Feasibility exergaming as a physical activity for older adults: a systematic literature review

Background Physical activity among older adults is important for both primary and secondary prevention of cardiovascular disease (CVD). Increases in physical activity by any level are associated with reduced cardiovascular risk, and physical activity contributes to overall well-being by managing risk factors, enhancing cardiovascular function, and supporting a healthy lifestyle for individuals already affected by CVD. Exercising with virtual reality technology has the potential to improve physical activity. Exergaming (a combination of exertion and video games) has an effect equivalent to other types of exercising on improving walking distance in older adults. To implement exergaming in cardiovascular care of general prevention of CVD feasibility for older adults using exergaming should be considered. Purpose To assess the feasibility of exergaming in older adults based on the experiences of acceptability, demand, implementation, and practicality of exergames. Methods A systematic literature review based on qualitative research. We assessed 4 online electronic databases (PubMed, Scopus, CINAHL and Web of Science) in December 2023 for peer-reviewed literature. The following search string was utilized across the databases: ((exergames OR exergaming OR active AND video AND games) AND (experiences OR perceptions OR attitudes OR views) AND (qualitative AND research OR qualitative AND study OR qualitative AND methods OR interview) AND (elderly OR aged OR older OR elder OR geriatric)). Results In total 158 articles were identified by the databases, whereof 31 were included in the analysis (see figure). Acceptability: Participants found exergaming enjoyable, especially with social interaction. Exergaming was seen a part of functioning in daily life. Demand: Exergaming was seen as physical and cognitive demanding. There could be technical (e.g. visuals in fast space) and safety (e.g. difficulties maintaining balance) challenges with exergaming. Practicality of exergaming: Introducing exergaming to older adults necessitates a thorough familiarization process. It is crucial for them to receive a comprehensive introduction, they should receive written and video instructions, along with follow-up calls to provide motivation for engaging in exergaming. Moreover, exergaming should be possible within the home environment. Implementation: To be able to follow improvement and being challenged in the exergame was seen as important to implementation. Participants expressed how to implement exergaming into their daily life and the importance that exergaming was age appropriate. Conclusion Exergaming is feasible for older adults and could be considered for use in preventive cardiology to stimulate physically activity. The study also helps to identify specific adaptations that need to be made to accommodate older adults.