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A novel Dance Dance Revolution (DDR) system for in-home training of stepping ability: basic parameters of system use by older adults
  1. S T Smith1,
  2. C Sherrington1,2,
  3. S Studenski3,
  4. D Schoene1,
  5. S R Lord1
  1. 1Falls and Balance Research Group, Prince of Wales Medical Research Institute, Sydney, Australia
  2. 2George Institute for International Health, University of Sydney, Sydney, Australia
  3. 3Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Stuart T Smith, Prince of Wales Medical Research Institute, Barker Street, Randwick, NSW 2031, Australia; s.smith{at}


Objective This series of studies was conducted to develop and establish characteristics of exercise videogame play in older adults. The videogame was a modified version of the popular Dance Dance Revolution (DDR; Konomi).

Methods Participants aged ≥70 were asked to make simple step movements in response to vertically drifting arrows presented on a video screen. Step responses were detected by a modified USB DDR mat, and characteristics of stepping performance such as step timing, percentage of missed target steps and percentage of correct steps were recorded by purpose-built software. Drift speed and step rate of visual stimuli were modified to increase task difficulty.

Results Significant linear relationships between stepping performance and stimulus characteristics were observed. Performance of older adults decreased as stimulus speed and step rate were increased. Optimal step performance occurred for a stimulus speed of 17° of visual angle per second and a step rate of one step every 2 s. At fast drift speeds (up to 35°/s), participants were more than 200 ms too slow in coordinating their steps with the visual stimulus. Younger adults were better able to perform the stepping task across a wider range of drift speeds than older adults.

Conclusion The findings suggest that older adults are able to interact with video games based upon DDR but that stepping performance is determined by characteristics of game play such as arrow drift speed and step rate. These novel “exergames” suggest a low-cost method by which older adults can be engaged in exercises that challenge balance and which can be conducted in their own homes.

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  • Funding National Health and Medical Research Council.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of New South Wales Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Obtained.