Exergames are body-centered games, which are controlled by various physical activities. Since they are additionally motivating and cognitive demanding, they tend to be a beneficial alternative for holistic fitness training. Therefore, the exergame’s design needs to guide the player in one’s individual comfort and performance zone (“dual flow”). Thus, a real-time adaptive game-play must be provided by combining a pre-classification of the player’s motor-skills and cognitive abilities, sensory-monitoring of psychophysiological player parameters while playing the game (e.g., heart rate, electroencephalogram, electrodermal activity) and adjustable ingame events (e.g., score system, difficulty, speed, graphics, sound) responding to the current physiological and psychological state of the exercising player. The proposed explorative design model for psychophysiological adaptable exergame fitness training for children is implemented in two interactive exergame concepts.
This paper outlines the intentions and current design behind the production of Mobius Floe, an immersive virtual reality game catered to acute and chronic pain patients. Researchers have shown that immersive virtual reality (VR) can serve as a non-pharmacological analgesic by inducing cognitive distraction in acute pain patients [Hoffman 2000]. Mobius Floe experiments with virtual reality as well as auditory immersion, a more experimental approach to cognitive distraction for pain relief; the results will be tested by acute as well as chronic pain patients to determine if chronic sufferers can benefit from similar VR practices as their acute counterparts. Mobius Floe’s game design is informed by contemporary game design theory and cognitive psychology in order to improve its distractive properties.
Often, logging data while playing a game-based health application is of specific interest, not only to the players themselves, but equally to therapists, health counselors, coaches, researchers, etc. Therefore, designing and developing a health game on its own is not enough; one also needs to foresee a health game data management system (DMS). In this paper we present eight requirements for a ‘generic’ health game DMS. We will start by discussing the diversity and similarity between four different health games and their data. After the analysis of the games and data, we will present a final set of requirements that need to be addressed when building a health game DMS: data-centralization, data-synchronization, data integrity, role-based access, accountability, a generic data structure, UI flexibility and development extensibility. We hope that these requirements can inform health game professionals when designing their own DMS.
Virtual rehabilitation games have the potential to increase children’s motivation during robot-assisted locomotion therapy. Based on this approach, two target-group specific rehabilitation games were developed. „Gabarello v.1.0“ and „Gabarello v.2.0“ are controlled by the patient’s motion in Hocoma’s gait-driven orthosis Lokomat®, which provides biofeedback values of the patient’s physical performance. These measurements are exploited to derive video game playability for the patient in real time. “Gabarello v.2.0” is connected to therapy devices through a specific middleware (“RehabConnex”). This set-up allows the extension of the game environment through the additional use of the sensor glove “PITS” (Institute of Neuroinformatics, ETH Zurich/University of Zurich) to complete a second task, while maintaining the game’s key features. Both rehabilitation games turn therapy into a stimulating, self-motivated, fun experience, supporting both patients and therapists. This explorative approach might be used as guideline for future rehabilitation game developments.
Entertainment game genres provide game designers with a taxonomy of known sets of mechanics, which are used as a foundation to design games. Serious games taxonomy in comparison do not provide the same kind of design knowledge. For this reason, we adopted a way of classifying serious games into four categories by tactical form, or the way the game is deployed in a certain context to achieve its primary purpose. Central to this paper is the discussion of our extended tactical from termed adaptive. DJ Fiero, a game designed to rehabilitate children with ABI (Acquired Brain Injury), is used as a case study to examine how the adaptive form fits the current sociopolitical and economic design challenges of the Dutch healthcare domain.
Smart Aging, a Serious games (SGs) platform in a 3D virtual environment aimed at the early detection of Mild Cognitive Impairments (MCI) in persons ageing between 50 and 80. The navigation in a 3D environment (loft) that simulates in a reduced space the basic elements of interaction of home living, associated with the game approach results in a powerful screening tool, more friendly and motivating with respect to the traditional paper&pencil tests. The Smart Aging platform asks people to perform tasks related to daily activities, closer to real life than traditional paper&pencil tests, and, in doing so, it is able to evaluate different cognitive functions. The platform has been realized through a strong collaboration between game developers, neurologists and neuropsychologists. A scientific validation phase is ongoing on a sample of 1000 users to provide evidence of the efficacy and usefulness of the Smart Aging system.
Active video games can potentially support healthy aging by stimulating physical activity. We conducted a survey study amongst 482 Dutch people over 65 to learn their opinions and found that many are not interested in playing active video games. Participants that have played them like and interact more with ordinary (computer) games and computers than those who have not. We hypothesize that in order for active video games to be used for health enhancement more promotional efforts are required to let more people experience active video gaming and to increase awareness on its use as physical activity.
Training emergency care skills is critical for patient safety and an essential part of medical education. Increasing demands on competences of doctors and limited training budgets necessitate new and cost-effective training methods. In the last decade, serious games have been propagated to train complex skills; they are expected to facilitate active, engaging and intrinsically motivated learning. Erasmus MC has developed a serious game to train emergency care skills, as a preparation for the faceto- face training. This ‘abcdeSIM’ game provides a realistic online emergency department environment where doctors can assess and stabilize patients in a virtual emergency department.
Diabetes heavily impacts the day-to-day routine of those affected and requires a large degree of self-control and discipline. Since the disease is incurable, patients must learn to self-identify with their situation. In the case of adolescents, the basic problem of diabetes patients is exacerbated by several aspects. They are under high social pressure to conform with the expectations and want to be recognized in the group. They often find themselves in spontaneous situations and expose themselves more than adults to extreme physical experiences. They no longer simply submit to instructions from parents, guardians, or other adults. These factors result in adolescent diabetics being exposed to the danger of taking their medication incorrectly or inadequately, which consequently entails far-reaching risks to their health.
Teenagers spend a large proportion of their day doing sedentary activities. They sit in school during classes and breaks, and after school they sit while doing homework, watching television or playing computer games. Novel ways of stimulating teenagers to be more active include applying games and play, because of its intrinsically motivating value. This paper presents a qualitative study of the role of persuasive feedback in a physical activity game. We performed interviews with teenagers who used a running game for several weeks. We describe their attitude towards persuasive feedback, its perceived effectiveness and possibilities for improvement.
The depression prevention video game SPARX was shown to be equally as effective as the classroom-based depression prevention program ‘Op Volle Kracht’ (OVK) in reducing depressive symptoms among adolescents girls. Because video games are known for their engaging qualities, this study examined possible motivational benefits of SPARX compared to OVK. No differences in autonomous and controlled motivation were found between conditions at any time point. However, OVK was negatively associated with autonomous motivation during the program, while SPARX and the OVK and SPARX combined were associated negatively with controlled motivation during the programs. Additionally, autonomous motivation and controlled motivation at the start of the interventions and controlled motivation half-way through the interventions was found to positively influence long-term depressive symptoms. Results indicate that depression prevention programs including video games can beneficially influence motivation. Further research is needed to delineate the effects of video game prevention programs on motivation.
Games can be serious. In the case of games for medical professionals, often very serious, as they are used to train for activities that are literally lifesaving. To achieve ’suspension of disbelief’ among medical professionals, a game must be realistic in terms of its’ interactive elements i.e. both the objects and the actors in the virtual environment. The central and key actor is the patient. Given the complexity of the real world patient, then it is unsurprising that ‘the patient’ in most virtual environments is but a pale representation of real world patients. This paper describes work-in-progress in an already widely deployed clinical immersive environment, CliniSpace, in building believable, and as importantly manageable, real time virtual patients with an approach called ‘active virtual patient management’ which offers both stand-alone customisable authoring and real-time virtual patient management to deliver believable virtual patients for medical education.
This study determined the efficacy of the game Tunnel Tail in improving players’ confidence in their ability to resist illegal drugs and alcohol. 246 students in the target age group of 11 to 13 years old were given a survey before and after playing Tunnel Tail. Players were split into two groups, which played either one or two twenty-minute sessions. Session length was based on data of average play time. Comparing survey responses before and after gameplay, 86% of active players showed improvement in at least one area of resistance attitudes. Players who reported reading and paying attention to the ingame dialogue showed greater improvement. Additionally, longer play time was correlated with increased confidence in resistance behaviors. Despite its limitations (small sample, lack of control group), the survey suggests that a larger study is warranted. Tunnel Tail provides an early glimpse of the potential for using sophisticated game apps to enhance learning of resistance skills and effect behavior change.
20% of Dutch youth suffer from psychiatric disorders that hamper their daily functioning and their personal development. Clients tend to drop out of school and have problems in their social environment. These clients often suffer from low social competencies and low empathic behavior, resulting in low treatment compliance. The study targets treatment motivation in order to prevent therapy dropout by introducing playful interventions.
Brain games can be an effective way to help people “train” and maintain cognitive agility over time. Although game content is based on wellestablished tasks, the means to motivate people to play remains more of an art than a science. This paper tests the impact of different types of feedback commonly used in entertainment-oriented games on intrinsic motivation, enjoyment and performance within a brain game. In a 2 by 2 factorial design, we compare performance-based feedback (a score) with task completion feedback (a badge) and two contexts for that feedback, private (viewed independently) versus shared (posted on a social network). Shared feedback is associated with higher motivation and game enjoyment. There is no difference in level of performance on intrinsic motivation. Contrast analysis and pairwise comparisons reveal that the shared and performance-based feedback is most motivating. We discuss the implications for brain games specifically and interventions more broadly.
The objective of this paper is to provide an overview of the iStoppFalls exergames, in association with digital game genres and aesthetics. This paper aims to present the links between game theory and the developed exergames presented in this paper, resulting in a series of proposed recommendations. Although there is a growing body of work associated to exergames and health rehabilitation there is little work focusing and identifying game theory and exergames. For the future development of exergames a series of proposed recommendations have been suggested to facilitate researchers, practitioners and participants in gaining further understanding of the use of exergames for health rehabilitation in particular, fall prevention. To the knowledge of the authors, the iStoppFalls is the first ambient assisted exercise program (AAEP) which utilizes 21st Century digital game technology with a primary focus on fall prevention.
Improved antimicrobial prescribing is a key effort to reduce the impact of increasing antimicrobial resistance. Quality improvement programmes in antimicrobial prescribing have to ensure the continued engagement of prescribers with optimal prescribing behaviours. Serious games have been proposed to improve clinical practice and may serve to resolve some of the behavioural and social barriers influencing prescribing. We describe here the ongoing development and future evaluation of a mobile device-based serious antimicrobial prescribing game for hospital clinicians.
We present the development of a virtual trainer for use by physiotherapists and patients in exercise based physiotherapy programmes. It allows a therapist to tailor exercise requirements to the specific needs and challenges of individual patients. Patients can select different programmes and follow a coach avatar to perform recorded exercises based on their needs. The Microsoft Kinect has been implemented as a means to track user’s body movements. This enables immersive and natural interaction between the user and virtual tuition world. Most importantly, the recorded skeletal joint data facilitates quantitative analysis and feedback of patient’s body movements. The proof of concept has been implemented and tested by 15 volunteers. Preliminary study shows the potential of using Kinect as a low cost solution for virtual physiotherapy training at home or clinic settings.
We present our work in the Active Parks project, aimed at encouraging older and sedentary people to take casual physical exercise in urban spaces, such as parks. This is achieved through the co-design of playful ‘phygital’ (physical and digital) artefacts and games to be installed in the park. The initial testing of our proof-of-concept prototype received extremely positive feedback as a potential way of motivating people to keep active in the park and in bridging the generation gap.
