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Rebsamen S1,2,3, Baschung Pister P1,2, de Bruin ED4,5, Knols RH1
1University Hospital Zurich, Direction of Research and Education, Physiotherapy Occupational Research Centre, Zurich, Switzerland, 2ZHAW Zurich University of Applied Sciences, Institute of Physiotherapy, Winterthur, Switzerland, 3Kantonsspital Winterthur, Institute of Physiotherapy, Winterthur, Switzerland, 4ETH Zurich, Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Zurich, Switzerland, 5Karolinska Institute, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
Background: Despite the overwhelming evidence for significant beneficial effects of aerobic training on health, most older adults show insufficient levels of weekly exercise. Recent advances in technology have presented an opportunity for combining exercise with cognitively challenging tasks through so called exergames. These provide potentially attractive means to facilitate training in an appealing ambience. High-intensity interval training (HIIT) is an effective way to improve exercise capacity as well as metabolic and cardiovascular health, yet the feasibility to perform HIIT using exergames in healthy older adults is unclear.
Purpose: This study aimed to evaluate the feasibility of an exergaming-based HIIT and its effects on cardiovascular fitness in healthy older adults.
Methods: Twelve healthy older participants (ten women, mean age 72.3 (SD 4.44) years) performed a high-intensity interval exergame intervention three times a week for four weeks. Feasibility outcomes included attrition, adherence, acceptability (Technology Acceptance Model Questionnaire, TAM), perceived usefulness (System Usability Scale, SUS), enjoyment of exergaming and comparisons between actual and target values of training intensity and time. The secondary outcome was cardiovascular and cardiorespiratory fitness (heart rate at rest (HRrest), heart rate variability (HRV), maximum heart rate (HRmax), and maximum workload (W, in watt) evaluated through maximal exercise testing).
Results: Eleven participants completed the twelve sessions (8.3 percent attrition) without any adverse events. Adherence to the HIIT intervention was 90.9 percent and participants showed high acceptance of the intervention with TAM scores between 5.8 and 6.7/7. User satisfaction was rated as excellent (SUS total score: 93.5/100) and the overall enjoyment of exergaming scored 4.45/5 points.
Total exercise time ranged from 19 to 35 min with a mean of 30.8 (SD 3.6) min. Actual high-intensity exercise time showed consistency with the target exercise time in ninety-eight percent of trainings. Eighty-six percent of high-intensity intervals met the targeted intensity range (>70-90% of HRmax). Thirty-six percent of the recovery periods were completed with a heart rate above the target range of 50-70% of HRmax.
Maximum workload (W) during the incremental exercise test post-training increased significantly compared to the baseline measurement (p=0.032, effect size r=0.77). Most of the other secondary outcome parameters showed trends toward significance or remained unchanged.
Conclusion(s): The results indicate that a high-intensity interval training through exergaming is feasible, safe and shows high satisfaction and acceptance in healthy older adults. This corroborates previous findings in showing that virtual reality-based approaches for performing aerobic training are perceived as usable. HIIT through exergaming has a significant effect on maximum power output on an incremental exercise test. Furthermore, the positive trends shown regarding exercise capacity warrant future studies in older adults.
Implications: To the best of our knowledge, this feasibility study is the first to explore the use of exergames as a high-intensity interval endurance training method in a healthy older population. A more extensive intervention period, higher work to recovery ratios as well as a higher-intensity activity should be considered in further projects.
Keywords: Exergames, High-intensity interval training, Older adults
Funding acknowledgements: No funding was received for this study.
Purpose: This study aimed to evaluate the feasibility of an exergaming-based HIIT and its effects on cardiovascular fitness in healthy older adults.
Methods: Twelve healthy older participants (ten women, mean age 72.3 (SD 4.44) years) performed a high-intensity interval exergame intervention three times a week for four weeks. Feasibility outcomes included attrition, adherence, acceptability (Technology Acceptance Model Questionnaire, TAM), perceived usefulness (System Usability Scale, SUS), enjoyment of exergaming and comparisons between actual and target values of training intensity and time. The secondary outcome was cardiovascular and cardiorespiratory fitness (heart rate at rest (HRrest), heart rate variability (HRV), maximum heart rate (HRmax), and maximum workload (W, in watt) evaluated through maximal exercise testing).
Results: Eleven participants completed the twelve sessions (8.3 percent attrition) without any adverse events. Adherence to the HIIT intervention was 90.9 percent and participants showed high acceptance of the intervention with TAM scores between 5.8 and 6.7/7. User satisfaction was rated as excellent (SUS total score: 93.5/100) and the overall enjoyment of exergaming scored 4.45/5 points.
Total exercise time ranged from 19 to 35 min with a mean of 30.8 (SD 3.6) min. Actual high-intensity exercise time showed consistency with the target exercise time in ninety-eight percent of trainings. Eighty-six percent of high-intensity intervals met the targeted intensity range (>70-90% of HRmax). Thirty-six percent of the recovery periods were completed with a heart rate above the target range of 50-70% of HRmax.
Maximum workload (W) during the incremental exercise test post-training increased significantly compared to the baseline measurement (p=0.032, effect size r=0.77). Most of the other secondary outcome parameters showed trends toward significance or remained unchanged.
Conclusion(s): The results indicate that a high-intensity interval training through exergaming is feasible, safe and shows high satisfaction and acceptance in healthy older adults. This corroborates previous findings in showing that virtual reality-based approaches for performing aerobic training are perceived as usable. HIIT through exergaming has a significant effect on maximum power output on an incremental exercise test. Furthermore, the positive trends shown regarding exercise capacity warrant future studies in older adults.
Implications: To the best of our knowledge, this feasibility study is the first to explore the use of exergames as a high-intensity interval endurance training method in a healthy older population. A more extensive intervention period, higher work to recovery ratios as well as a higher-intensity activity should be considered in further projects.
Keywords: Exergames, High-intensity interval training, Older adults
Funding acknowledgements: No funding was received for this study.
Topic: Cardiorespiratory; Robotics & technology; Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: Swiss Federal Institue of Technology Zürich (ETH)
Ethics committee: Ethikkommission der ETH Zürich
Ethics number: EK 2017-N-26
All authors, affiliations and abstracts have been published as submitted.
