Usability of the serious game VirtualTer's home version and intrinsic motivation of healthy elderly people
Aging, Postural Balance, Exergames, Virtual Reality.
Introduction: Virtual reality games are promising tools for gait and balance rehabilitation in the elderly. These games use challenge, narrative and interactivity to generate intrinsic motivation in the patient. Strategies that increase intrinsic motivation may be more effective with regard to learning transfer and behavior changes. In this context, the potential of the game is mainly due to the motivational factor that they awaken in their users. However, there is an important aspect that must be considered when thinking about clinical practice: the usability of the game. In this sense, it is important to investigate the home usability and the intrinsic motivation of healthy elderly people after using a serious game for balance rehabilitation at home.Objective: To analyze the usability of the home version of the VirtualTer serious game and the intrinsic motivation of healthy elderly people after using the system. Method: This is a descriptive and cross-sectional study, with a sample of 25 healthy elderly recruited in a non-probabilistic way and for convenience. The home version of the VirtualTer serious game, developed for the rehabilitation of postural balance in the elderly, was used. The game had VirtualTer challenge stages (forest, mountain and desert), which stimulate the lateral reach of the trunk. The game was run using a notebook and the PoseNet motion capture interface, a pose recognition software via webcam. The game was applied in the home environment, and each elderly person performed three repetitions. An evaluation of sociodemographic data was carried out, in addition to the application of the Short Physical Performance Battery (SPPB); International Physical Activity Questionnaire (IPAQ); and the WHODAS 2.0 Disability Rating Scale. After applying the game, the elderly answered the Intrinsic Motivation Inventory (IMI) and the System Usability Scale (SUS). Results: The study included 25 elderly people, with moderate physical performance, a high degree of physical inactivity and sedentary behavior, 68% of whom were female. The median age was 69 (IQ 61 – 76.5) years. The WHODAS 2.0 analysis showed a median score of 55 (IQ 42.5 – 69) points, indicating a population with moderate disability. The total score of the SUS scale obtained a median of 72.50 (IQ 95 – 28); which classifies a good usability of the home version of VirtualTer. The variables gender (p=0.04), marital status (p=0.03) and education (p=0.01) indicated statistical significance with the usability scale. The intrinsic motivation measured by the IMI resulted in a median of 87 (IQ 96 – 56) points, which indicates greater motivation of the players. Conclusion: The home version of VirtualTer is a serious game with good usability and good intrinsic motivation, from the patient's point of view, which indicates the effectiveness of the system as a rehabilitation tool for postural balance in the elderly.