Challenges in Evaluating Exergames with Older Adults
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Did They Really Like the Game? -- Challenges in Evaluating Exergames with Older Adults Jan Smeddinck .athrin M. Gerling AEstract University of Bremen 8niversity of Saskatchewan Exergames offer exciting perspectives not only for rec- Bibliothekstrae 1 110 Science Place reational, but also for therapeutic use. Increasing num- Bremen 28359, Germany Saskatoon S7N 5C9, Canada Eers of older adults in many industrialized countries smeddinck#tzi.de [email protected] raise the need for affordable and reliaEle solutions to help people to stay healthy and fit at advanced ages. Marc Herrlich Rainer 0alaka :hile games user research is vital to increasing the University of Bremen 8niversity of Bremen Tuality of game designs and improving game design Bibliothekstrae 1 BiEliothekstrae 1 processes, many research tools are difficult to use with Bremen 28359, Germany Bremen 28359, Germany senior gamers, and the target group is especially vul- [email protected] [email protected] nerable to mistakes both in game design and games user research. 0arNus Krause :e report and classify some of these challenges along University of Bremen with possible approaches, aiming to fuel intensified ex- Bibliothekstrae 1 change about methodological experiences among re- Bremen 28359, Germany searchers in the field. [email protected] Author .eywords Evaluation, methodology, games, entertainment, game design, older adults, physical therapy. ACM Classification Keywords ..4.2 [Computers and Society]: Social Issues ± Assis- Copyright is held by the author/owner(s). tive technologies for people with disabilities, Handi- CHI‘12, May 5±10, 2012, Austin, Texas, USA. capped persons/special needs; K.8.0 [Personal Compu- AC0 978-1-4503-1016-1/12/05. ting]: General - Games. Introduction Challenges: Evaluating Games with Elderly ,ndustrialized societies are faced with a growing num- The challenges that were noted in a range of studies ber of older adults, and many industries have started to involving exergames developed at the 8niversity of embrace senior citizens as a new target audience. Even Bremen, Germany (Figure 1) and the University of Sas- in video game development, which has traditionally Natchewan, Canada (Figure 2) can be categorized focused on a younger audience, older adults are in- roughly as general challenges related to the evaluation creasingly considered a valuable user group. Yet, little of games with older adults, as well as challenges specif- is Nnown aEout their needs regarding interface and ic to the evaluation of exergames for the elderly. Figure 1. Cinderella is a multi- game design. This is particularly difficult when design- General Challenges player game for up to three play- ing exergames, which aim to encourage players to re- ers. The game encourages move- Four general game-related challenges were observed ments according to music rhythm. main physically active [8]. Since motion detection has during our studies, ranging from issues caused by the 0ovements are based on Ninesiatric Eecome part of mainstream gaming hardware (Ninten- impact of age-related changes to a lacN of gaming ex- exercises. ,t is part of the Wuppdi! do Wii controllers, Sony Playstation Move, Microsoft suite that contains five small games perience and a low level of computer literacy, which for the support of motion-Eased .inect, etc.), games that motivate physical activities influences the perception of games among older adults. therapy for ParNinson‘s disease are availaEle to a wide range of users. Although re- patients. search suggests that such games are beneficial for old- Anxiety related to technology necessary for an evalua- er adults [7], age-related changes and impairments tion: Pretests of the Wuppdi! prototype [2] showed that influence the interaction process [3], leading to a varie- an experimentation room that displays too many cables ty of proElems related to the usability and accessibility and computers as parts of non-invasive research tools of such games. In this context, an important step to- (cameras, microphones, etc.) can scare and confuse wards the development of senior-friendly games is the elderly participants to the point that they withdraw establishment of a user-centered design process, which from an experiment. Negative feelings related to per- introduces evaluations at an early point of the devel- sonal performance: Failure in games is often attributed opment process. However, applying established meth- to personal failure rather than poor game design [4]. ods in games user research [6] can be difficult due to 0any participants are concerned that their performance is tested instead of the Tuality of the game. Social fac- Figure 2. A virtual garden specifi- the impact of age-related changes and special needs of cally designed for institutionalized the target audience. tors severely influence the research of exergames for older adults using Microsoft Kinect older adults as many elderly try to be polite when ex- as input device. Gestures were ,n this paper, we summarize results of our own case perimenters are present. To this end, experimenter designed in collaboration with a studies to identify core challenges of evaluating exer- physical therapist. Additionally, the effects should Ee considered carefully as a potential game features a caliEration routine games with older adults, and we address the develop- Eias, especially when conducting interviews or focus which adapts interaction paradigms ment of evaluation methods that allow researchers and groups that include direct questioning of participants. to the range of motion of individual practitioners to meet the needs of older adults. There- players. Overstraining participants: Player performance and by, we hope to foster the creation of accessible exer- their ability of answering extensive questionnaires vary games and games for physical therapy for senior citi- on a daily basis [3]. During the evaluation of Wuppdi! zens. [2], therapists and caregivers pointed out that individu- al physical fitness and cognitive awareness among older eo-stream recordings, but also in the resulting approx- * Questionnaires are crucial tools for the evaluation of games. When adults may vary strongly from one day to the next and imated skeletal postures and movements. As a result, working with older adults, standard also over the course of a day. The duration of play ses- game prototypes we used had to Ee adjusted to be Tuestionnaires from games user sions and the length of asynchronous Tualitative in- much more tolerant towards imprecise input. This can research are often difficult to ap- struments have to be adjusted accordingly. Ee challenging in combination with the differences in ply, because they do not fully match the application context and Challenges Specific to Exergames range of motion among elderly and tracNing difficulties may overstrain participants. At- resulting from additional special needs, for example tempts at simplifying the answer- Evaluating exergames with older adults is particularly when participants are in wheelchairs [3]. ing process lead to contradictory challenging. In this section, we list different problems results: that we oEserved during our evaluation sessions. Another important aspect of physical therapy game During the evaluation of Silver- First of all, encouraging physical activity among elderly design is the involvement of therapists, family mem- Promenade, Gerling et al. [4] in- Eers and nursing staff, who have additional interests, troduced smiley scales to facilitate users may increase certain health risks for frail partici- the answering process. pants. Cognitive load is increased when participants such as being able to support a player with playing the However, attempts in the Wuppdi! have to coordinate movements, interact with games game and tracNing their performance (cf. [1]). While project to represent Likert scales and try to reflect on their experience. Such multi tasks most therapists were interested in our research proto- through smiley scales did not im- types and the approach of games for physical therapy, prove the understanding of the are particularly challenging for older adults but also many were cautious to point out that they would not Tuestions. Instead, reading ques- Eeneficial in physical therapy [5]. Additionally, partici- tions as a structured interview pants were extremely focused on in-game events while want the games to get in the way of their work, or to improved participants‘ aEilities of ”replace‘ therapeutic intervention time. Still, these third responding adeTuately. playing the :uppdi! prototypes, and sometimes came close to stumbling in the real world. For older adults, party groups can be valuable to the game design pro- this may be a serious health hazard as falls can easily cess, assume roles in the game mechanics (cf. [7]) and lead to bone fractures. Furthermore, we observed in data analysis, since they are practically involved with tendencies in older adults to overexert while engaging the patients and often provide important insights into with exergames to complete all tasks within an evalua- individual participants‘ capaEilities and needs. The in- tion [4]. Since they only informed the experimenter clusion of methods allowing researchers to harness the about their exhaustion after the gaming session, it was potential benefits brought in by third parties could not possiEle to aEort it. The application of multiple tests prove highly valuable. to measure physical stress and exertion requires ex- Discussion tended ethics approval and the involvement