Exergaming acceptance and experience in healthy older people and older people with musculoskeletal pain.

  • Yvonne Khoo

Student thesis: Doctoral Thesis


The research reported in the thesis investigated exergaming acceptance and expe-rience in older people with special reference to technology acceptance, flowstate, chronic pain and balance control. In recent years, there has been an increasing amount of literature on the beneficial effects of exergaming on older people’s health, well-being and balance, including the use of exergaming as a method of pain con-trol. Nevertheless, when taken separately, specific studies vary in methodology and in type(s) of exergaming topics studied. Health benefits from exergaming may only be gained if older people take part in it. There is evidence in the literature to indicate that usage of a technology is preceded by user acceptance. Few studies, to date, have investigated how older people perceive and experience exergaming in relation to their perceived abilities and future intention to use it, from a technology acceptance point of view. Therefore, the purpose of this thesis was to see if (1) the exergaming technology was acceptable to healthy older people and older people with chronic pain and (2) it had any effect in the self-reported health status, pain conditions and balance in older people with chronic pain. The current thesis consists of two separate studies. In Study 1, twenty-eight healthy older people participated in six 40-minute exergaming sessions within a three-week period. In Study 2, fifty-four older people with chronic musculoskeletal pain attended a twelve 40-minute exercise intervention within a six-week period, either randomised into an exergaming group (IREXTMsystem) or standard physical exercises. A modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT) was analysed at baseline and upon completion of the intervention, including specific time points throughout the study. Self-perceived chronic pain and flow state were analysed at baseline and after exercise intervention. Rate of perceived expended physical and mental effort was recorded after every exercise session and compared between groups. Heart rate was recorded in the second study. Postural sway was assessed at the start and the end of the intervention with Centre of Pressure data being extracted via a Kistler force plate (AP SD, AP range ,ML SD, ML range and CoP velocity), where the conditions were quiet bipedal standing with eyes open and eyes closed. Evidence from both studies showed that exergaming technology was acceptable to healthy older people and older people with chronic musculoskeletal pain. Recorded high levels of flow indicated the occurrence of flow during the intervention. Perfor-mance expectancy emerged as the strongest predictor of older people’s behavioural intention to use exergaming. Previous behaviour was an important influence of future behaviour, within the context of exergaming. In Study 1, there were significant increases throughout the intervention in most of the flow state variables except challenge-skill-balance, paradox of control and transformation of time. Thematic analysis of olde rpeople’s responses relating to exergaming revealed that enjoyment was the most frequently cited theme. The significant increase of perceived physical exertion suggested that exergaming provided light-to-moderate intensity exercise for this cohort of healthy older people.In Study 2, an interesting pattern emerged over time where earlier on in the interven-tion, effort expectancy significantly predicted older people’s behavioural intention to use exergaming (instead of performance expectancy). This role was then taken over by performance expectancy midway through the intervention. This indicated that this sample of older people with chronic pain prioritised their personal ability to play the exergames, after which, they then considered the usability of the exergaming technology in choosing whether to use it in future, if it were readily made available. In addition, there was evidence of improvement in
Date of Award7 Feb 2014
Original languageEnglish
Awarding Institution
  • Teesside University
SupervisorDenis Martin (Supervisor)

Cite this