Feasibility of a Mobile Exergame for Patients with Heart Failure

Background: Physical activity is beneficial and recommended to improve outcomes for patients with heart failure (HF). Exergaming combines gaming technology with physical activity. Therefore, we developed a mobile exergame in a co-design process, the exergame would engage participants in physical activity anywhere and anytime. This study aims to assess the feasibility of a newly developed mobile exergame, heart farming, for patients with HF. Methods: A total of 14 participants with HF used the exergame on their smartphones for one month (9 Swedish and 5 Spanish participants; 9 males, mean 72 years, range 61-82 years). Participants were provided an introduction to the exergame, and follow-up was carried out regularly by telephone. Participants were advised to increase the daily walking duration by 10 minutes a day, based on the number of meters walked in the 6-minute walk test (6MWT). Areas of feasibility identified were acceptability, demand, implementation, and practicality, which were examined during telephone follow-ups and interviews, and data downloaded from the exergame. Results: Participants found the farming theme appealing, and coaching encouraged them to perform the exergame on a regular basis (acceptability). Based on the 6MWT, the personal goal for daily walking was set (mean of 704 meters, range 250-900 meters). Participants reported that daily goals and tasks were manageable. The exergame was perceived as appropriate to decrease sedentary time, and participants reported improved physical health (demand). The exergame was perceived as easy to learn and use, and adjustable to individual needs (implementation). Exergaming while walking and conversing with others was described as less convenient (practicality). Conclusion: Participants with HF valued personalized support and the exergame's farming theme was appealing. The goal to increase walking by 10 minutes a day was seen as a realistic way to reduce sedentary behavior. When introducing the exergame, it is essential to emphasize the importance of proper lighting, so meters walked are accurately recorded.