Knowledge about the experiences of flow by older adults through the engagement of digital games is scarce. This article describes an important element of an international, multicenter, randomized, controlled trial which utilized three purpose-built exergames to facilitate physical activity and to assist with fall prevention of adults aged 65+ years in their homes. Measurement of flow was assessed through the distribution of the Activity Flow State Scale in participants assigned to the intervention group after completion of the trial. Results were analyzed across three areas: study centers, age-groups (50–69 years, 70–78 years, 79–84 years, and 85+), and gender. A positive trend in results was shown by participants from Valencia and Cologne and by gender. Future work should consider qualitative data collection to complement the quantitative data and to provide an in-depth understanding of users’ experiences with exergames.
AbtC. C. (1975). Serious games. New York, NY: Viking Compass.
2.
BlakeA. J.MorganK.BendallM. J.DallossoH.EbrahimS. B.ArieT. H.,… BasseyE. J. (1988). Falls by elderly people at home: Prevalence and associated factors. Age Ageing, 17, 365–472.
3.
BoguslawskiG. (2007). Body movement, social interaction and engagement in video game play: It’s a different game all together. London, England: CiteSeer.
4.
BrownE.CairnsP. (2004). A grounded investigation of game immersion. In CHI 2004, ACM Conference on Human Factors in Computing (pp. 1297–1300). New York: ACM Press. Retrieved fromhttp://dl.acm.org/citation.cfm?id=986048
5.
ChenM.KolkoB.CuddihyE.MedinaE. (2005). Modelling and measuring engagement in computer games. Paper presented at the annual conference for the Digital Games Research Association (DiGRA), Vancouver, Canada, June 2005.
6.
ChoiD. H.KimJ.KimH. (2007). ERP training with a web-based electronic learning system: The flow theory perspective. International Journal of Human-Computer Studies, 65, 223–243. doi:10.1016/j.ijhcs.2006.10.002
7.
CsikszentmihalyiM. (1975). Beyond boredom and anxiety. San Francisco, CA: Jossey-Bass Publishers
8.
CsikszentmihalyiM. (1990). Flow. New York, NY: Harper Collins Publishers.
9.
CsikszentmihalyiM. (1993). The evolving self: A psychology for the third millennium. New York, NY: HarperCollins.
10.
CsikszentmihalyiM.AbuhamdehS.NakamuraJ. (2005). Flow. In ElliotA. J.DweckC. S. (Eds.), Handbook of competence and motivation (pp. 598–608). New York, NY: Guilford Press.
11.
DietrichA. (2004). Neurocognitive mechanisms underlying the experience of flow. Consciousness and Cognition, 13, 746–761. doi:10.1016/j.concog.2004.07.002
12.
EllisG. D.VoelklJ. E.MorrisC. (1994). Measurement and analysis issues with explanation of variance in daily experience using the flow model. Journal of Leisure Research, 26, 337–356.
ErmiL.MäyräF. (2005). Fundamental components of the gameplay experience: Analysing immersion. DiGRA conference Changing views: Worlds in play, Vancouver, Canada.
15.
GamberiniL.AlcanizM.BarresiG.FabregatM.IbanezF.ProntuL. (2006). Cognition, technology and games for the elderly: An introduction to ELDERGAMES Project. Psychology Journal, 4, 285–308.
16.
GerlingK.LivingstonI.NackeL.MandrykR. (2012). Full-body motion-based game interaction for older adults. In Proceedings SIGCHI conference on human factors in computing systems (pp. 1873–1882). doi:10.1145/2207676.2208324. Retrieved fromhttp://dl.acm.org/citation.cfm?id=2208324
17.
GillespieL.RobertsonM.GillespieW.LambS.GatesS.CummingR.RoweR. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD007146.pub3
18.
GschwindY. J.EichbergS.MarstonH. R.EjupiA.de RosarioH.KrollM.…DelbaereK. (2014). ICTbased system to predict and prevent falls (iStoppFalls): Study protocol for an international multicenter randomized controlled trial. BMC Geriatrics, 14, 91. doi:10.1186/1471-2318-14-91
19.
IJsselsteijnW.PoelsK.de KortY. A. W. (2008). The game experience questionnaire: Development of a self-report measure to assess player experiences of digital games. FUGA Deliverable D3.3. Technical Report. Eindhoven, the Netherlands: TU Eindhoven.
20.
JacksonS.MarshH. W. (1996). Development and validation of a scale to measure optimal experience: The Flow State Scale. Journal of Sport and Exercise Psychology, 18, 17–35.
21.
KannusP.SievanenH.PalvanenM.JarvinenT.ParkkariJ. (2005). Prevention of falls and consequent injuries in elderly people. Lancet, 366, 1885–1893.
MarstonH. R. (2010). Wii like to play too: Computer gaming habits of older adults (Unpublished PhD Thesis). Teesside University, Middlesbrough, England.
24.
MarstonH. R. (2012). Older adults as 21st century game designers. The Computer Games Journal, Whitsun, 1, 90–102.
25.
MarstonH. R. (2013a). Design recommendations for digital game design within an aging society. Educational Gerontology, 39, 103–118. doi:10.1080/03601277.2012.689936
26.
MarstonH. R. (2013b). Digital gaming perspectives of older adults: Content vs. interaction. Educational Geronotology, 39, 194–208. doi:10.1080/03601277.2012.700817
27.
MarstonH. R.KrollM.FinkD.EichbergS. (2014). Digital game aesthetics of the iStoppFalls exergame. In SchoutenB.. (Eds.), Games for health (pp. 89–100). Wiesbaden, Germany: Springer Fachmedien Wiesbaden. doi:10.1007/978-3-658-07141_12. Retrieved fromhttp://link.springer.com/chapter/10.1007%2F978-3-658-07141-7_12
28.
MarstonH. R.WoodburyA.GschwindY. J.KrollM.FinkD.EichbergS.…DelbaereK. (forthcoming). The design of a purpose built exergame for fall prediction and prevention for older adults. Submitted to European Review of Aging and Physical Activity (EURAPA). Retrieved fromhttp://www.eurapa.net/
29.
McHorneyC. A.WareJ. E.RaczekA. E. (1993). The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care, 31, 247–263.
NackeL.LindleyC. (2008b). Flow and immersion in first-person shooters: Measuring the player’s gameplay experience. In Proceeding of the 2008 conference on future play: Research, play, share (pp. 87–88). Toronto, Canada: ACM. Retrieved fromhttp://dl.acm.org/citation.cfm?id=1496998
Office for National Statistics. (2012). Population Ageing in the United Kingdom, its Constituent Countries and the European Union. Office for National Statistics. Retrieved August 2015, fromhttp://www.ons.gov.uk/ons/dcp171776_258607.pdf
34.
Office for National Statistics. (2013). Estimates of the very old (including Centenarians), 2002-2011, England and Wales. Statistical Bulletin. Retrieved July 2013, fromhttp://www.ons.gov.uk/ons/dcp171778_303741.pdf
35.
O’LoughlinJ. L.RobitailleY.BoivinJ. F.SuissaS. (1993). Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. American Journal of Epidemiology, 137, 342–354.
PallantJ. (2013). SPSS survival manual: A step by step guide to data analysis using IBM SPSS. 5th ed. Maidenhead, England: Open University Press.
38.
PayneB. R.JacksonJ. J.NohS. R.Stine-MorrowE. A. (2011). In the zone: Flow state and cognition in older adults. Psychology Aging, 26, 738–743.
39.
SawyerB.SmithP. (2008, February). Serious game taxonomy. Paper presented at the Serious GameSummit 2008, San Francisco, CA.
40.
TinettiM. E.WilliamsC. S. (1997). Falls, injuries due to falls, and the risk of admission to a nursing home. New England Journal of Medicine, 337, 1279–1284. doi:10.1056/NEJM199710303371806
VollmeyerR.RheinbergF. (2006). Motivational effects on selfregulated learning with different tasks. Educational Psychology Review, 18, 239–253. doi:10.1007/s10648-006-9017-0
43.
WatsonD.ClarkL. A.TellegenA. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.
44.
WeibelD.WissmathB.HabeggerS.SteinerY.GronerR. (2008). Playing online games against computer—vs. human-controlled opponents: Effects on presence, flow, and enjoyment. Computers in Human Behavior, 24, 2274–2291.
45.
WhitelockL. A.McLaughlinA. C.LeidheiserW.GandyW.AllaireJ. C. (2014). Know before you go: feelings of flow for older players depends on game and player characteristics. In Proceedings of the first ACM SIGCHI annual symposium on Computer-human interaction in play (pp. 277–286). doi:10.1145/2658537.2658703. Retrieved fromhttp://dl.acm.org/citation.cfm?id=2658703
Yogev-SeligmannG.HausdorffJ. M.GiladiN. (2008). The role of executive function and attention in gait. Mov Disord, 23, 329–342.
48.
ZijlstraG. A.vanH.vanE.vanR.StalenhoefP. A.KempenG. (2007). Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing, 36, 304–309.
49.
ZydaM. (2005). From visual simulation to virtual reality in games. Computer, 38, 25–32. doi:10.1109/MC.2005.297
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
