Critical Reflections on Technology to Support Physical Activity among Older Adults: An Exploration of Leading HCI Venues
Kathrin Gerling, Mo Ray, Vero Vanden Abeele, Adam B. Evans · 2020 · ACM Transactions on Accessible Computing · doi:10.1145/3374660
Summary
This critical review examines how "active ageing" policy discourse has influenced HCI research on technology supporting physical activity for older adults. Through a structured search of leading HCI venues (1997-2017), the authors identified 22 papers representing 18 unique systems. Using thematic analysis informed by critical sports science, they explore whether HCI perpetuates a deficit-focused view of ageing—treating older adults as a homogeneous group defined by decline who need technological interventions to remain "productive" and reduce healthcare costs. The review categorizes systems by application context (treatment vs. prevention) and analyzes how older adults are portrayed in research design and reporting, how their perspectives inform technology design, and how they experience physical activity technology. All 18 systems fell exclusively within the health domain, addressing rehabilitation, occupational therapy, or reducing sedentarism—none primarily aimed at leisure, enjoyment, or skill development for its own sake.
Key findings
The review reveals that deficit-focused perspectives dominate HCI research on physical activity for older adults. Research motivations overwhelmingly emphasize "treating" age-related decline, reducing healthcare costs, or preventing disease—rarely acknowledging older adults' strengths, life experiences, or the pleasures of physical activity. Most systems adopted prescriptive approaches, with technology making a priori decisions about activity types and integration, leaving little room for older adults to voice preferences or adapt activities to individual situations. While most projects claimed user-centered design, genuine participatory design involving older adults as co-designers was rare; instead, "design by proxy" through therapists or caregivers was common, risking systematic misrepresentation of older adults' interests. Only two of 18 systems referenced hedonism or enjoyment as design considerations. Game-based solutions were prevalent, chosen not because games appeal to older adults, but because gameplay maps easily onto movement tracking—a functionalist rather than user-centered rationale. Evaluation approaches favored short-term quantitative measures over long-term engagement studies.
Relevance
This paper offers essential guidance for practitioners designing technology for older adults—applicable beyond physical activity to any domain. The core critique is that treating older adults primarily as declining, at-risk individuals who need "fixing" through technology is both ethically problematic and likely to produce less effective, less engaging systems. Four challenges for future work are identified: (1) prioritize agency over prescriptive interventions—let older adults choose activities and engagement levels rather than imposing expert-determined routines; (2) move beyond design by proxy to genuine participatory design with older adults as co-researchers; (3) build on strengths while remaining mindful of vulnerability—ability-based design with dynamic difficulty adjustment can provide challenge without frustration; (4) balance functionalism with hedonism—technology should support enjoyment and pleasure, not just measurable health outcomes. For accessibility practitioners, this paper challenges assumptions about what older users "need" and advocates centering their voices, preferences, and right to make their own choices about technology engagement.
Tags: older adults · aging · physical activity · active ageing · exergames · participatory design · rehabilitation · critical analysis · literature review