Second lives for the third age: using virtual worlds to encourage exercise participation in older people

Falls are associated with considerable morbidity, mortality and cost to society and health services every year. Falling is most common in older people, with accident and emergency admissions in the UK ranging from 2.7% per year for ages 60–64 up to 9.5% for the over 75s. There is strong evidence that balance-retraining exercises can be of significant benefit. Recovery and long term maintenance of balance are strongly influenced by the regularity, task-specificity and volume of training. Resource constraints require the great majority of this training to take place outside the health-care system. In motivated patients treatment may be effective; however, in other cases, patients may lose interest in performing repetitive tasks and may not complete the therapy programme. There is growing interest in the use of computer-games as a rewarding activity to motivate patients to practise rehabilitation skills, but most computer games are not designed, and may not be appropriate, for an over-75 age-group. We have interfaced low-cost balance-measurement platforms to a computer to allow older people to control “avatars”; (3D mannequins) dancing in a 3D simulated environment. We chose dance as it is an age-appropriate, single or multiple-participant activity. The movements required to control the avatars were based-on balance rehabilitation exercises. We piloted the system with 6 older people (ages 80–91) undertaking exercise classes for balance rehabilitation. Although the cohort had no previous computer-experience and represented a wide-range of physical abilities, they were all able to control basic avatar movements, with some participants able to control a rich-set of dance movements after only a few minutes practice. All participants enjoyed the experience. It appears that older people are able to enjoy interaction with virtual environments, and this, together with appropriate sensors, may be a useful mechanism to motivate exercise in this age group.