Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: a randomised controlled trial

Abstract

BackgroundThe use of exergaming is a potential alternative to traditional methods of balance training, which can be repetitive and somewhat monotonous. The purpose of this study was to assess the effects of exergaming using XBOX Kinect™ versus traditional gym-based exercise with no virtual stimuli (TGB) on postural control, technology acceptance, flow experience and exercise intensity, in young healthy adults.MethodsFifty healthy active adults (age: 33.8 ± 12.7 years, height: 172.9 ± 11.9 cm, weight: 75 ± 15.8 kg) were recruited; 44 completed both baseline and post-intervention data collection. Participants were randomised (blind card) allocation to one of two groups: (1) received balance training using the XBOX Kinect™ and (2) performed traditional gym-based exercise. Exercises were matched for intensity, duration and movement patterns across groups. All participants completed three, 30-minute, exercise sessions a week for four weeks. Postural sway was measured using a Kistler™ Force platform during unipedal standing. Mean heart rate (HR) and rate of perceived exertion (RPE) were collected during each exercise session to determine and verify that intensity of exercise was matched between groups. Technology acceptance was measured with the Unified Theory of Acceptance and Use of Technology (UTAUT) and flow experience with the Flow State Scale (FSS).ResultsHeart rate was matched between groups and BORG RPE was significantly lower in the Kinect™ group. There were significant between-group differences in postural sway in the medial-lateral direction and CoP. There were also significant differences in technology acceptance between groups for performance expectancy, social influence and behavioral intention, with higher values in the Kinect exercise group. The flow state scale showed significant differences between the groups on several dimensions, with higher values in the Kinect exercise group.ConclusionObjective physiological demand of exercise (HR) was matched across groups, but the exergaming group perceived it as being less demanding and of lower intensity. This suggests that exergaming may offer an alternative method of rehabilitation exercise through improved concordance. Balance training in healthy adults using the Kinect is both accepted and intrinsically motivating.Trial registrationRetrospectively registered on 27th July 2016. Trial number NCT02851017.

The effects of exergaming on pain, postural control, technology acceptance and flow experience in older people with chronic musculoskeletal pain: a randomised controlled trial

“…Similar results have been reported in previous studies [58,83], which suggests that the immersive environment during exergaming can facilitate distortion of time amongst users. Distortion of time during exercise implies that users experience deep involvement when exercising and become fully invested in the exercise experience [126].…”

“…While of the postural control measures decreased over time in both groups with eyes open and closed, statistically signi cant reductions over time were observed on ML SD, AP SD and the CoP excursion in the anterior-posterior and medio-lateral direction in the exergaming group with vision, indicating better postural control. These improvements in balance are encouraging in comparison with those reported by Barry et al [83]. They found signi cant improvements over time in ML SD, ML range and CoP velocity in healthy adults who had participated in a three-times weekly exergaming intervention for four weeks.…”

“…Postural control was measured as Centre of Pressure (CoP) displacement and velocity, using a portable Kistler™ force platform (Model 9286AA, W 40 x L 60 x H 3.5cm) with a sampling rate of 1000 Hz [82]. Participants stood barefoot on the Kistler™ force plate and looked directly ahead at a visual target (black 100 mm diameter circle) positioned 3 m from the centre of the force plate at eye level [72,83,84] . Participants were asked to stand as still as possible on their dominant leg (preferred kicking), with their eyes open and arms by their side, for three periods of 30s.…”

“…Flow experience was measured using the Flow State Scale questionnaire (FSS) [86]. Flow is the degree to which people experience an optimal psychological state associated with complete absorption in the task that they are doing (a concept widely researched in various elds [58,83,87,88]. The FSS consists of 36 questions with nine subscales and response options on a Likert scale from 1 (strongly disagree) to 5 (strongly agree).…”

Movements of older adults during exergaming interventions that are associated with the Systems Framework for Postural Control: A systematic review

“…Components of the SFPC should be considered when choosing apparatus and designing exergames for older adults and exergames that track movement compliance should be used, where possible, and rated during exergame training to monitor correct form and distinguish capabilities of older individuals. Future exergaming interventions should closely match movements in the exergaming group with that of the control group [54]. The movements should also be based on informed guidelines from current best practices and where possible incorporate movements that are theoretically linked to training deficits in PC.…”