Physical and psychosocial effects of Wii exergames use in assisted living residents
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Older adults with functional limitations residing in assisted living facilities are at risk of mobility decline, cognitive impairment, and depression. Effective interventions like structural exercise programs that limit functional decline and promote independent capabilities are important to allow older adults to remain in an assisted living facility and delay nursing home placement. The purpose of this dissertation was to investigate the effects of self-efficacy theoretical-based Staying Active, Healthy Aging (SAHA) program using Wii Fit exergames on physical function, fear of falling, cognition, depression, and quality of life in assisted living residents. The factors that influence assisted living residents to exercise were explored as well. The study was a quasi-experimental pre/post-test design with a controlled trial. The Wii exergame group participated in Wii Fit gaming activities and received health education. Four mechanisms of Bandura's self-efficacy theory (Bandura, 1997) were used to enhance residents' exercise self-efficacy, including enactive mastery experiences, vicarious experiences, verbal persuasion, and emotional or physical feedback. The control group only received the health education intervention. The study showed that participants in the Wii exergame group had significantly decreased depressive symptoms and had significant improvements in balance and mobility. The education group showed no significant improvement in any of the outcome measures. Five themes emerged that facilitated participants' desire to exercise: (1) health and mobility; (2) increased alertness; (3) elevated mindset; (4) social interaction; and (5) structured program. Barriers to engage in exercise included: (1) age- or health-related impairments to exercise; and (2) unpleasant experience related to exercise. In conclusion, findings provide support for integrating self-efficacy theory into exergames as a mechanism to encourage older adults to engage in exercise. In addition, exergames show promise as a potential tool to improve and maintain physical and psychosocial health for older adults.