Critical Reflections on Technology to Support Physical Activity among Older Adults

Contemporary policy on ageing overwhelmingly focuses on active ageing and achieving a sustainable increase in disability-free years, leading to an agenda that promotes interventions that often focus on deficits of older persons with little consideration of their perspectives on physical activity. As the integration of technology to support physical activity routines becomes more common, this trend also becomes relevant to the Human-Computer Interaction (HCI) research community. In this article, we present findings from a structured search of technical systems addressing physical activity among older adults that were published at the most cited HCI venues. Drawing from Thematic Analysis, we explore how the model of active ageing informs existing research, and how it is operationalized in technology design. We find that the deficit-focused perspective on ageing is reflected in many technology solutions published at the most visible HCI venues, and discuss shortcomings and strengths of present research to help guide discourse and future work in HCI.

[1]  Adrian Bauman,et al.  Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological Evidence, Prevalence, and Interventions to Promote "Active Aging". , 2016, The Gerontologist.

[2]  Clara Berridge,et al.  Successful aging and its discontents: a systematic review of the social gerontology literature. , 2014, The Gerontologist.

[3]  Lynne Baillie,et al.  Senior designers: empowering seniors to design enjoyable falls rehabilitation tools , 2012, CHI.

[4]  A. Sparkes,et al.  Being Fred: big stories, small stories and the accomplishment of a positive ageing identity , 2009 .

[5]  Don Nutbeam,et al.  What would the Ottawa Charter look like if it were written today? , 2008 .

[6]  Catrine Tudor-Locke,et al.  Leisure-time physical activity and occupational sitting: Associations with steps/day and BMI in 54-59 year old Australian women. , 2009, Preventive medicine.

[7]  M. Narici,et al.  Physical activity and older adults: a review of health benefits and the effectiveness of interventions , 2004, Journal of sports sciences.

[8]  Stefan Agamanolis,et al.  Exertion interfaces: sports over a distance for social bonding and fun , 2003, CHI '03.

[9]  Gazihan Alankus,et al.  Towards customizable games for stroke rehabilitation , 2010, CHI.

[10]  D. Bassett,et al.  The technology of accelerometry-based activity monitors: current and future. , 2005, Medicine and science in sports and exercise.

[11]  Deborah Lupton,et al.  Critical perspectives on digital health technologies , 2014 .

[12]  S. Katz,et al.  Critical perspectives on successful aging: does it "appeal more than it illuminates"? , 2015, The Gerontologist.

[13]  Daniel Jackson,et al.  Designing for and with People with Parkinson's: A Focus on Exergaming , 2015, CHI.

[14]  Florence March,et al.  2016 , 2016, Affair of the Heart.

[15]  Kathrin Maria Gerling,et al.  Visual complexity, player experience, performance and physical exertion in motion-based games for older adults , 2013, ASSETS.

[16]  A. King,et al.  Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. , 2007, Medicine and science in sports and exercise.

[17]  J. Billeter.  Researching Age-Friendly Communities: Stories from older people as co-investigators , 2015 .

[18]  Jürgen Pripfl,et al.  Lessons learned from the deployment of a long-term autonomous robot as companion in physical therapy for older adults with dementia a mixed methods study , 2016, 2016 11th ACM/IEEE International Conference on Human-Robot Interaction (HRI).

[19]  Adam Evans,et al.  "Swim for Health": Program Evaluation of a Multiagency Aquatic Activity Intervention in the United Kingdom , 2013 .

[20]  E. Tulle,et al.  The Ageing Body and the Ontology of Ageing: Athletic Competence in Later Life , 2008 .

[21]  Robin Hunicke,et al.  The case for dynamic difficulty adjustment in games , 2005, ACE '05.

[22]  C. Phoenix,et al.  Pleasure: a forgotten dimension of physical activity in older age. , 2014, Social science & medicine.

[23]  Gazihan Alankus,et al.  Stroke therapy through motion-based games: a case study , 2011, ASSETS '10.

[24]  Felismina Rosa Parreira Mendes,et al.  Active ageing: A right or a duty? , 2013 .

[25]  Martijn H. Vastenburg,et al.  Flowie: A persuasive virtual coach to motivate elderly individuals to walk , 2009, 2009 3rd International Conference on Pervasive Computing Technologies for Healthcare.

[26]  Jennie Popay,et al.  Injustice is killing people on a large scale--but what is to be done about it? , 2010, Journal of public health.

[27]  G. Cardon,et al.  The effect of pedometer use in combination with cognitive and behavioral support materials to promote physical activity. , 2008, Patient education and counseling.

[28]  Peter R. Cavanagh,et al.  Exercise and physical activity for older adults , 1998 .

[29]  Sport England,et al.  Active People Survey 3 , 2007 .

[30]  Arthur F Kramer,et al.  Copenhagen Consensus statement 2019: physical activity and ageing , 2019, British Journal of Sports Medicine.

[31]  Susan L Murphy,et al.  Review of physical activity measurement using accelerometers in older adults: considerations for research design and conduct. , 2009, Preventive medicine.

[32]  Janice J Eng,et al.  A Community‐Based Fitness and Mobility Exercise Program for Older Adults with Chronic Stroke: A Randomized, Controlled Trial , 2005, Journal of the American Geriatrics Society.

[33]  Lynne Parkinson,et al.  Purpose and pleasure in late life: Conceptualising older women's participation in art and craft activities. , 2013, Journal of aging studies.

[34]  Sinziana Mazilu,et al.  GaitAssist: a daily-life support and training system for parkinson's disease patients with freezing of gait , 2014, CHI.

[35]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[36]  L. Kulik,et al.  Older adults as digital content producers , 2013, CHI.

[37]  Elizabeth E. Wheatley.  Discipline and Resistance: Order and Disorder in a Cardiac Rehabilitation Clinic , 2005, Qualitative health research.

[38]  A. Azzouz.  2011 , 2020, City.

[39]  Dominic Malcolm.  Sport, Medicine and Health: The medicalization of sport? , 2016 .

[40]  Andrea Taylor,et al.  Group pulmonary rehabilitation delivered to the home via the internet: feasibility and patient perception , 2011, CHI.

[41]  C. Phoenix,et al.  Seeing the world of physical culture: the potential of visual methods for qualitative research in sport and exercise , 2010 .

[42]  Begoña García Zapirain,et al.  Elderly user experience to improve a Kinect-based game playability , 2015, Behav. Inf. Technol..

[43]  Paul B. Baltes,et al.  Successful aging: Perspectives from the behavioral sciences , 1990 .

[44]  Regan L. Mandryk,et al.  Long-Term Use of Motion-Based Video Games in Care Home Settings , 2015, CHI.

[45]  Kass Gibson,et al.  Exercise as a poisoned elixir: inactivity, inequality and intervention , 2017 .

[46]  Ian Rees Jones,et al.  The natural, the normal and the normative: contested terrains in ageing and old age. , 2010, Social science & medicine.

[47]  Rachael Powell,et al.  Acceptability of physical activity to inactive older adults: a systematic review and meta-synthesis , 2016 .

[48]  L. Miles,et al.  2000 , 2000, RDH.

[49]  Sun W. Park,et al.  New Frontiers in Resilient Aging: Growth is not just for the young: growth narratives, eudaimonic resilience, and the aging self , 2010 .

[50]  S. M. García,et al.  2014: , 2020, A Party for Lazarus.

[51]  Dominic Malcolm,et al.  Sport, medicine and health: a research agenda for social scientists , 2014 .

[52]  T. Fulmer,et al.  Successful aging. , 2002, The American journal of nursing.

[53]  C. Martin.  2015 , 2015, Les 25 ans de l’OMC: Une rétrospective en photos.

[54]  I. Olkin,et al.  Using pedometers to increase physical activity and improve health: a systematic review. , 2007, JAMA.

[55]  Regan L. Mandryk,et al.  Wheelchair-based game design for older adults , 2013, ASSETS.

[56]  Karen A Schutzer,et al.  Barriers and motivations to exercise in older adults. , 2004, Preventive medicine.

[57]  Jo-Ana D Chase,et al.  Physical Activity Intervention Effects on Physical Function Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. , 2017, Journal of aging and physical activity.

[58]  Matthew K. Miller,et al.  Designing Wheelchair-Based Movement Games , 2015, ACM Trans. Access. Comput..

[59]  Lynne Baillie,et al.  Exploring & designing tools to enhance falls rehabilitation in the home , 2013, CHI.

[60]  Gazihan Alankus,et al.  Stroke Therapy through Motion-Based Games: A Case Study , 2010, TACC.

[61]  A. Broocks,et al.  Therapeutic Impact of Exercise on Psychiatric Diseases , 2000, Sports medicine.

[62]  Brett Smith,et al.  Exercise is medicine? Most of the time for most; but not always for all , 2017 .

[63]  J. Fereday,et al.  Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development , 2006 .

[64]  N. Mutrie,et al.  Interventions to promote walking: systematic review , 2007, BMJ : British Medical Journal.

[65]  R. Dionigi,et al.  Competitive Sport as Leisure in Later Life: Negotiations, Discourse, and Aging , 2006 .

[66]  Krzysztof Z. Gajos,et al.  Ability-Based Design: Concept, Principles and Examples , 2011, TACC.

[67]  Jodi Forlizzi,et al.  Considerations for technology that support physical activity by older adults , 2012, ASSETS '12.

[68]  Ian D. Walker,et al.  An assistive robotic table for older and post-stroke adults: results from participatory design and evaluation activities with clinical staff , 2014, CHI.

[69]  Adam Evans,et al.  “Unbeknown to you, they really watch you!”: experiencing the ageing, physically active body in cardiac rehabilitation , 2013 .

[70]  E. Tulle,et al.  Acting your age? Sports science and the ageing body , 2008 .

[71]  M. Myers.  Qualitative Research and the Generalizability Question: Standing Firm with Proteus , 2000 .

[72]  Jylana L. Sheats,et al.  Harnessing Different Motivational Frames via Mobile Phones to Promote Daily Physical Activity and Reduce Sedentary Behavior in Aging Adults , 2013, PloS one.

[73]  Lynne Baillie,et al.  A novel knee rehabilitation system for the home , 2014, CHI.

[74]  Freya MacMillan,et al.  West End Walkers 65+: A randomised controlled trial of a primary care-based walking intervention for older adults: Study rationale and design , 2011, BMC public health.

[75]  A. Walker,et al.  Active and successful aging: a European policy perspective. , 2015, The Gerontologist.

[76]  Jenny Waycott,et al.  Not For Me: Older Adults Choosing Not to Participate in a Social Isolation Intervention , 2016, CHI.

[77]  Adam Evans,et al.  ‘Some of these people aren’t as fit as us …’: experiencing the ageing, physically active body in cardiac rehabilitation , 2015 .

[78]  Michael P Kelly,et al.  Why is changing health-related behaviour so difficult? , 2016, Public health.

[79]  Enrico Tronci.  1997 , 1997, Les 25 ans de l’OMC: Une rétrospective en photos.

[80]  Dominic Malcolm,et al.  Sport, health and medicine: a sociological agenda , 2014 .

[81]  Katie Brittain,et al.  An Age-Old Problem: Examining the Discourses of Ageing in HCI and Strategies for Future Research , 2015, TCHI.

[82]  CASSANDRA PHOENIX,et al.  Narratives at work: what can stories of older athletes do? , 2011, Ageing and Society.

[83]  C. Phoenix,et al.  Physical Activity and Sport in Later Life: Critical Perspectives , 2015 .

[84]  Claudio Dionigi,et al.  The normalization of sport for older people? , 2017 .

[85]  Lynne Baillie,et al.  Time to exercise!: an aide-memoire stroke app for post-stroke arm rehabilitation , 2016, MobileHCI.

[86]  M. Barnes,et al.  Transforming Practice with Older People through an Ethic of Care , 2015, British journal of social work.

[87]  Xing-Dong Yang,et al.  Physio@Home: Exploring Visual Guidance and Feedback Techniques for Physiotherapy Exercises , 2015, CHI.

[88]  Antonella De Angeli,et al.  Ubiquitous technologies for older people , 2017, Personal and Ubiquitous Computing.

[89]  Regan L. Mandryk,et al.  Full-body motion-based game interaction for older adults , 2012, CHI.

[90]  Marc Herrlich,et al.  Exergames for Physiotherapy and Rehabilitation: A Medium-term Situated Study of Motivational Aspects and Impact on Functional Reach , 2015, CHI.

[91]  Don Wright,et al.  Physical Activity Guidelines for Health and Prosperity in the United States , 2018, JAMA.

[92]  O. Jolanki,et al.  Moral Argumentation in Talk about Health and Old Age , 2004, Health.

[93]  R. Sallis.  Exercise is medicine and physicians need to prescribe it! , 2008, British Journal of Sports Medicine.

[94]  Andrew K. Przybylski,et al.  The Motivational Pull of Video Games: A Self-Determination Theory Approach , 2006 .

[95]  Lynne Baillie,et al.  Investigating the long-term use of exergames in the home with elderly fallers , 2014, CHI.

[96]  Fred Coalter,et al.  The Social Benefits of Sport An Overview to Inform the Community Planning Process , 2005 .

[97]  Rylee A. Dionigi,et al.  The world turned upside down: sport, policy and ageing , 2016 .

[98]  A. James.  2010 , 2011, Philo of Alexandria: an Annotated Bibliography 2007-2016.

[99]  C. Phoenix,et al.  Expanding the agenda for research on the physically active aging body. , 2009, Journal of aging and physical activity.

[100]  Yu-Min Fang,et al.  Users' psychological perception and perceived readability of wearable devices for elderly people , 2016, Behav. Inf. Technol..

[101]  David Ogilvie,et al.  The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design , 2008, BMC public health.