Chasing the sinusoid: Extrinsic motivation and monitoring of friction loaded squat exercise training

Abstract

Purpose: Ageing societies are seeking exercise training that efficaciously combats frailty and imbalance in societies with increasing populations of older adults. However, proper execution of such exercise is labour intensive, for reasons such as the repetitive character of exercise training and its general tendency to be perceived as boring, amongst others. This so-called lack of companionship 1 barrier limits adherence to an exercise regimen and thereby makes exercise regimens less suitable for unsupervised training. Here we present the design of a friction loaded squat training support tool that uses gaming technology to create extrinsic motivation for the sustained execution of squats. Recent studies show that the combination 2 of resistance training and core strength is an effective means of improving the power and strength of limbs 3, as well as improving the overall balance performance of older adults. Method: We employed an iterative design approach with palpable artifacts referred to as design science. The three principal stakeholders in a gamebased training tool are: the physiotherapist, the game designer, and the client. The subsequent prototypes gradually include various dimensions of training and motivation. Initial training aspects include a clear trail of the proper execution of a squat. Feedback on the correct execution will be included in future versions. Motivational aspects start with player engagement, i.e., by exploiting the novelty and including game-play elements such as a scoring system that provides feedback of in and out-game actions. Results & Discussion: A friction loaded squat movement plotted in the time domain can be considered a sinusoid movement. This target trail of the exercise is fitted to the individual needs of the client by varying its amplitude and frequency. Feedback on the correct execution has been deferred to future versions of the tool. The graphical theme, look, feel, and implementation of the interactive sinusoid movement have been established through paper-prototype experiments with a small group of potential clients. In addition, we built on the experience of testing a tool that supports frictionless sit-to-stand exercise, in which the actual event is important rather than the precise of movement in time. The current prototype adheres to the design for an acceptance4 principle. It is a 'trivial game', which implements a readily recognisable exercise trail (a sinusoid movement), an engaging setting, a scoring system, and to some extent curiosity and free roaming. The obvious trail is an important aspect for therapists. The game-play elements adhere to the extrinsic motivation of clients, whereas the integration into a true game is an accepted basis for game designers. Experience sampling with the multiple stakeholders indicates the game demonstrates adherence and acceptance were improved through use of them gaming technique. More importantly, this prototype and series of tests induced innovations in design and activities as well as confirmed the positive intent of the users to use the tool for unsupervised training.