The intervention group started with 18 and the control group with 17 residents with an unequal distribution of gender (10 male versus 22 female) (table 2). After three months there was a drop-out of three residents in the intervention group due to not interested anymore, back pain and too burdened.
3.1 Primary research questions (table 3)
The median mental well-being score (of maximum 50) for the residents of the intervention group at time points 0, 3 and 6 months was 42, 45 and 45, respectively. For the residents of the control group, this score was 41 at all three time points. The median score (of maximum 20) of the staff member questionnaire on the mental well-being of the residents was 18, 18 and 16 in the intervention group at the respective time points of 0, 3 and 6 months. The scores of the control group at the same time points were 14, 17 and 16, respectively
The median sleep score (of maximum 30) for the residents of the intervention group at time points 0, 3 and 6 months was 23, 24 and 28 respectively. For the residents of the control group this was 24, 25 and 25, respectively. The median score (of maximum 10) of the staff member questionnaire on the sleep quality of the residents was of 7, 7.5 and 8 in the intervention group at the respective time points of 0, 3 and 6 months. The scores of the control group remained equal to seven over the full 6 months.
The median pain score (of maximum 20) among the residents of the intervention group at time point 0, 3 months and 6 months, respectively, was 18, 18.5 and 20. For the residents of the control group this was 17, 14 and 16 respectively. The median score (maximum of 5) of the staff member questionnaire about the pain complaints of the residents was four at all time points in both the intervention and control groups.
In the intervention group, the median score (maximum of 30) on subjective cognition was 24, 26 and 26 at the respective time points. In the control group, this score was 23, 26 and 27. The mean scores (maximum of 2) on the two open questions assessing cognitive functioning of the residents evolved from 1.8 at the start to 1.9 and to 1.7 after 3 and 6 months respectively in the intervention group. In the control group, these scores were 1.2, 1.6 and 1.5 at the same time points. The mean scores (maximum of 5) on the clock-drawing test, evolved from 3.1 at the start to 2.9 and to 3.5 after 3 and 6 months, respectively. In the control group, these scores were 2; 1.8 and 2.5 at the same times.
In the stroop-color-word test, the median time difference between correctly naming the colors of column 2 and column 3 in the intervention group was 28s, 29.5s and 28s at time points 0, 3 and 6 months. In the control group, these median time differences were 37s; 30.5s and 30.5s at the same times.
3.2 Secondary research questions
On average, 23.3 exergame sessions were organized in the three residential care centers. As registered by the coaches, there was an average participation rate of 88%. The main reasons for not showing up were other animation, visits of relatives and physical complaints. Coaches gave an average fun score of 8.9/10 and an average intensity of exercise score of 11.6/20 over the three months of playing (table 4).
After three months, residents were asked if they had fun, if they made new friends and if they would continue to play it in the future. On a 5-point likert scale, the average of these responses were 4.4, respectively; 2.8 and 4.4. Residents particularly liked being together and playing the games. Residents mentioned that feeling fitter and upgrading their social contacts were the major advantages of the exergames. For future exergame sessions, residents suggest offering more different games, organizing a weekly session and playing together with several people (table 5).
According to the coaches, the feasibility of the exergames and the positive effect both scored on average 4.1 on a 5-item Likert-scale. The average score on ‘continue playing in the future’ was 4.3 and on ‘fun factor for the coaches’ 4.7. The major advantages according to the coaches were maintaining mobility, the fun factor and the sportive, competitive ambience. Major disadvantages were the low accessibility for more physically disabled residents, the intensive coaching and the limited offer of games. The coaches advised to develop games specifically serving elderly (table 6).