, Lamb SE, Missikpode C, Wallace RB, et al. High prevalence of falls, fear of falling, and impaired balance in older adults with pain in the United States: findings from the 2011 National Health and Aging Trends Study. J Am Geriatr Soc. 2014;62:1844–1852. doi: 10.1111/jgs.13072.
    1. Leveille SG, Bean J, Bandeen-Roche K, Jones R, Hochberg M, Guralnik JM. Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc. 2002;50:671–678. doi: 10.1046/j.1532-5415.2002.50161.x.
    1. Leveille SG, Kiel DP, Jones RN, Roman A, Hannan MT, Sorond FA, et al. The MOBILIZE Boston Study: design and methods of a prospective cohort study of novel risk factors for falls in an older population. BMC Geriatr. 2008;8:16. doi: 10.1186/1471-2318-8-16.
    1. Leveille SG, Jones RN, Kiely DK, Hausdorff JM, Shmerling RH, Guralnik JM, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009;302:2214–2221. doi: 10.1001/jama.2009.1738.
    1. Holmes B, Leggett S, Mooney V, Nichols J, Negri S, Hoeyberghs A. Comparison of female geriatric lumbar-extension strength: asymptomatic versus chronic low back pain patients and their response to active rehabilitation. J Spinal Disord. 1996;9:17–22. doi: 10.1097/00002517-199602000-00003.
    1. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine J. 2004;1:106–115. doi: 10.1016/S1529-9430(03)00174-8.
    1. Bean JF, Vora A, Frontera WR. Benefits of exercise for community-dwelling older adults. Arch Phys Med Rehabil. 2004;85(Suppl 3):S42.
    1. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–1434. doi: 10.1249/mss.0b013e3180616b27.
    1. Skelton DA, Beyer N. Exercise and injury prevention in older people. Scand J Med Sci Sports. 2003;13:17–85. doi: 10.1034/j.1600-0838.2003.00300.x.
    1. Clemson L, Singh MF, Bundy A, Cumming RG, Weissel E, Munro J, et al. LiFE Pilot Study: a randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Aust Occup Ther J. 2010;57:42–50. doi: 10.1111/j.1440-1630.2009.00848.x.
    1. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JCT. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56:2234–2243. doi: 10.1111/j.1532-5415.2008.02014.x.
    1. Steadman J, Donaldson N, Kalra L. A randomized controlled trial of an enhanced balance training program to improve mobility and reduce falls in elderly patients. J Am Geriatr Soc. 2003;51:847–852. doi: 10.1046/j.1365-2389.2003.51268.x.
    1. Cooper KM, Bilbrew D, Dubbert PM, Kerr K, Kirchner K. Health barriers to walking for exercise in elderly primary care. Geriatr Nurs. 2001;22:258–262. doi: 10.1067/mgn.2001.119470.
    1. Jones DA, Newham DJ, Clarkson PM. Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors. Pain. 1987;30:233–242. doi: 10.1016/0304-3959(87)91079-7.
    1. Crombie IK, Irvine L, Williams B, McGinnis AR, Slane PW, Alder EM, et al. Why older people do not participate in leisure time physical activity: a survey of activity levels, beliefs and deterrents. Age Ageing. 2004;33:287–292. doi: 10.1093/ageing/afh089.
    1. Zandieh R, Martinez J, Flacke J, Jones P, Van Maarseveen M. Older adults’ outdoor walking: inequalities in neighbourhood safety, pedestrian infrastructure and aesthetics. Int J Environ Res Public Health. 2016;13:1179. doi: 10.3390/ijerph13121179.
    1. Medagama A, Galgomuwa M. Lack of infrastructure, social and cultural factors limit physical activity among patients with type 2 diabetes in rural Sri Lanka, a qualitative study. PLoS One. 2018;13:e0192679. doi: 10.1371/journal.pone.0192679.
    1. Girvan C. What is a virtual world? Definition and classification. Educ Technol Res Dev. 2018;66:1087–1100. doi: 10.1007/s11423-018-9577-y.
    1. Gigante MA. Virtual reality systems. Amsterdam: Elsevier; 1993. Virtual reality: definitions, history and applications; pp. 3–14.
    1. Schroeder R. Defining virtual worlds and virtual environments. J Virtual Worlds Res. 2008;1(1). .
    1. Wohlgenannt I, Simons A, Stieglitz S. Virtual reality. Bus Inf Syst Eng. 2020;62:455–61. 10.1007/s12599-020-00658-9.
    1. Oh Y, Yang S. Defining exergames & exergaming. 2010. pp. 1–17.
    1. Billis AS, Konstantinidis EI, Ladas AI, Tsolaki MN, Pappas C, Bamidis PD. Evaluating affective usability experiences of an exergaming platform for seniors. 2011. pp. 1–4.
    1. Kappen DL, Mirza-Babaei P, Nacke LE. Older adults’ physical activity and exergames: a systematic review. Int J Hum Comput Interact. 2019;35:140–167. doi: 10.1080/10447318.2018.1441253.
    1. Stojan R, Voelcker-Rehage C. A systematic review on the cognitive benefits and neurophysiological correlates of exergaming in healthy older adults. J Clin Med. 2019;8:734. doi: 10.3390/jcm8050734.
    1. Wang Y-L, Hou H-T, Tsai C-C. A systematic literature review of the impacts of digital games designed for older adults. Educ Gerontol. 2020;46:1–17. doi: 10.1080/03601277.2019.1694448.
    1. Tanaka K, Parker J, Baradoy G, Sheehan D, Holash JR, Katz L. A comparison of exergaming interfaces for use in rehabilitation programs and research. Loading. 2012;6(9):69–81.
    1. GestureTek . Gesture-driven interactive technology & virtual reality systems for therapy & rehabilitation. 2008.
    1. Pirovano M, Surer E, Mainetti R, Lanzi PL, Borghese NA. Exergaming and rehabilitation: a methodology for the design of effective and safe therapeutic exergames. Entertainment Computing. 2016;14:55–65. doi: 10.1016/j.entcom.2015.10.002.
    1. Reddy Bethi S. Exergames for telerehabilitation. arXiv. 2020;:arXiv-2006.
    1. Brox E, Luque LF, Eveston GJ, Hernandez JEG. Exergames for elderly: social exergames to persuade seniors to increased physical activity. 2011. pp. 546–549.
    1. Galvin J, Levac D. Facilitating clinical decision-making about the use of virtual reality within paediatric motor rehabilitation: describing and classifying virtual reality systems. Dev Neurorehabil. 2011;14:112–122. doi: 10.3109/17518423.2010.535805.
    1. Agmon M, Perry CK, Phelan E, Demiris G, Nguyen HQ. A pilot study of Wii Fit Exergames to improve balance in older adults. J Geriatr Phys Ther. 2011;34:161–167. doi: 10.1519/JPT.0b013e3182191d98.
    1. Katzman WB, Gladin A, Lane NE, Wong S, Liu F, Jin C, et al. Feasibility and acceptability of technology-based exercise and posture training in older adults with age-related Hyperkyphosis: Pre-Post Study. JMIR Aging. 2019;2:e12199. doi: 10.2196/12199.
    1. Jorgensen MG, Laessoe U, Hendriksen C, Nielsen OB, Aagaard P. Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2013;68:845–852. doi: 10.1093/gerona/gls222.
    1. Wollersheim D, Merkes M, Shields N, Liamputtong P, Wallis L, Reynolds F, et al. Physical and psychosocial effects of Wii video game use among older women. Int J Emerg Technol Soc. 2010;8:85–98.
    1. Zheng H, Li J, Salmon CT, Theng Y-L. The effects of exergames on emotional well-being of older adults. Comput Hum Behav. 2020;110:106383. doi: 10.1016/j.chb.2020.106383.
    1. Chen C-K, Tsai T-H, Lin Y-C, Lin C-C, Hsu S-C, Chung C-Y, et al. Acceptance of different design exergames in elders. PLoS One. 2018;13:e0200185. doi: 10.1371/journal.pone.0200185.
    1. Khoo ET, Merritt T, Cheok AD. Designing physical and social intergenerational family entertainment. Interact Comput. 2009;21:76–87. doi: 10.1016/j.intcom.2008.10.009.
    1. Lenhart A, Kahne J, Middaugh E, Macgill AR, Evans C, Vitak J. Teens, video games, and civics: teens’ gaming experiences are diverse and include significant social interaction and civic engagement. Report from Pew Internet & American Life Project; 2008. .
    1. O’Loughlin E, Sabiston CM, Kakinami L, McGrath JJ, Consalvo M, O’Loughlin JL, et al. Development and validation of the reasons to Exergame (RTEX) scale in Young adults: exploratory factors analysis. JMIR Serious Games. 2020;8:e16261. doi: 10.2196/16261.
    1. Schwarz A, DeSmet A, Cardon G, Chastin S, Costa R, Grilo A, et al. Mobile Exergaming in adolescents’ everyday life—contextual design of where, when, with whom, and how: the SmartLife case. Int J Environ Res Public Health. 2018;15:835. doi: 10.3390/ijerph15050835.
    1. Turner P, Turner S, Van de Walle G. How older people account for their experiences with interactive technology. Behav Inform Technol. 2007;26:287–296. doi: 10.1080/01449290601173499.
    1. Oppenauer C, Preschl B, Kalteis K, Kryspin-Exner I. Technology in old age from a psychological point of view. Berlin: Springer; 2007. pp. 133–142.
    1. Le HTN. Nintendo vs. its competitors in marketing efforts: from the point of view of customers. 2018.
    1. Beaulieu-Boire L, Belzile-Lachapelle S, Blanchette A, Desmarais P, Lamontagne-Montminy L, Tremblay C, et al. Balance rehabilitation using Xbox Kinect among an elderly population: a pilot study. J Nov Physiother. 2015;5:261.
    1. Flynn S, Palma P, Bender A. Feasibility of using the Sony PlayStation 2 gaming platform for an individual poststroke: a case report. J Neurol Phys Ther. 2007;31:180–189. doi: 10.1097/NPT.0b013e31815d00d5.
    1. Gallardo-Meza C, Simon K, Bustamante-Ara N, Ramirez-Campillo R, García-Pinillos F, Keogh JW, et al. Effects of 4 weeks of active exergames training on muscular fitness in elderly women. J Strength Cond Res. 2020. 10.1519/JSC.0000000000003560.
    1. Lee S, Shin S. Effectiveness of virtual reality using video gaming technology in elderly adults with diabetes mellitus. Diabetes Technol Ther. 2013;15:489–496. doi: 10.1089/dia.2013.0050.
    1. Robinson J, Dixon J, Macsween A, van Schaik P, Martin D. The effects of exergaming on balance, gait, technology acceptance and flow experience in people with multiple sclerosis: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2015;7:8. doi: 10.1186/s13102-015-0001-1.
    1. Smith ST, Sherrington C, Studenski S, Schoene D, Lord SR. A novel dance dance revolution (DDR) system for in-home training of stepping ability: basic parameters of system use by older adults. Br J Sports Med. 2011;45:441–445. doi: 10.1136/bjsm.2009.066845.
    1. Studenski S, Perera S, Hile E, Keller V, Spadola-Bogard J, Garcia J. Interactive video dance games for healthy older adults. J Nutr Health Aging. 2010;14:850–852. doi: 10.1007/s12603-010-0119-5.
    1. Kim JH, Jang SH, Kim CS, Jung JH, You JH. Use of virtual reality to enhance balance and ambulation in chronic stroke: a double-blind, randomized controlled study. Am J Phys Med Rehabil. 2009;88:693–701. doi: 10.1097/PHM.0b013e3181b33350.
    1. Kim YM, Chun MH, Yun GJ, Song YJ, Young HE. The effect of virtual reality training on unilateral spatial neglect in stroke patients. Ann Rehabil Med. 2011;35:309. doi: 10.5535/arm.2011.35.3.309.
    1. McEwen D, Taillon-Hobson A, Bilodeau M, Sveistrup H, Finestone H. Virtual reality exercise improves mobility after stroke: an inpatient randomized controlled trial. Stroke. 2014;45:1853–1855. doi: 10.1161/STROKEAHA.114.005362.
    1. Kizony R, Katz N, Weiss PL. Virtual reality based intervention in rehabilitation: relationship between motor and cognitive abilities and performance within virtual environments for patients with stroke. 2004.
    1. Subramanian S, Knaut LA, Beaudoin C, McFadyen BJ, Feldman AG, Levin MF. Virtual reality environments for post-stroke arm rehabilitation. J Neuro Eng Rehabil. 2007;4:20. doi: 10.1186/1743-0003-4-20.
    1. You SH, Jang SH, Kim YH, Hallet M, Ahn SH, Kwon YH, et al. Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study. Stroke. 2005;35:1166–1171. doi: 10.1161/01.STR.0000162715.43417.91.
    1. Glegg SM, Tatla SK, Holsti L. The GestureTek virtual reality system in rehabilitation: a scoping review. Disabil Rehabil Assist Technol. 2014;9:89–111. doi: 10.3109/17483107.2013.799236.
    1. Orimo H, Ito H, Suzuki T, Araki A, Hosoi T, Sawabe M. Reviewing the definition of “elderly”. Geriatr Gerontol Int. 2006;6:149–158. doi: 10.1111/j.1447-0594.2006.00341.x.
    1. Faul F, Erdfelder E, Lang A, Buchner A. G*power 3: a flexible statistical power analysis program for the social, behavioral and biomedical sciences. Behav Res Methods. 2007;39:175–191. doi: 10.3758/BF03193146.
    1. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–1160. doi: 10.3758/BRM.41.4.1149.
    1. Shamliyan TA, Wang SY, Olson-Kellogg B, Kane RL. Physical therapy Interventions for knee pain secondary to osteoarthritis. Comparative effectiveness review no. 77. (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290–2007- 10064-I.) Rockville, MD: Agency for Healthcare Research and Quality; November 2012. . AHRQ Publication. 2012; 13: EH115.
    1. Hatton AL, Dixon J, Martin D, Rome K. The effect of textured surfaces on postural stability and lower limb muscle activity. J Electromyogr Kinesiol. 2009;19:957–964. doi: 10.1016/j.jelekin.2008.04.012.
    1. Carey SJ, Turpin C, Smith J, Whatley J, Haddox D. Improving pain management in an acute care setting. The Crawford Long Hospital of Emory University experience. Orthop Nurs. 1997;16:29–36. doi: 10.1097/00006416-199707000-00007.
    1. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152:2399–2404. doi: 10.1016/j.pain.2011.07.005.
    1. Clark WC, Yang JC, Tsui S, Ng K, Clark SB. Unidimensional pain rating scales: a multidimensional affect and pain survey (MAPS) analysis of what they really measure. Pain. 2002;98:241–247. doi: 10.1016/S0304-3959(01)00474-2.
    1. Clark WC, Janal MN, Carroll JD. Hierarchical clustering of 270 pain/emotion descriptors: towards a revision of the McGill Pain Questionnaire. In: Bromm B, Desmedt JE, editors. Pain and the brain: from nociception to sensation. New York: Raven Press; 1995. pp. 319–333.
    1. Yang JC, Clark WC, Tsui SL, Ng KF, Clark SB. Preoperative Multidimensional Affect and pain Survey (MAPS) scores predict postcolectomy analgesia requirement. Clin J Pain. 2000;16:314–320. doi: 10.1097/00002508-200012000-00007.
    1. Knotkova H, Clark WC, Mokrejs P, Padour F, Kuhl JP. What do rathings on unidimensional pain and emotion scales really mean? A Multidimensional Affect and Pain Survey (MAPS) analysis of cancer patient responses. J Pain Symptom Manag. 2004;28:19–27. doi: 10.1016/j.jpainsymman.2003.11.003.
    1. Knotkova H, Clark WC, Keohan ML, Kuhl JP, Winer RT, Wharton RN. Validation of the Multidimensional Affect and Pain Survey (MAPS) J Pain. 2006;7:161–169. doi: 10.1016/j.jpain.2005.10.002.
    1. Griswold GA, Clark WC. Item analysis of cancer patient responses to the Multidimensional Affect and Pain Survey demonstrates high inter-item consistency and discriminability and determines the content of a short form. J Pain. 2005;6:67–74. doi: 10.1016/j.jpain.2004.10.008.
    1. Clark WC, Kuhl JP, Keohan ML, Knotkova H, Winer RT, Griswold GA. Factor analysis validates the cluster structure of the dendrogram underlying the Multidimensional Affect and Pain Survey (MAPS) and challenges the a priori classification of the descriptors in the McGill Pain Questionnaire (MPQ) Pain. 2003;106:357–363. doi: 10.1016/j.pain.2003.08.005.
    1. Scoppa F, Capra R, Gallamini M, Shiffer R. Clinical stabilometry standardization: basic definitions–acquisition interval–sampling frequency. Gait Posture. 2013;37:290–292. doi: 10.1016/j.gaitpost.2012.07.009.
    1. Barry G, van Schaik P, MacSween A, Dixon J, Martin D. Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: a randomised controlled trial. BMC Sports Sci Med Rehabil. 2016;8:25. doi: 10.1186/s13102-016-0050-0.
    1. Pinsault N, Vuillerme N. Test–retest reliability of centre of foot pressure measures to assess postural control during unperturbed stance. Med Eng Phys. 2009;31:276–286. doi: 10.1016/j.medengphy.2008.08.003.
    1. Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: towards a unified view. MIS Q. 2003;27:425–478. doi: 10.2307/30036540.
    1. Jackson SA, Marsh HW. Development of validation of a scale to measure optimal experience: the flow state scale. J Sport Exerc Psychol. 1996;18:17–35. doi: 10.1123/jsep.18.1.17.
    1. Fritz BS, Avsec A. The experience of flow and subjective well-being of music students. Horiz Psychol. 2007;16:5–17.
    1. Jackson SA. Toward a conceptual understanding of the flow experience in elite athletes. Res Q Exerc Sport. 1996;67:76–90. doi: 10.1080/02701367.1996.10607928.
    1. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med. 1970;2:92–98.
    1. Zijlstra FRH. Efficiency in work behavior. A design approach for modern tools. Delft: Delft University of Technology; 1993.
    1. Raymakers JA, Samson MM, Verhaar HJJ. The assessment of body sway and the choice of the stability parameter(s) Gait Posture. 2005;21:48–58. doi: 10.1016/j.gaitpost.2003.11.006.
    1. Keselman HJ. A Monte Carlo investigation of three estimates of treatment magnitude: epsilon squared, eta squared, and omega squared. Can Psychol Rev. 1975;16:44. doi: 10.1037/h0081789.
    1. Bland M, Altman DG. Measurement error and correlation coefficients. Br Med J. 1996;313:41–42. doi: 10.1136/bmj.313.7048.41.
    1. Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8:283–291. doi: 10.1016/j.ejpain.2003.09.004.
    1. Chao Y-Y, Scherer YK, Montgomery CA. Effects of using Nintendo Wii™ exergames in older adults: a review of the literature. J Aging Health. 2015;27:379–402. doi: 10.1177/0898264314551171.
    1. Skjæret N, Nawaz A, Morat T, Schoene D, Helbostad JL, Vereijken B. Exercise and rehabilitation delivered through exergames in older adults: an integrative review of technologies, safety and efficacy. Int J Med Inform. 2016;85:1–16. doi: 10.1016/j.ijmedinf.2015.10.008.
    1. Collado-Mateo D, Merellano-Navarro E, Olivares PR, García-Rubio J, Gusi N. Effect of Exergames on musculoskeletal pain: a systematic review and meta-analysis. Scand J Med Sci Sports. 2018;28(3):760–71.
    1. Sobral Monteiro-Junior R, Pereira de Souza C, Lattari E, Rocha BF, Mura G, Machado S, et al. Wii-workouts on chronic pain, physical capabilities and mood of older women: a randomized controlled double blind trial. CNS Neurol Disord Drug Targets. 2015;14:1157–1164. doi: 10.2174/1871527315666151111120131.
    1. Karahan AY, Tok F, Yildirim P, Ordahan B, Turkoglu G, Sahin N. The effectiveness of exergames in patients with ankylosing spondylitis: a randomized controlled trial. Adv Clin Exp Med. 2016;25:931–936. doi: 10.17219/acem/32590.
    1. Kim S-S, Min W-K, Kim J-H, Lee B-H. The effects of VR-based Wii fit yoga on physical function in middle-aged female LBP patients. J Phys Ther Sci. 2014;26:549–552. doi: 10.1589/jpts.26.549.
    1. Witmer BG, Singer MJ. Measuring presence in virtual environments: a presence questionnaire. Presence. 1998;7:225–240. doi: 10.1162/105474698565686.
    1. Jameson E, Trevena J, Swain N. Electronic gaming as pain distraction. Pain Res Manag. 2011;16:27–32. doi: 10.1155/2011/856014.
    1. Rutter CE, Dahlquist LM, Weiss KE. Sustained efficacy of virtual reality distraction. J Pain. 2009;10:391–397. doi: 10.1016/j.jpain.2008.09.016.
    1. Magora F, Cohen S, Shochina M, Dayan E. Virtual reality immersion method of distraction to control experimental ischemic pain. Isr Med Assoc J. 2006;8:261–265.
    1. Huang H-C, Wong M-K, Yang Y-H, Chiu H-Y, Teng C-I. Impact of playing exergames on mood states: a randomized controlled trial. Cyberpsychol Behav Soc Netw. 2017;20:246–250. doi: 10.1089/cyber.2016.0322.
    1. Rosenberg D, Depp CA, Vahia IV, Reichstadt J, Palmer BW, Kerr J, et al. Exergames for subsyndromal depression in old adults: a pilot study of a novel interaction. Am J Geriatr Psychiatr. 2010;18:221–226. doi: 10.1097/JGP.0b013e3181c534b5.
    1. Bisson E, Contant B, Sveistrup H, Lajoie Y. Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training. Cyber Psychol Behav. 2007;10:16–23. doi: 10.1089/cpb.2006.9997.
    1. Whyatt C, Merriman NA, Young WR, Newell FN, Craig C. A Wii bit of fun: a novel platform to deliver effective balance training to older adults. Games Health J. 2015;4:423–433. doi: 10.1089/g4h.2015.0006.
    1. Nicholson VP, McKean MR, Burkett BJ. Twelve weeks of BodyBalance® training improved balance and functional task performance in middle-aged and older adults. Clin Interv Aging. 2014;9:1895. doi: 10.2147/CIA.S71769.
    1. Stel VS, Smit JH, Pluijm SM, Lips P. Balance and mobility performance as treatable risk factors for recurrent falling in older persons. J Clin Epidemiol. 2003;56:659–668. doi: 10.1016/S0895-4356(03)00082-9.
    1. Low DC, Walsh GS, Arkesteijn M. Effectiveness of exercise interventions to improve postural control in older adults: a systematic review and meta-analyses of centre of pressure measurements. Sports Med. 2017;47:101–112. doi: 10.1007/s40279-016-0559-0.
    1. Guskiewicz KM, Perrin DH. Research and clinical applications of assessing balance. J Sport Rehabil. 1996;5:45–63. doi: 10.1123/jsr.5.1.45.
    1. Aagaard P. Training-induced changes in neural function. Exerc Sport Sci Rev. 2003;31:61–67. doi: 10.1097/00003677-200304000-00002.
    1. Ekkekakis P, Petruzzello SJ. Analysis of the affect measurement conundrum in exercise psychology: I. fundamental issues. Psychol Sport Exerc. 2000;1:71–88. doi: 10.1016/S1469-0292(00)00010-8.
    1. Ekkekakis P, Petruzzello SJ. Analysis of the affect measurement conundrum in exercise psychology: IV. A conceptual case for the affect circumplex. Psychol Sport Exerc. 2002;3:35–63. doi: 10.1016/S1469-0292(01)00028-0.
    1. Kwan BM, Bryan A. In-task and post-task affective response to exercise: translating exercise intentions into behaviour. Br J Health Psychol. 2010;15:115–131. doi: 10.1348/135910709X433267.
    1. Muuraiskangas S, Tiri J, Kaartinen J. Easy physical exercise application for the elderly. 2010.
    1. Brodsky G. The relation between verbal and non-verbal behavior change. Behav Res Ther. 1967;5:183–191. doi: 10.1016/0005-7967(67)90033-2.
    1. Zajonc RB. Social facilitation. Science. 1965;149:269–274. doi: 10.1126/science.149.3681.269.
    1. Markus H. The effect of mere presence on social facilitation: an unobtrusive test. J Exp Soc Psychol. 1978;14:389–397. doi: 10.1016/0022-1031(78)90034-3.
    1. Micheo W, Baerga L, Miranda G. Basic principles regarding strength, flexibility, and stability exercises. PM R. 2012;4:805–811. doi: 10.1016/j.pmrj.2012.09.583.
    1. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100:126–131.
    1. Gerling KM, Schild J, Masuch M. Exergaming for elderly: analyzing player experience and performance. Mensch Comput. 2011;1:401–411.
    1. Jackson SA, Roberts GC. Positive performance states of athletes: toward a conceptual understanding of peak performance. Sport Psychol. 1992;6:156–171. doi: 10.1123/tsp.6.2.156.
    1. Young JA, Pain MD. The zone: evidence of a universal phenomenon for athletes across sports. Athl Insight Online J Sport Psychol. 1999;1:21–30.
    1. Nakamura J, Csikszentmihalyi M. The concept of flow. In: Snyder CR, Lopez SJ, editors. Handbook of positive psychology. New York: Oxford University Press; 2002. pp. 89–105.
    1. Jackson SA. Joy, fun, and flow state in sport. In Emotions in Sport. Hanin, YL (ed). Champaign, Illinois: Human Kinetics; 2000. p. 135–55.
    1. Starkes J, Allard F. Cognitive issues in motor expertise. Amsterdam: Elsevier; 1993.
    1. Macnamara BN, Hambrick DZ, Oswald FL. Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis. Psychol Sci. 2014;25:1608–1618. doi: 10.1177/0956797614535810.
    1. Moholdt T, Weie S, Chorianopoulos K, Wang AI, Hagen K. Exergaming can be an innovative way of enjoyable high-intensity interval training. BMJ Open Sport Exerc Med. 2017;3:e000258. doi: 10.1136/bmjsem-2017-000258.
    1. American College of Sports Medicine . ACSM’s Guidelines for exercise testing and prescription. 10. Philadelphia: Wolters Kluwer; 2018.
    1. O’Huiginn B, Smyth B, Coughlan G, Fitzgerald D, Caulfield B. Therapeutic exergaming. In 2009 Sixth International Workshop on Wearable and Implantable Body Sensor Networks, Berkeley, CA. 2009. pp. 273–7. 10.1109/BSN.2009.43.
    1. Tobaigy A, Alshehri MA, Timmons S, Helal OF. The feasibility of using exergames as a rehabilitation tool: the attitudes, awareness, opinions and experiences of physiotherapists, and older people towards exergames. J Phys Ther Sci. 2018;30:555–562. doi: 10.1589/jpts.30.555.
    1. Sony UK | Latest technology & news | Electronics | Entertainment | Sony UK. . Accessed 22 Jul 2020.
    1. Nintendo. Nintendo UK’s official site. . Accessed 22 Jul 2020.

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