Gamification in Mixed-Reality Exergames for Older Adult Patients in a Mobile Immersive Diagnostic Center: A Pilot Study in the BewARe Project

This paper describes the gamification design of mixed-reality mini-exergames for older adult patients with hypertension and reports on results from a pilot study with 22 older adult users in the BewARe project dedicated to the development of an intelligent system for physical training enhanced by wearable sensors and immersive technologies. For the purpose of this paper, the gamification design was decomposed following the mechanics, dynamics and aesthetics (MDA) framework. The objective of the research presented in this paper was to validate the gamification design of mini-exergames focused on endurance training and to explore the emotional responses of the older adult users to this type of immersive training. The pilot study applied a mixed methods approach and collected quantitative and qualitative data. The results show that gamified exergames are positively evaluated by older adult users, who enjoy and value the hedonic quality over the pragmatic quality. Research presented in this paper has revealed some interesting tendencies, such as gender-specific preferences, importance of interaction with the virtual trainer and the familiarity effect.

I. Introduction

In recent years a wide range of game-based design approaches including gamification and exergames have been used to motivate specific behaviors including physical exercising. The application of game design elements to non-games contexts to make any activity more engaging has a long history in human-computer interaction [1]. Gamification has been used as a design strategy to enhance motivation, achievement, enjoyment, engagement and the overall user experience. Approaches to gamification have evolved from the design of software systems and interfaces to reframing activities as gameful and playful experiences [1]. Given the insights from practice and research showing that motivational effects cannot be deterministically produced by a set of design elements, but emerge from the experience of the entire environment [1], the focus of gamification has evolved from the application of game design elements such as points and reward systems, to affording gameful experiences by applying formalised game design frameworks such as the MDA framework, which stands for mechanics, dynamics and aesthetics [2].