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Active computer gaming (ACG) is a way for older people to participate in strength and balance exercise. Involving older adults in the development of a bespoke ACG system may optimise its usability and acceptability. The purpose of this paper is to employ user-centred design to develop an ACG system to deliver strength and balance exercises, and to explore its safety, usability and acceptability in older adults.

This paper describes user involvement from an early stage, and its influence on the development of the system to deliver strength and balance exercise suitable for display on a flat screen or using an Oculus Rift virtual reality (VR) headset. It describes user testing of this ACG system in older adults.

Service users were involved at two points in the development process. Their feedback was used to modify the ACG system prior to user testing of a prototype of the ACG system by n=9 older adults. Results indicated the safety, usability and acceptability of the system, with a strong preference for the screen display.

The sample size for user testing was small; however, it is considered to have provided sufficient information to inform the further development of the system.

Findings from user testing were used to modify the ACG system. This paper identified that future research could explore the influence of repeated use on the usability and acceptability of ACG in older adults.

There is limited information on the usability and acceptability VR headsets in this population.

The Leap Motion represents a new generation of depth sensing cameras designed for close range tracking of hands and fingers, operating with minimal latency and high spatial precision (0.01 mm). The purpose of this paper is to develop virtual reality (VR) simulations of three well-known hand-based rehabilitation tasks using a commercial game engine and utilising a Leap camera as the primary mode of interaction. The authors present results from an initial evaluation by professional clinicians of these VR simulations for use in their hand and finger physical therapy practice.

A cross-disciplinary team of researchers collaborated with a local software company to create three dimension interactive simulations of three hand focused rehabilitation tasks: Cotton Balls, Stacking Blocks, and the Nine Hole Peg Test. These simulations were presented to a group of eight physiotherapists and occupational therapists (n=8) based in the Regional Acquired Brain Injury Unit, Belfast Health, and Social Care Trust for evaluation. After induction, the clinicians attempted the tasks presented and provided feedback by filling out a questionnaire.

Results from questionnaires (using a Likert scale 1-7, where 1 was the most favourable response) revealed a positive response to the simulations with an overall mean score across all questions equal to 2.59. Clinicians indicated that the system contained tasks that were easy to understand (mean score 1.88), and though it took several attempts to become competent, they predicted that they would improve with practice (mean score 2.25). In general, clinicians thought the prototypes provided a good illustration of the tasks required in their practice (mean score 2.38) and that patients would likely be motivated to use the system (mean score 2.38), especially young patients (mean score 1.63), and in the home environment (mean score 2.5).

Cameras offer an unobtrusive and low maintenance approach to tracking user motion in VR therapy in comparison to methods based on wearable technologies. This paper presents positive results from an evaluation of the new Leap Motion camera for input control of VR simulations or games. This mode of interaction provides a low cost, easy to use, high-resolution system for tracking fingers and hands, and has great potential for home-based physical therapies, particularly for young people.