Use of a technology-based system to motivate older adults in performing physical activity: a feasibility study

Els Knippenberg, Annick Timmermans, Steven Palmaers, Annemie Spooren, Els Knippenberg, Annick Timmermans, Steven Palmaers, Annemie Spooren

Abstract

Background: Maintaining or initiating regular physical activity (PA) is important for successful aging. Technology-based systems may support and stimulate older adults to initiate and persevere in performing PA. The aim of the current study was to assess to which extent a customised Kinect system is 1) a credible tool to increase PA in older adults, 2) motivating to perform PA by older adults, and 3) easy to be used in older adults.

Methods: A mixed-method cross-sectional feasibility study was performed in 5 aged care facilities in Flanders, Belgium. Aged participants were asked to perform a 20-30 min test with the intelligent Activity-based Client-centred Training (i-ACT) system. After the test, the 'Credibility and Expectancy Questionnaire' (CEQ), the 'Intrinsic Motivation Inventory'(IMI), the System Usability Scale (SUS), and semi-structured interviews were conducted in the older adults. Feedback was gathered using the thinking aloud method in both aged participants and healthcare professionals.

Results: A total of 48 older adults (20 males and 28 females, mean age = 81.19 (SD = 8.10)), were included. The scores pertaining to system credibility and expectancy, system usability, and motivation towards use were moderate to good. Participants reported that they liked using the i-ACT system, but that the context could be more attractive by adding more visualisations. Twelve professionals stated that they observed involvement in older adults but think that i-ACT is better used in day care centres.

Conclusions: This study indicates that i-ACT is a usable and motivational system to engage older adults to perform PA and therefore supports successful aging. Future research is necessary to investigate the efficacy of i-ACT to perform PA and the transfer to regain and/or maintain engagement in ADLs that older adults find meaningful and purposeful at an older age. Also, further development of i-ACT is advisable to adapt the i-ACT system towards implementation at the home of older adults.

Trial registration: ClinicalTrial.gov ID NCT04489563 , 23 July 2020 - Retrospectively registered.

Keywords: Client-centred; Older adults; Physical activity; Technology.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Client interface during performance of the exercise “lifting knee”
Fig. 2
Fig. 2
Visual representation of the results of the thematic analysis

References

    1. World Health Organization. Ageing and Health: World Health Organization; 2018 [updated 5 February 2018. Available from: .
    1. European Commission. 2018 Ageing report: policy challenges for ageing societies: ageing working Group of the Economic Policy Committee (EPC) and European Commission’s Directorate-General for Economic and Financial Affairs (DG ECFIN); 2018 [updated 25 May 2018. Available from: .
    1. Bonder BR, Bello-Haas VD. Functional Performance in Older Adults. 3 ed: F.A. Davis 2008.
    1. Rowe JW, Kahn RL. Successful Aging1. The Gerontologist. 1997;37(4):433–440. doi: 10.1093/geront/37.4.433.
    1. Fanning J, Awick EA, Wójcicki TR, Gothe N, Roberts S, Ehlers DK, et al. Effects of a DVD-delivered exercise intervention on maintenance of physical activity in older adults. J Phys Act Health. 2016;13(6):594–598. doi: 10.1123/jpah.2015-0173.
    1. Keadle SK, Arem H, Moore SC, Sampson JN, Matthews CE. Impact of changes in television viewing time and physical activity on longevity: a prospective cohort study. Int J Behav Nutr Phys Act. 2015;12(1):156. doi: 10.1186/s12966-015-0315-0.
    1. Canadian Association of Occupational Therapists. Enabling Occupation: An Occupational Therapy Perspective. Rev Ed ed: CAOT; 2002 01/01/2002.
    1. Roberts S, Awick E, Fanning JT, Ehlers D, Motl RW, McAuley E. Long-term maintenance of physical function in older adults following a DVD-delivered exercise intervention. J Aging Phys Act. 2017;25(1):27–31. doi: 10.1123/japa.2015-0284.
    1. World Health Organization. Physical activity: World Health Organization; 2018 [updated 23 February 2018. Available from: .
    1. World Health Organization. Global Recommendations on Physical Activity for Health - 65 years and above. : World Health Organization; 2011 [Available from: .
    1. de Labra C, Guimaraes-Pinheiro C, Maseda A, Lorenzo T, Millán-Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 2015;15:154. doi: 10.1186/s12877-015-0155-4.
    1. Frost R, Belk C, Jovicic A, Ricciardi F, Kharicha K, Gardner B, et al. Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis. BMC Geriatr. 2017;17(1):157. doi: 10.1186/s12877-017-0547-8.
    1. Glasgow RE, Bull SS, Gillette C, Klesges LM, Dzewaltowski DA. Behavior change intervention research in healthcare settings: a review of recent reports with emphasis on external validity. Am J Prev Med. 2002;23(1):62–69. doi: 10.1016/S0749-3797(02)00437-3.
    1. Burton E, Farrier K, Galvin R, Johnson S, Horgan NF, Warters A, et al. Physical activity programs for older people in the community receiving home care services: systematic review and meta-analysis. Clin Interv Aging. 2019;14:1045–1064. doi: 10.2147/CIA.S205019.
    1. World Health Organization. World report on ageing and health Luxembourg: World Health Organization; 2015 [updated 30 September 2015. Available from: .
    1. Molina KI, Ricci NA, de Moraes SA, Perracini MR. Virtual reality using games for improving physical functioning in older adults: a systematic review. J Neuroeng Rehabil. 2014;11:156. doi: 10.1186/1743-0003-11-156.
    1. Itakussu EY, Valenciano PJ, Trelha CS, Marchiori L, editors. Benefits of Exercis Training with NINTENDO® Wii for Healthy Elderly Population: Literature Review. 2015.
    1. Webster D, Celik O. Systematic review of Kinect applications in elderly care and stroke rehabilitation. J Neuroeng Rehabil. 2014;11:108. doi: 10.1186/1743-0003-11-108.
    1. De Boissieu P, Denormandie P, Armaingaud D, Sanchez S, Jeandel C. Exergames and elderly: a non-systematic review of the literature. Eur Geriatr Med. 2017;8(2):111–116. doi: 10.1016/j.eurger.2017.02.003.
    1. Nuic D, Vinti M, Karachi C, Foulon P, Van Hamme A, Welter M-L. The feasibility and positive effects of a customised videogame rehabilitation programme for freezing of gait and falls in Parkinson’s disease patients: a pilot study. J Neuroeng Rehabil. 2018;15(1):31. doi: 10.1186/s12984-018-0375-x.
    1. American Occupational Therapy Association Occupational therapy practice framework: domain and process. Am J Occup Ther. 2002;56(6):609–639.
    1. Siegert RJ, Taylor WJ. Theoretical aspects of goal-setting and motivation in rehabilitation. Disabil Rehabil. 2004;26(1):1–8. doi: 10.1080/09638280410001644932.
    1. Spooren AI, Janssen-Potten YJ, Kerckhofs E, Seelen HA. Outcome of motor training programmes on arm and hand functioning in patients with cervical spinal cord injury according to different levels of the ICF: a systematic review. J Rehabil Med. 2009;41(7):497–505. doi: 10.2340/16501977-0387.
    1. Enemark Larsen A, Rasmussen B, Christensen JR. Enhancing a client-Centred practice with the Canadian occupational performance measure. Occup Ther Int. 2018;2018:5956301. doi: 10.1155/2018/5956301.
    1. Prescott S, Fleming J, Doig E. Goal setting approaches and principles used in rehabilitation for people with acquired brain injury: a systematic scoping review. Brain Inj. 2015;29(13–14):1515–1529. doi: 10.3109/02699052.2015.1075152.
    1. Carswell A, McColl MA, Baptiste S, Law M, Polatajko H, Pollock N. The Canadian occupational performance measure: a research and clinical literature review. Can J Occup Ther Rev Can D’ergother. 2004;71(4):210–222. doi: 10.1177/000841740407100406.
    1. Vanroy J, Seghers J, van Uffelen J, Boen F. Can a framed intervention motivate older adults in assisted living facilities to exercise? BMC Geriatr. 2019;19(1):46. doi: 10.1186/s12877-019-1060-z.
    1. Knippenberg E, Van Hout L, Smeets W, Palmaers S, Timmermans A, Spooren A. Developing an intelligent activity-based client-centred training system with a user-centred approach. Technol Health Care. 2020;28(4):355–68. doi: 10.3233/THC-191854.
    1. Tashakkori A, Teddlie C, Teddlie CB. Mixed methodology: combining qualitative and quantitative approaches: sage; 1998.
    1. Jager J, Putnick DL, Bornstein MH. II. More than just convenient: the scientific merits of homogeneous convenience samples. Monogr Soc Res Child Dev 2017;82(2):13–30.
    1. Deci EL, Eghrari H, Patrick BC, Leone DR. Facilitating internalization: the self-determination theory perspective. J Pers. 1994;62(1):119–142. doi: 10.1111/j.1467-6494.1994.tb00797.x.
    1. Markland D, Hardy L. On the factorial and construct validity of the intrinsic motivation inventory: conceptual and operational concerns. Res Q Exerc Sport. 1997;68(1):20–32. doi: 10.1080/02701367.1997.10608863.
    1. McAuley E, Duncan T, Tammen VV. Psychometric properties of the intrinsic motivation inventory in a competitive sport setting: a confirmatory factor analysis. Res Q Exerc Sport. 1989;60(1):48–58. doi: 10.1080/02701367.1989.10607413.
    1. Tsigilis N, Theodosiou A. Temporal stability of the intrinsic motivation inventory. Percept Mot Skills. 2003;97(1):271–280. doi: 10.2466/pms.2003.97.1.271.
    1. Bangor A, Kortum PT, Miller JT. An empirical evaluation of the system usability scale. Intl J Hum Comput Interact. 2008;24(6):574–594. doi: 10.1080/10447310802205776.
    1. Borkovec TD, Nau SD. Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatry. 1972;3(4):257–260. doi: 10.1016/0005-7916(72)90045-6.
    1. Devilly GjB, T D. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry 2000;31:73–86.
    1. Ericsson KA, Simon HA. Verbal reports as data. Psychol Rev. 1980;87(3):215. doi: 10.1037/0033-295X.87.3.215.
    1. Boren T, Ramey J. Thinking aloud: reconciling theory and practice. IEEE Trans Prof Commun. 2000;43(3):261–278. doi: 10.1109/47.867942.
    1. Mortelmans D. Handboek kwalitatieve onderzoeksmethoden. Acco: Leuven; 2007.
    1. Howitt D. Introduction to qualitative research methods in psychology: putting theory into practice: Pearson UK; 2019.
    1. Knippenberg E, Spooren A. Opportunities of markerless motion detection systems for use in neurological rehabilitation: a qualitative study on patient and therapist perspective. Austin Journal of Robotics and Automation. 2016;3(1).
    1. Chen TL, Bhattacharjee T, Beer JM, Ting LH, Hackney ME, Rogers WA, et al. Older adults’ acceptance of a robot for partner dance-based exercise. PLoS One. 2017;12(10):e0182736. doi: 10.1371/journal.pone.0182736.
    1. Barry G, Galna B, Rochester L. The role of exergaming in Parkinson’s disease rehabilitation: a systematic review of the evidence. J Neuroeng Rehabil. 2014;11(1):33. doi: 10.1186/1743-0003-11-33.
    1. Gallagher R, Damodaran H, Werner WG, Powell W, Deutsch JE. Auditory and visual cueing modulate cycling speed of older adults and persons with Parkinson’s disease in a virtual cycling (V-cycle) system. J Neuroeng Rehabil. 2016;13(1):77. doi: 10.1186/s12984-016-0184-z.
    1. Knippenberg E, Verbrugghe J, Lamers I, Palmaers S, Timmermans A, Spooren A. Markerless motion capture systems as training device in neurological rehabilitation: a systematic review of their use, application, target population and efficacy. J Neuroeng Rehabil. 2017;14(1):61. doi: 10.1186/s12984-017-0270-x.
    1. van Seben R, Reichardt L, Smorenburg S, Buurman B. Goal-setting instruments in geriatric rehabilitation: a systematic review. J Frailty Aging. 2017;6(1):37–45.
    1. Morgan GS, Willmott M, Ben-Shlomo Y, Haase AM, Campbell RM. A life fulfilled: positively influencing physical activity in older adults–a systematic review and meta-ethnography. BMC Public Health. 2019;19(1):362. doi: 10.1186/s12889-019-6624-5.

Source: PubMed

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