Validity and usability of a smart ball-driven serious game to monitor grip strength in community-dwelling elderlies

Telemonitoring is one of the most expedient answers to the strong need for preventive care imposed by the rapidly aging society. We propose an innovative solution to the detection of early signs of frailty by presenting a serious game controlled by a smart sensorized soft plastic ball, designed to achieve continuous home-based monitoring of muscle weakness in older adults. Design, development and testing of the smart ball and of the game interface devised to guide the monitoring procedure are presented. Reliability and concurrent validity of the system in measuring maximal grip strength against the clinical standard Jamar were evaluated. Serious game usability and acceptance were investigated on 26 elderlies. Smart ball and Jamar measurements were well-correlated (0.76 and 0.80 for dominant and non-dominant hand) and test-retest reliability of pressure measurements was excellent (Intraclass Correlation Coefficient > 0.94). The serious game was well-accepted by the 96.1% of participants, who provided a strongly positive usability score (87.7/100). The smart ball-driven serious game demonstrated excellent reliability and good validity in measuring grip strength. The proposed smart ball-driven serious game can be used for home self-monitoring of grip strength in elderlies.