Chang Chien-Hsiang, Wei Chun-Chun, Lien Wei-Chih, Yang Tai-Hua, Liu Bo, Lin Yimo, Tan Poh Thong, Lin Yang-Cheng
Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan.
Department of Creative Design, National Yunlin University of Science and Technology, Yunlin, Taiwan.
JMIR Serious Games. 2025 Jan 21;13:e50669. doi: 10.2196/50669.
Aging in older adults results in a decline in physical function and quality of daily life. Due to the COVID-19 pandemic, the exercise frequency among older adults decreased, further contributing to frailty. Traditional rehabilitation using repetitive movements tends not to attract older adults to perform independently.
Intelligent Rehabilitation Exergame System (IRES), a novel retro interactive exergame that incorporates real-time surface electromyography, was developed and evaluated.
Frail older adults were invited to use the IRES for rehabilitation using lower limb training twice per week for 4 weeks. Participants were required to have no mobility or communication difficulties and be willing to complete the 4-week study. The enrolled cohort had baseline scores ranging from 1 to 5 on the Clinical Frailty Scale, as described by Rockwood et al. Three major lower limb movements (knee extension, plantar flexion, and dorsiflexion) were performed 20 times for each leg within 30 minutes. The surface electromyography collected and analyzed muscle potential signals for review by health care professionals to customize the protocol for the next training. The System Usability Scale (SUS) and Taiwanese version of the EuroQol-5 Dimensions (EQ-5D) were administered after completing the first (week 1, baseline) and last training (week 4, one-month follow-up) to evaluate the usability of the IRES and its effects on the quality of life of participants.
A total of 49 frail older adults (mean age 74.6 years) were included in the analysis. The usability of the IRES improved according to the mean SUS score, from 82.09 (good) at baseline to 87.14 (good+) at 1-month follow-up. The willingness to use (t96=-4.51; P<.001), learnability (t96=-4.83; P<.001), and confidence (t96=-2.27; P=.02) in working with the IRES increased. After using the IRES for 1 month, significant improvements were observed in the ease of use (t47=2.05; P=.04) and confidence (t47=2.68; P<.001) among participants without previous rehabilitation experience. No sex-based differences in the SUS scores were found at baseline or 1-month follow-up. The quality of life, as assessed by the EQ-5D, improved significantly after 1 month of IRES training compared to that at baseline (t96=6.03; P<.001).
The novel IRES proposed in this study received positive feedback from frail older adults. Integrating retro-style exergame training into rehabilitation not only improved their rehabilitation motivation but also increased their learning, system operability, and willingness to continue rehabilitation. The IRES provides an essential tool for the new eHealth care service in the post-COVID-19 era.
老年人的衰老会导致身体功能和日常生活质量下降。由于新冠疫情，老年人的锻炼频率降低，这进一步加剧了身体虚弱。传统的重复性运动康复方法往往无法吸引老年人独立进行锻炼。
开发并评估了智能康复运动游戏系统（IRES），这是一种新型的复古交互式运动游戏，集成了实时表面肌电图技术。
邀请身体虚弱的老年人使用IRES进行下肢训练，每周两次，共4周。参与者需无行动或沟通障碍，并愿意完成为期4周的研究。根据Rockwood等人的描述，纳入队列的临床衰弱量表基线评分在1至5分之间。每条腿在30分钟内进行20次三大下肢运动（膝关节伸展、跖屈和背屈）。收集并分析表面肌电图以获取肌肉电位信号，供医疗保健专业人员审查，以便为下一次训练定制方案。在完成第一次训练（第1周，基线）和最后一次训练（第4周，1个月随访）后，使用系统可用性量表（SUS）和台湾版欧洲五维健康量表（EQ-5D）评估IRES的可用性及其对参与者生活质量的影响。
共有49名身体虚弱的老年人（平均年龄74.6岁）纳入分析。根据SUS平均得分，IRES的可用性有所提高，从基线时的82.09（良好）提高到1个月随访时的87.14（良好+）。使用IRES的意愿（t96=-4.51；P<.001）、学习能力（t96=-4.83；P<.001）和信心（t96=-2.27；P=.02）均有所增加。使用IRES 1个月后，无既往康复经验的参与者在易用性（t47=2.05；P=.04）和信心（t47=2.68；P<.001）方面有显著改善。在基线或1个月随访时，未发现SUS评分存在性别差异。与基线相比，IRES训练1个月后，EQ-5D评估的生活质量有显著改善（t96=6.03；P<.001）。
本研究中提出的新型IRES获得了身体虚弱的老年人的积极反馈。将复古风格的运动游戏训练融入康复不仅提高了他们的康复积极性，还增强了他们的学习能力、系统可操作性以及继续康复的意愿。IRES为新冠疫情后时代的新型电子医疗服务提供了重要工具。
