The VITAAL Stepping Exergame Prototype for Older Adults With Major Neurocognitive Disorder: A Usability Study.

This study investigates the usability of a stepping exergame in older adults with major neurocognitive disorder (MNCD) residing in a long-term care facility. A mixed methods study was conducted. Participants played exergames for 30 min on one try-out session. During the exergames, the think aloud method was used, and field notes were taken by the facilitator. Following the exergames, participants completed the System Usability Scale (SUS) and a semi-structured in-depth interview about usability including their personal experiences. Audio files were transcribed and a thematic content analysis of the think aloud data, field notes and interviews were performed using NVivo 12. Twenty-two participants with MNCD were included [mean age = 84.3 ± 5.5 (70-95) years; 81.8% women; Short Physical Performance Battery score = 7.5 ± 3.2 (1-12), Montreal Cognitive Assessment score = 11.9 ± 4.4 (2-19)]. System usability was rated "ok to good" with a mean SUS score of 57.8 ( = 12.3) with scores ranging from 37.5 to 90.0. Five main themes emerged from the thematic content analysis: (1) perceived user friendliness and acceptability of the exergames; (2) interactional experience; (3) motivational factors; (4) training modalities; and (5) risks. There were no adverse events nor dropouts. Participants evaluated the usability of the exergames positively. The results indicate that the stepping exergame is usable in older adults with MNCD.