App development for KOKU

KOKU is a fun, evidence-based app designed to reduce falls in older people and those with Dementia or Parkinson’s by improving strength and balance.

Falls are one of the biggest health risks for older adults, yet most prevention approaches feel clinical, laborious and uninspiring. This case study demonstrates how gamification and user-led design turned evidence-based exercises into an engaging app that improves lives worldwide. If you’re exploring digital health innovationgamification or user-led design this is a powerful example of research meeting creativity.

The Challenge 

Turn years of research on falls prevention into an accessible, engaging digital tool for older adults with global appeal.

Our Approach

Co-Design with Users We worked closely with older adults and clinicians to ensure the solution was practical, enjoyable, and easy to use for non-tech-savvy audiences.

Gamification for Motivation We transformed clinical exercise programmes into interactive mini-games, making strength and balance training engaging and sustainable.

Inclusive, Accessible Design The app was tested for usability and accessibility, ensuring it worked seamlessly across devices and met NHS standards for health apps.

Exercise made engaging 

We transformed complex clinical research into a simple, playful app that older adults love to use. The app combines OTAGO and FaME exercise programmes with interactive mini-games, making strength and balance training enjoyable and sustainable. Designed for accessibility, it works on tablets and smartphones, even for users with limited tech experience. KOKU is now NHS-approved, widely adopted across multiple countries, and continuously evolving to support people with Dementia and

The Impact

  • ORCHA score: 84% (highest for older adult wellbeing apps) 
  • Rolled out in UK, US, Denmark, Norway, Latin America 
  • Clinical trials show improved balance after 4 weeks 
  • Users include people aged up to 105 years old 

Reason Digital are fantastic to work with, they took on board all our stakeholders views, the evidence and specific design needs for older people – the results speak for themselves as we have positive research findings and great testimonials from clients and patients

Professor Emma Stanmore

University of Manchester