Boccia XR as an enjoyable and effective rehabilitation tool for older adults in limited spaces

This study aimed to evaluate the enjoyment and muscle activity for "Boccia XR," a virtual adaptation of Boccia designed to be played in smaller spaces. We compared the effects of Boccia XR, traditional Boccia, and treadmill walking on mood and muscle activity among healthy older adults.

Eighteen healthy older adults (mean age 73.3 ± 5.4 years) participated in three random physical activity sessions: Boccia XR, traditional Boccia, and treadmill walking. Mood changes were assessed using the Profile of Mood States 2nd Edition (POMS 2), focusing on positive (Vigor-Activity: VA) and negative (Total Mood Disturbance: TMD) mood scales. Muscle activity in the lower limbs was measured using electromyography (EMG), targeting four key muscles: the rectus femoris (RF), semitendinosus (ST), tibialis anterior (TA), and medial gastrocnemius (MG). Muscle activity was normalized to the maximum voluntary contraction (MVC).

VA scores significantly increased after Boccia XR (53.7 to 56.2) and traditional Boccia (53.8 to 58.3), with no significant change for treadmill walking (55.3 to 56.3). TMD scores significantly decreased after Boccia XR (43.5 to 40.5) and traditional Boccia (42.6 to 39.5), with no change for treadmill walking (41.2 to 40.5). For muscle activity, RF activation was higher for Boccia XR (13.3 %MVC) and traditional Boccia (14.5 %MVC) compared to treadmill walking (8.3 %MVC). MG activation was lower in Boccia XR (18.4 %MVC) and traditional Boccia (18.2 %MVC) compared to treadmill walking (28.8 %MVC). ST and TA muscle activities were comparable across all tasks.

Boccia XR and traditional Boccia demonstrated significant improvements in both positive mood and reductions in negative mood compared to treadmill walking. Muscle activity analysis revealed that RF activation was higher during both Boccia activities, while MG activation was lower compared to treadmill walking. Despite the lower activation of the MG, the level was sufficient for sedentary older adults. Boccia XR provides similar physical and psychological benefits as traditional Boccia but with the added advantage of requiring less space.

Boccia XR can be effectively integrated into rehabilitation programs for older adults, particularly in environments with limited space, such as rehabilitation facilities or at-home settings. By offering both physical and psychological benefits, Boccia XR has the potential to enhance exercise adherence and overall physical function in older adults. Its engaging and space-efficient format makes it a practical tool for promoting regular physical activity in this population, supporting the maintenance of ADL and improving quality of life.