Shi Qiu et al.
Incorporating social interaction and cognitive stimulation into balance training can motivate older adults to engage more actively and consistently. We developed Balance Bird, an exergame designed to enhance physical, social, and cognitive activity for older adults. Thirty-six participants (18 older adults and 18 university students) were tested in pairs across three game modes featuring different types of bodily interaction and cognitive tasks: (1) the Single-Balance Ball Game (SBBG), where older players complete cognitive tasks independently; (2) the Dual-Balance Ball Game (DBBG), where older and younger players use lower limbs as input and complete cognitive tasks together; and (3) the Gesture-Balance Ball Game (GBBG), where older participants use gestures while younger ones use lower limbs to complete tasks. Our main findings revealed that all participants scored significantly higher in game competence in the GBBG compared to the SBBG. However, they experienced significantly less flow in the GBBG than in the DBBG. Female participants reported higher user experience and lower negative affect compared to males. Older participants also reported a better user experience overall, despite perceiving more challenges. In this study, we contribute empirical evidence that Balance Bird positively impacts physical, social and cognitive health for older adults.