Modification in the Motor Skills of Seniors in Care Homes Using Serious Games and the Impact of COVID-19: Field Study

Abstract

Background: The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. At the beginning of 2020, the COVID-19 pandemic led to many restrictions, which affected seniors in care facilities in the form of severe isolation. The isolation led, among other things, to a lack of exercise, which has led to a multitude of negative effects for this target group. Serious games can potentially help by being used anywhere at any time to strengthen skills with few resources.

Objective: The aim of this study is to evaluate the effectiveness of a serious game to strengthen motor skills (study 1) and the influence of pandemic restrictions (study 2) on seniors in care facilities.

Methods: The data on motor skills (measured by the Tinetti test) originated from an intervention study with repeated measurements that was interrupted by the pandemic conditions. Data were collected 4 times every 3 months with an intervention group (IG, training 3 times for 1 hour per week) and a control group (CG, no intervention). There were 2 substudies. The first considered the first 6 months until the pandemic restrictions, while the second considered the influence of the restrictions on motor skills.

Results: The sample size was 70. The IG comprised 31 (44%) participants, with 22 (71%) female and 9 (29%) male seniors with an average age of 85 years. The CG comprised 39 (56%) participants, with 31 (79%) female and 8 (21%) male seniors with an average age of 87 years. In study 1, mixed-design ANOVA showed no significant interaction between measurement times and group membership for the first measurements (F_2.136=1.414, P<.25, partial η2=.044), but there was a significant difference between the CG (mean 16.23, SD 1.1) and the IG (mean 19.81, SD 1.2) at the third time of measurement (P=.02). In study 2 the mixed-design ANOVA (used to investigate motor skills before and after the pandemic conditions between the 2 groups) couldn't reveal any significant interaction between measurement times and group membership: F_1.67=2.997, P<.09, partial η2=.043. However, there was a significant main effect of the time of measurement: F_1.67=5.44, P<.02, partial η²=.075.

Conclusions: During the first 6 months, the IG showed increased motor skills, whereas the motor skills of the CG slightly deteriorated and showed a statistically significant difference after 6 months. The pandemic restrictions leveled the difference and showed a significant negative effect on motor skills over 3 months. As our results show, digital games have the potential to break down access barriers and promote necessary maintenance for important skills. The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. This potentially great benefit for the challenges of tomorrow shows the relevance of the topic and demonstrates the urgent need for action and research.

Trial registration: Deutsches Register klinischer Studien DRKS00016633; https://tinyurl.com/yckmj4px.

Keywords: COVID-19; aged; care home; coronavirus effects; digital game; digital health; eHealth; elder; exercise; intervention effects analysis; long-term care; motor; motor skills; movement; older adult; pandemic; physical activity; senior population; seniors; serious games.

Figure 1

Exemplary Bowling module in the serious game MemoreBox.

Figure 2

Survey times, periods of operationalization, and dropout reasons. CG: control group; IG: intervention group.

Figure 3

Results of the Tinetti total score for the IG and CG over 6 months of intervention. T0: IG (mean 18.16, SD 5.88), CG (mean 16.67, SD 6.58); T1: IG (mean 19, SD 6.77), CG (mean 16.62, SD 7.93); T2: IG (mean 19.81, SD 6.34), CG (mean 16.23, SD 7.14); CG: control group; IG: intervention group.

Figure 4

Significant differences after 9 months of intervention between IG and CG and between measurement times. CG: control group; IG: intervention group.