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Feasibility, Usability, and Effects of Leisure-Based Cognitive Training Using a Fully Immersive Virtual Reality System in Older Adults: Single-Arm Pretest-Posttest Pilot Study. 在老年人中使用完全沉浸式虚拟现实系统进行休闲认知训练的可行性、可用性和效果:单臂前测后测先导研究。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-09 DOI: 10.2196/66673
I-Ching Chuang, Xiao-Ting Huang, I-Chen Chen, Yih-Ru Wu, Ching-Yi Wu
<p><strong>Background: </strong>Cognitive training is an effective approach to support cognitive function in older adults. Incorporating meaningful leisure activities, such as gardening, may enhance both engagement and training outcomes. While fully immersive virtual reality (VR) offers ecologically valid and engaging environments that can further boost motivation, limited research has explored the combination of VR-based cognitive training and leisure activities for older adults.</p><p><strong>Objective: </strong>This study aims to assess the feasibility, usability, and preliminary effectiveness of leisure-based VR cognitive training for community-dwelling older adults.</p><p><strong>Methods: </strong>A fully immersive VR cognitive training system, controlled via a head-mounted display, was developed, incorporating gardening-themed activities such as planting, fertilizing, watering, and harvesting. These tasks were designed to engage multiple cognitive domains, including memory, attention, executive function, processing speed, and visuospatial abilities. The program consisted of 16 sessions delivered over 8 weeks (twice weekly, 1 hour per session). Cognitive outcomes were assessed before and after training using the Montreal Cognitive Assessment, the digit symbol substitution test, word list immediate and delayed recall, spatial span, and the Stroop Color and Word Test. Feasibility, acceptance, and usability were evaluated using the System Usability Scale and a posttraining questionnaire. Licensed occupational therapists from both community and institutional settings assessed the training system's usability.</p><p><strong>Results: </strong>All 41 participants (mean age 69.79, SD 5.05 y) completed the training with 100% adherence and no serious adverse events. Feasibility ratings-particularly for perceived usefulness, intention to use, and subjective norms-reflected strong acceptance. Usability ratings from older adults indicated high ease of use, enjoyment, and positive experience, while professionals rated the system as moderately usable (mean System Usability Scale score 68.01, SD 8.38). Statistically significant improvements were observed in general cognition (P=.004), processing speed (P=.049), immediate and delayed memory (P<.001), and executive function (P=.002). No significant changes were found in visuospatial memory (P=.29).</p><p><strong>Conclusions: </strong>This study provides preliminary evidence supporting the feasibility and usability of a gardening-based VR cognitive training program for older adults. Feasibility was demonstrated through full adherence, absence of major adverse events, and high participant acceptance. Usability feedback was favorable from both older adults and professionals across community and long term care settings. Additionally, improvements in multiple cognitive domains, including general cognition, processing speed, memory, and executive function, suggest potential cognitive benefits. Future randomized cont
背景:认知训练是支持老年人认知功能的有效方法。加入有意义的休闲活动,如园艺,可以提高参与度和培训效果。虽然完全沉浸式虚拟现实(VR)提供了生态有效且引人入胜的环境,可以进一步提高动机,但有限的研究探索了基于VR的认知训练和老年人休闲活动的结合。目的:本研究旨在评估基于休闲的VR认知训练在社区老年人中的可行性、可用性和初步效果。方法:开发一套通过头戴式显示器控制的全沉浸式VR认知训练系统,将种植、施肥、浇水、收获等园艺主题活动融入其中。这些任务被设计成涉及多个认知领域,包括记忆、注意力、执行功能、处理速度和视觉空间能力。该计划包括16个课程,为期8周(每周两次,每次1小时)。认知结果在训练前后通过蒙特利尔认知评估、数字符号替代测试、单词列表即时和延迟回忆、空间广度和Stroop颜色和单词测试进行评估。使用系统可用性量表和培训后问卷对可行性、可接受性和可用性进行评估。来自社区和机构的持牌职业治疗师评估了培训系统的可用性。结果:所有41名参与者(平均年龄69.79,SD 5.05 y)完成了100%的依从性训练,无严重不良事件。可行性评级——特别是感知有用性、使用意图和主观规范——反映了强烈的接受度。来自老年人的可用性评分表明易用性,享受性和积极的体验,而专业人士认为系统可用性中等(平均系统可用性量表得分68.01,标准差8.38)。在一般认知(P= 0.004)、处理速度(P= 0.049)、即时记忆和延迟记忆方面均有统计学意义的改善。结论:本研究为基于园艺的老年人VR认知训练计划的可行性和可用性提供了初步证据。通过完全依从性、无主要不良事件和高参与者接受度证明了可行性。来自社区和长期护理机构的老年人和专业人士的可用性反馈都是有利的。此外,多个认知领域的改善,包括一般认知,处理速度,记忆和执行功能,表明潜在的认知益处。未来的随机对照试验需要更多样化的样本和更长期的随访来证实和扩展这些发现。
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引用次数: 0
Usability Evaluation of a Virtual Reality Multisensory Sham-Feeding Device for Patients Undergoing Fasting Periods for Colorectal Cancer Surgery: Mixed Methods Study. 结直肠癌手术禁食期虚拟现实多感官假喂养装置的可用性评估:混合方法研究。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-08 DOI: 10.2196/75641
Xingzhu Yuan, Peiling Ye, Xinyue Liu, Yuehan Hu, Qin Xu, Wenyi Zhao, Ka Li
<p><strong>Background: </strong>Colorectal cancer surgery requires perioperative fasting to ensure safety, but this can cause physiological and psychological discomfort, such as impaired intestinal motility, bloating, immune suppression, anxiety, and appetite loss. To address this challenge, we developed the virtual reality (VR) multisensory sham-feeding device (VRMS-SFD), based on Pavlov conditioned reflex mechanism, where vagal stimulation triggered by seeing, smelling, or thinking about food activates cephalic-phase responses, promoting digestive secretion and intestinal motility. The device integrates multisensory stimulation-visual (food presentation), auditory (eating sounds and relaxing music), and olfactory (food-specific scents)-to create a VR dining experience. It features three VR scenes (Chinese restaurant, fruit shop, and dessert shop) with 23 food options, offering immersive interaction through a head-mounted display and synchronized scent release.</p><p><strong>Objective: </strong>This study aimed to evaluate the usability, acceptability, and safety of the VRMS-SFD in patients with colorectal cancer during postoperative fasting, assessing its potential to alleviate discomfort, stimulate appetite, and enhance emotional well-being.</p><p><strong>Methods: </strong>A mixed methods design was used. Participants used VRMS-SFD for 20 minutes during each meal time over 3 postoperative days. Quantitative data included the System Usability Scale (SUS) and demographic or clinical variables. Qualitative data were obtained from 15- to 30-minute semistructured interviews, transcribed verbatim, and thematically analyzed using NVivo (version 15.0; QSR International). When no new themes emerged, the sample size was considered sufficient, and data saturation was achieved. Two researchers independently coded transcripts, with discrepancies resolved by a third reviewer. The study was ethically approved (1087) and clinically registered.</p><p><strong>Results: </strong>A total of 37 patients were included. The mean SUS score was 77.78 (SD 7.90; range 62.5-97.5), indicating high usability. Participants rated ease of use (mean 4.46, SD 0.56), learnability (mean 4.27, SD 0.69), and confidence (mean 4.27, SD 0.61) positively. There was no correlation between SUS score and age (r=0.05). Thematic analysis revealed four themes: (1) immersive and enjoyable experience, with patients describing the device as "novel" and "engaging"; (2) reduced fasting-related discomfort, including less bloating, improved mood, and reported peristalsis; (3) appetite stimulation, with many noting increased hunger; and (4) improvement suggestions, such as enhancing scent authenticity, simplifying controls, and diversifying music. One participant experienced transient dizziness, resolving within 5 minutes post-device removal, with no other adverse events. Quantitative and qualitative findings converged, confirming robust usability and clinical benefits.</p><p><strong>Conclusions: </s
背景:结直肠癌手术需要围手术期禁食以确保安全,但这可能引起生理和心理上的不适,如肠动力受损、腹胀、免疫抑制、焦虑和食欲下降。为了应对这一挑战,我们开发了基于巴甫洛夫条件反射机制的虚拟现实(VR)多感官假喂养装置(VRMS-SFD),其中由看到、闻到或想到食物引发的迷走神经刺激激活了头期反应,促进了消化分泌和肠道运动。该设备集成了多感官刺激——视觉(食物展示)、听觉(吃饭的声音和放松的音乐)和嗅觉(特定食物的气味)——来创造VR用餐体验。它有三个VR场景(中餐厅、水果店和甜品店),有23种食物选择,通过头戴式显示器和同步气味释放提供沉浸式互动。目的:本研究旨在评估VRMS-SFD在结直肠癌患者术后禁食期间的可用性、可接受性和安全性,评估其缓解不适、刺激食欲和增强情绪幸福感的潜力。方法:采用混合方法设计。术后3天,参与者在每次用餐时间使用VRMS-SFD 20分钟。定量数据包括系统可用性量表(SUS)和人口统计学或临床变量。定性数据从15到30分钟的半结构化访谈中获得,逐字转录,并使用NVivo (version 15.0; QSR International)进行主题分析。当没有出现新的主题时,认为样本量足够,并且达到数据饱和。两名研究人员分别对转录本进行编码,差异由第三位审稿人解决。该研究获得了伦理批准(1087)并进行了临床注册。结果:共纳入37例患者。平均SUS评分77.78 (SD 7.90,范围62.5-97.5),可用性较高。参与者积极评价易用性(平均4.46,SD 0.56),易学性(平均4.27,SD 0.69)和置信度(平均4.27,SD 0.61)。SUS评分与年龄无相关性(r=0.05)。主题分析揭示了四个主题:(1)沉浸式和愉快的体验,患者对设备的描述是“新颖”和“吸引人”;(2)减少与禁食相关的不适,包括减少腹胀,改善情绪,并报告蠕动;(3)食欲刺激,许多人注意到饥饿感增加;(4)提高气味真实性、简化控制、音乐多样化等改进建议。一名参与者出现短暂性头晕,在器械移除后5分钟内消退,无其他不良事件。定量和定性研究结果一致,证实了强大的可用性和临床效益。结论:VRMS-SFD可能是一种可行的、被广泛接受的工具,可以减轻结直肠癌手术患者的禁食相关不适,增强食欲,改善情绪健康。未来的迭代应该改进气味校准和用户界面。需要更大规模的客观测量试验(如胃肠运动和激素水平)来验证疗效并探索在其他条件下的应用。试验注册:中国临床试验注册中心(ChiCTR), ChiCTR2100051419;https://www.chictr.org.cn/showprojEN.html?proj=134263。
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引用次数: 0
Comparing Caregiver Perceptions of a Social Robot and Tablet for Serious Game Delivery in Dementia Care: Cross-Sectional Comparison Study. 比较护理人员对社交机器人和平板电脑在痴呆症护理中的严肃游戏传递的看法:横断面比较研究。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-07 DOI: 10.2196/76209
Dorothy Bai, Kelvin Tan Cheng Kian, Po-Yin Chen, Yeh-Liang Hsu, Gong-Hong Lin

Background: Social robots integrated with serious games hold promise as innovative nonpharmacological strategies in dementia care. However, limited studies have adopted quantitative, platform-level comparisons from the perspective of formal caregivers, who are key stakeholders in technology implementation in dementia care settings.

Objective: This study aimed to evaluate the feasibility, usability, and overall user experience of a serious game-based interaction model delivered via a screen-equipped social robot, compared to a tablet-based version of the same model, from the perspective of formal dementia caregivers.

Methods: A cross-sectional comparative study was conducted with 120 formal dementia caregivers. Each caregiver individually interacted with both a screen-equipped social robot and a touchscreen tablet, delivering identical serious game content incorporating cognitive exercises, music therapy, and reminiscence. The robot featured multimodal interaction capabilities, including voice, gestures, movement, and facial expression display, while the tablet relied on standard touchscreen functions. Caregivers evaluated both platforms using the User Experience Questionnaire (UEQ), System Usability Scale (SUS), and a customized Technology Acceptance Model (TAM). Group comparisons were performed using t tests, with post hoc Benjamini-Hochberg correction applied to control for multiple comparisons.

Results: Caregivers generally favored the social robot over the tablet. The robot received higher total UEQ scores (mean 1.29, SD 1.14, vs mean 0.99, SD 1.08; P=.004), particularly in enjoyment (P=.002), friendliness (P=.006), clarity (P=.002), organization (P=.02), interest (P=.01), and innovation (P=.002). In the SUS, caregivers rated the robot higher for quick learning (mean 2.71, SD 0.79 vs mean 2.44, SD 0.81; P=.002), while overall SUS scores were comparable. TAM results indicated higher total scores for the robot (mean 4.03, SD 0.47 vs mean 3.67, SD 0.58; P=.002), with stronger ratings in perceived usefulness (P=.002), ease of use (P=.002), attitudes (P=.002), and behavioral intentions (P=.002). All P values are from 2-tailed t tests and were adjusted using the Benjamini-Hochberg procedure.

Conclusions: The social robot used in this study was perceived by formal dementia caregivers as providing a more favorable user experience and eliciting a stronger intention to use compared to a tablet-based platform. These findings support the feasibility of social robots as a platform for delivering technology-supported activities in dementia care and provide a foundation for future research on their implementation and outcomes in dementia care.

背景:与严肃游戏相结合的社交机器人有望成为痴呆症护理的创新非药物策略。然而,有限的研究采用了定量的、平台级的比较,从正式护理人员的角度来看,他们是痴呆症护理环境中技术实施的关键利益相关者。目的:本研究旨在评估通过配备屏幕的社交机器人提供的基于游戏的严肃互动模型的可行性、可用性和整体用户体验,并与基于平板电脑的相同模型进行比较,从正式痴呆症护理人员的角度出发。方法:对120名痴呆护理人员进行横断面比较研究。每个护理人员都单独与配备屏幕的社交机器人和触摸屏平板电脑互动,提供包含认知练习、音乐治疗和回忆的相同严肃游戏内容。机器人具有多模式交互功能,包括语音、手势、动作和面部表情显示,而平板电脑则依赖于标准的触摸屏功能。护理人员使用用户体验问卷(UEQ)、系统可用性量表(SUS)和定制的技术接受模型(TAM)来评估这两个平台。采用t检验进行组间比较,采用事后Benjamini-Hochberg校正对多重比较进行对照。结果:护理人员普遍更喜欢社交机器人而不是平板电脑。机器人的UEQ总分更高(平均1.29,SD 1.14,平均0.99,SD 1.08, P= 0.004),特别是在享受(P= 0.002)、友好(P= 0.006)、清晰(P= 0.002)、组织(P= 0.02)、兴趣(P= 0.01)和创新(P= 0.002)方面。在SUS中,护理人员对机器人的快速学习评分较高(平均2.71,SD 0.79 vs平均2.44,SD 0.81; P= 0.002),而总体SUS评分具有可比性。TAM结果表明,机器人的总分较高(平均4.03分,标准差0.47比平均3.67分,标准差0.58,P=.002),在感知有用性(P=.002)、易用性(P=.002)、态度(P=.002)和行为意图(P=.002)方面评分较高。所有P值均来自双尾t检验,并使用Benjamini-Hochberg程序进行调整。结论:与基于平板电脑的平台相比,本研究中使用的社交机器人被正式的痴呆症护理人员认为提供了更有利的用户体验,并引发了更强的使用意愿。这些发现支持了社交机器人作为在痴呆症护理中提供技术支持活动平台的可行性,并为其在痴呆症护理中的实施和结果的未来研究奠定了基础。
{"title":"Comparing Caregiver Perceptions of a Social Robot and Tablet for Serious Game Delivery in Dementia Care: Cross-Sectional Comparison Study.","authors":"Dorothy Bai, Kelvin Tan Cheng Kian, Po-Yin Chen, Yeh-Liang Hsu, Gong-Hong Lin","doi":"10.2196/76209","DOIUrl":"10.2196/76209","url":null,"abstract":"<p><strong>Background: </strong>Social robots integrated with serious games hold promise as innovative nonpharmacological strategies in dementia care. However, limited studies have adopted quantitative, platform-level comparisons from the perspective of formal caregivers, who are key stakeholders in technology implementation in dementia care settings.</p><p><strong>Objective: </strong>This study aimed to evaluate the feasibility, usability, and overall user experience of a serious game-based interaction model delivered via a screen-equipped social robot, compared to a tablet-based version of the same model, from the perspective of formal dementia caregivers.</p><p><strong>Methods: </strong>A cross-sectional comparative study was conducted with 120 formal dementia caregivers. Each caregiver individually interacted with both a screen-equipped social robot and a touchscreen tablet, delivering identical serious game content incorporating cognitive exercises, music therapy, and reminiscence. The robot featured multimodal interaction capabilities, including voice, gestures, movement, and facial expression display, while the tablet relied on standard touchscreen functions. Caregivers evaluated both platforms using the User Experience Questionnaire (UEQ), System Usability Scale (SUS), and a customized Technology Acceptance Model (TAM). Group comparisons were performed using t tests, with post hoc Benjamini-Hochberg correction applied to control for multiple comparisons.</p><p><strong>Results: </strong>Caregivers generally favored the social robot over the tablet. The robot received higher total UEQ scores (mean 1.29, SD 1.14, vs mean 0.99, SD 1.08; P=.004), particularly in enjoyment (P=.002), friendliness (P=.006), clarity (P=.002), organization (P=.02), interest (P=.01), and innovation (P=.002). In the SUS, caregivers rated the robot higher for quick learning (mean 2.71, SD 0.79 vs mean 2.44, SD 0.81; P=.002), while overall SUS scores were comparable. TAM results indicated higher total scores for the robot (mean 4.03, SD 0.47 vs mean 3.67, SD 0.58; P=.002), with stronger ratings in perceived usefulness (P=.002), ease of use (P=.002), attitudes (P=.002), and behavioral intentions (P=.002). All P values are from 2-tailed t tests and were adjusted using the Benjamini-Hochberg procedure.</p><p><strong>Conclusions: </strong>The social robot used in this study was perceived by formal dementia caregivers as providing a more favorable user experience and eliciting a stronger intention to use compared to a tablet-based platform. These findings support the feasibility of social robots as a platform for delivering technology-supported activities in dementia care and provide a foundation for future research on their implementation and outcomes in dementia care.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e76209"},"PeriodicalIF":4.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Virtual Reality-Based Assessment of Attention-Deficit/Hyperactivity Disorder and Comorbid Symptoms in Children: Framework Development and Standardization Study. 基于虚拟现实的儿童注意缺陷/多动障碍和共病症状评估:框架开发和标准化研究。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-07 DOI: 10.2196/69146
Harim Jeong, Minjoo Kang, Kennet Sorenson, Jacob Moore, Robert James Blair, Ellen Leibenluft, Jeffrey H Newcorn, Beth Krone, Singi Jeong, Donghee Kim, Soonjo Hwang

Background: As virtual reality (VR) technology becomes increasingly prevalent, its potential for collecting objective behavioral data in psychiatric settings has been widely recognized. However, the lack of standardized methodologies limits reproducibility and data integration across studies, particularly in assessing attention-deficit/hyperactivity disorder (ADHD) and associated behaviors, such as irritability and aggression.

Objective: This study examines the use of VR-based movement data to operationalize core ADHD symptoms (hyperactivity and inattention) and comorbid disruptive behaviors (irritability and aggression), aiming to identify reproducible and clinically actionable metrics and evaluate their explanatory power for each symptom domain to assess the overall use of these variables.

Methods: A total of 45 children (mean age 9.06, SD 2.11 years; n=14/45, 31% female) participated in the study and were divided into 2 groups: 28 (62%) diagnosed with ADHD and 17 (38%) controls. Seven VR-derived movement variables were analyzed: average speed, acceleration, total distance, area occupied, distance between the hands and head, frequency of movement, and time spent still. Correlation and stepwise regression analyses identified which variables best predicted ADHD symptoms and comorbid behaviors.

Results: Among the 7 VR-derived variables, average speed (mean r=0.460, SD 0.097) and total distance (mean r=0.442, SD 0.116) showed the broadest associations, each correlating with 8 measures. In contrast, frequency of movement was related only to hyperactivity (r=0.416; P=.004), suggesting strong but narrow predictive value. Stepwise regression identified total distance as the sole and strongest predictor of hyperactivity (R2=0.411) and, except for participant-reported irritability, yielded significant models for all other measures (mean R2=0.282, SD 0.064; all P<.05).

Conclusions: This study provides empirical evidence on VR-derived movement variables that can inform the development of standardized methodologies for ADHD and comorbid behavior assessment. The identified metrics and their predictive patterns offer a basis for integrating VR-based measures into future research and clinical applications.

背景:随着虚拟现实(VR)技术的日益普及,其在精神病设置中收集客观行为数据的潜力已得到广泛认可。然而,缺乏标准化的方法限制了研究的可重复性和数据整合,特别是在评估注意力缺陷/多动障碍(ADHD)和相关行为(如易怒和攻击)时。目的:本研究考察了基于vr的运动数据对核心ADHD症状(多动和注意力不集中)和合并症破坏性行为(易怒和攻击)的应用,旨在确定可重复和临床可操作的指标,并评估其对每个症状领域的解释能力,以评估这些变量的总体使用情况。方法:共45例患儿(平均年龄9.06岁,SD 2.11岁,n=14/45,女性占31%)分为2组,确诊ADHD患儿28例(62%),对照组17例(38%)。分析了七个vr衍生的运动变量:平均速度、加速度、总距离、占用的面积、手和头之间的距离、运动频率和静止时间。相关分析和逐步回归分析确定了哪些变量最能预测ADHD症状和共病行为。结果:在7个vr衍生变量中,平均速度(平均r=0.460, SD = 0.097)和总距离(平均r=0.442, SD = 0.116)的相关性最广,各与8个测量相关。相比之下,运动频率仅与多动症相关(r=0.416; P= 0.004),提示预测价值强但窄。逐步回归将总距离确定为多动症的唯一且最强的预测因子(R2=0.411),除参与者报告的易怒外,所有其他测量指标均产生显著模型(平均R2=0.282, SD 0.064;所有p)结论:本研究为vr衍生的运动变量提供了经验证据,可以为ADHD和共病行为评估的标准化方法的发展提供信息。确定的指标及其预测模式为将基于vr的措施整合到未来的研究和临床应用中提供了基础。
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引用次数: 0
Vision AI-Based Gamified Cognitive Prosthesis for Executive Function: Feasibility and Usability Study. 基于视觉人工智能的游戏化认知假体:可行性与可用性研究。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-06 DOI: 10.2196/74157
Co Yih Siow, Yao-Hua Yang, Cheng-Jui Tsai, Wan-Wan Yang, Chaur-Jong Hu, Jia-Ying Sung, Jowy Tani

Background: Dementia is a progressive neurodegenerative condition marked by cognitive decline and loss of functional independence. Among cognitive domains, executive dysfunction is a critical early contributor to reduced self-care capacity and increased caregiver burden. While cognitive assistive technologies have focused primarily on memory, few tools address executive function in real-time, daily tasks. To fill this gap, we developed a novel gamified cognitive prosthesis that integrates artificial intelligence (AI) and computer vision to guide users step-by-step through a simulated egg-cooking task. This system provides real-time audiovisual feedback to support planning, sequencing, and error correction.

Objective: This study aimed to evaluate whether the AI-based cognitive prosthesis improves task completion time and executive function performance in individuals with mild dementia.

Methods: We conducted a pilot study involving 12 patients with mild dementia and 7 age-matched healthy controls. Participants were asked to complete a 6-step gamified egg boiling task under 2 conditions: with and without guidance. The task was evaluated using a custom "Daily Task Completion Test" and a modified executive function performance test (EFPT) adapted to the cooking activity. Demographic and clinical data (age, sex, education, Mini-Mental State Examination, Clinical Dementia Rating, activities of daily living, instrumental activities of daily living, and Dementia Severity Rating Scale) were recorded. The System Usability Scale (SUS) was also collected postintervention.

Results: In the mild dementia group, AI assistance significantly reduced median task completion time from 134.75 (IQR 92.50-134.75) to 92.00 (IQR 65.00-92.00; P=.03) seconds, and significantly improved the Executive Function Performance Test (EFPT) scores from 4.25 (IQR 1.75-4.25) to 1.00 (IQR 0.00-1.00; P=.005), reflecting a 31.7% improvement in efficiency and a 76.5% reduction in required assistance. No significant changes were observed in the control group. The mean SUS score was 80.53 (SD 24.97), indicating high usability. The AI system achieved a cumulative recognition precision of 0.93 (SD 0.07) and cumulative recall of 0.94 (SD 0.11).

Conclusions: This pilot study provides preliminary evidence that an AI-based cognitive prosthesis can enhance executive function and task performance in individuals with mild dementia. The results support the feasibility of using real-time AI guidance in everyday tasks to promote independence. Given its modular design and promising usability profile, this system may serve as the foundation for future digital therapeutics targeting executive dysfunction. Larger, longitudinal studies are warranted to evaluate sustained cognitive and functional benefits.

背景:痴呆是一种以认知能力下降和功能独立性丧失为特征的进行性神经退行性疾病。在认知领域,执行功能障碍是降低自我照顾能力和增加照顾者负担的关键早期贡献者。虽然认知辅助技术主要集中在记忆上,但很少有工具能处理实时的日常任务的执行功能。为了填补这一空白,我们开发了一种新的游戏化认知假体,它集成了人工智能(AI)和计算机视觉,指导用户逐步完成模拟煮鸡蛋的任务。该系统提供实时视听反馈,以支持计划、排序和纠错。目的:本研究旨在评估基于人工智能的认知假体是否能改善轻度痴呆患者的任务完成时间和执行功能表现。方法:我们进行了一项涉及12例轻度痴呆患者和7例年龄匹配的健康对照的初步研究。参与者被要求在两种情况下完成6步游戏化煮蛋任务:有指导和没有指导。使用自定义的“每日任务完成测试”和适应烹饪活动的修改的执行功能性能测试(EFPT)来评估任务。记录人口统计学和临床数据(年龄、性别、教育程度、简易精神状态检查、临床痴呆评分、日常生活活动、日常生活工具活动和痴呆严重程度评定量表)。干预后收集系统可用性量表(SUS)。结果:在轻度痴呆组中,人工智能辅助显着将任务完成时间中位数从134.75 (IQR 92.50-134.75)降低到92.00 (IQR 65.00-92.00; P= 0.03)秒,并显着提高执行功能表现测试(EFPT)分数从4.25 (IQR 1.75-4.25)提高到1.00 (IQR 0.00-1.00; P= 0.005),反映效率提高31.7%,所需辅助减少76.5%。对照组未见明显变化。平均SUS评分为80.53 (SD 24.97),可用性较高。人工智能系统的累计识别精度为0.93 (SD 0.07),累计召回率为0.94 (SD 0.11)。结论:这项初步研究提供了初步证据,表明基于人工智能的认知假体可以增强轻度痴呆患者的执行功能和任务表现。研究结果支持在日常任务中使用实时人工智能指导以促进独立性的可行性。鉴于其模块化设计和有前景的可用性,该系统可以作为未来针对执行功能障碍的数字治疗的基础。更大规模的纵向研究有必要评估持续的认知和功能益处。
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引用次数: 0
The Impact of Active Augmented Reality Games on Physical Activity and Cognition Among Older Adults: Feasibility Study. 主动增强现实游戏对老年人身体活动和认知的影响:可行性研究。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-03 DOI: 10.2196/73221
Amy Shirong Lu, Bhagyashree Parkar, Shiveshchandra Gupta, Sierra Hall, Dominika M Pindus, Arthur F Kramer
<p><strong>Background: </strong>Physical activity (PA) enhances physical health as well as cognitive and brain health, yet motivating older adults to initiate and sustain PA remains challenging, a difficulty exacerbated by the COVID-19 pandemic. Active augmented reality (AAR) games, integrating digital gameplay with real-world physical movement, provide an enjoyable and accessible means for PA promotion among older adults in independent living environments, mitigating barriers such as poor weather and unfavorable neighborhood environments. However, limited research has explored the feasibility and impact of AAR interventions in this population.</p><p><strong>Objective: </strong>This feasibility study examines the acceptability, safety, and preliminary effects of AAR games to enhance PA levels and cognitive functions among older adults, as well as their user experiences. We also examined the practicality of home-based AAR gameplay using minimal equipment and constrained physical space.</p><p><strong>Methods: </strong>Sixteen independent-living older adults aged 65-85 years (mean 74.6, SD 3.73) participated in a single-session AAR intervention using the Active Arcade game set by playing four 10-minute AAR games. PA levels were assessed using ActiGraph wGT3x-bt accelerometers and Polar H10 heart rate monitors. Cognitive function was evaluated pre- and post-gameplay using NIH Toolbox's visual reasoning test and Flanker inhibitory control and attention tests. Surveys of PA intention and motivation as well as the gaming experience questionnaire, along with semistructured interviews, were conducted afterwards, providing both quantitative and qualitative insights into the feasibility and appeal of AAR gameplay from the target population.</p><p><strong>Results: </strong>All participants completed the study protocol without adverse events, demonstrating high feasibility and acceptability. Participants engaged in moderate-to-vigorous PA during 20%-30% of the gameplay, as measured by accelerometers and heart rate monitors. Of the 16 participants, 7 were taking beta blockers. The mean values of average %HRMax suggest that those not on beta blockers generally met the moderate-intensity threshold, whereas those on beta blockers tended to fall slightly below it. Cognitive assessments revealed significant improvements in visual reasoning postintervention, with the effect sustained after adjustment for age and education (P=.03), suggesting potential cognitive benefits from a single bout of AAR gameplay. Survey responses indicated high levels of PA intention (mean 4.15/5, SD 0.59), motivation (mean 5.67/7, SD 1.24), high positive affect (mean 4.35/5, SD 0.80), and low negative affect (mean 1.30/5, SD 0.46) associated with AAR gameplay. Around 75% of gameplay occurred within a 4×4 ft area (mean 29.77/40 min, SD 2.46), indicating suitability for home environments. Thematically analyzed interview feedback emphasized participants' enjoyment, ease of use, desire for pro
背景:身体活动(PA)可以增强身体健康以及认知和大脑健康,但激励老年人开始和维持PA仍然具有挑战性,这一困难因COVID-19大流行而加剧。主动增强现实(AAR)游戏将数字游戏玩法与现实世界的物理运动相结合,为生活在独立生活环境中的老年人提供了一种愉快和方便的PA推广手段,减轻了恶劣天气和不利的社区环境等障碍。然而,有限的研究探讨了AAR干预在这一人群中的可行性和影响。目的:本可行性研究考察了AAR游戏提高老年人PA水平和认知功能的可接受性、安全性和初步效果,以及他们的用户体验。我们还研究了使用最小设备和有限物理空间的家庭AAR游戏玩法的实用性。方法:16名年龄在65-85岁的独立生活老年人(平均74.6,SD 3.73)参加了一个单期AAR干预,使用Active Arcade游戏设置,通过玩4个10分钟的AAR游戏。采用ActiGraph wGT3x-bt加速计和Polar H10心率监测仪评估PA水平。使用NIH工具箱的视觉推理测试和Flanker抑制控制和注意力测试评估游戏前和游戏后的认知功能。随后进行了PA意图和动机调查以及游戏体验问卷调查和半结构化访谈,从目标人群中提供了关于AAR玩法可行性和吸引力的定量和定性见解。结果:所有参与者均完成了研究方案,无不良事件发生,具有较高的可行性和可接受性。通过加速计和心率监测器测量,参与者在20%-30%的游戏时间内进行中度至剧烈的PA。在16名参与者中,有7人服用了受体阻滞剂。平均%HRMax的平均值表明,未服用受体阻滞剂的患者通常达到中等强度阈值,而服用受体阻滞剂的患者往往略低于中等强度阈值。认知评估显示干预后视觉推理的显著改善,在调整年龄和教育程度后效果持续(P=.03),这表明单一回合的AAR游戏可能带来认知益处。调查结果表明,与AAR游戏玩法相关的高水平的PA意图(平均4.15/5,SD 0.59)、动机(平均5.67/7,SD 1.24)、高水平的积极情绪(平均4.35/5,SD 0.80)和低水平的消极情绪(平均1.30/5,SD 0.46)。大约75%的游戏玩法发生在4×4英尺范围内(平均29.77/40分钟,标准差2.46),表明适合家庭环境。主题分析的访谈反馈强调了参与者的乐趣,易用性,对渐进式难度的渴望,以及满足不同身体能力和个人偏好的需求。结论:AAR游戏对于老年人的PA和认知参与来说是一种可行的、可访问的、愉快的选择。未来的研究应探讨AAR干预措施的长期效果、可持续性和更广泛的适用性,以充分发挥其在老龄化人群中的潜力。
{"title":"The Impact of Active Augmented Reality Games on Physical Activity and Cognition Among Older Adults: Feasibility Study.","authors":"Amy Shirong Lu, Bhagyashree Parkar, Shiveshchandra Gupta, Sierra Hall, Dominika M Pindus, Arthur F Kramer","doi":"10.2196/73221","DOIUrl":"10.2196/73221","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Physical activity (PA) enhances physical health as well as cognitive and brain health, yet motivating older adults to initiate and sustain PA remains challenging, a difficulty exacerbated by the COVID-19 pandemic. Active augmented reality (AAR) games, integrating digital gameplay with real-world physical movement, provide an enjoyable and accessible means for PA promotion among older adults in independent living environments, mitigating barriers such as poor weather and unfavorable neighborhood environments. However, limited research has explored the feasibility and impact of AAR interventions in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This feasibility study examines the acceptability, safety, and preliminary effects of AAR games to enhance PA levels and cognitive functions among older adults, as well as their user experiences. We also examined the practicality of home-based AAR gameplay using minimal equipment and constrained physical space.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixteen independent-living older adults aged 65-85 years (mean 74.6, SD 3.73) participated in a single-session AAR intervention using the Active Arcade game set by playing four 10-minute AAR games. PA levels were assessed using ActiGraph wGT3x-bt accelerometers and Polar H10 heart rate monitors. Cognitive function was evaluated pre- and post-gameplay using NIH Toolbox's visual reasoning test and Flanker inhibitory control and attention tests. Surveys of PA intention and motivation as well as the gaming experience questionnaire, along with semistructured interviews, were conducted afterwards, providing both quantitative and qualitative insights into the feasibility and appeal of AAR gameplay from the target population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All participants completed the study protocol without adverse events, demonstrating high feasibility and acceptability. Participants engaged in moderate-to-vigorous PA during 20%-30% of the gameplay, as measured by accelerometers and heart rate monitors. Of the 16 participants, 7 were taking beta blockers. The mean values of average %HRMax suggest that those not on beta blockers generally met the moderate-intensity threshold, whereas those on beta blockers tended to fall slightly below it. Cognitive assessments revealed significant improvements in visual reasoning postintervention, with the effect sustained after adjustment for age and education (P=.03), suggesting potential cognitive benefits from a single bout of AAR gameplay. Survey responses indicated high levels of PA intention (mean 4.15/5, SD 0.59), motivation (mean 5.67/7, SD 1.24), high positive affect (mean 4.35/5, SD 0.80), and low negative affect (mean 1.30/5, SD 0.46) associated with AAR gameplay. Around 75% of gameplay occurred within a 4×4 ft area (mean 29.77/40 min, SD 2.46), indicating suitability for home environments. Thematically analyzed interview feedback emphasized participants' enjoyment, ease of use, desire for pro","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73221"},"PeriodicalIF":4.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Active Video Games to Improve Behavioral Intentions and Cognitive Function in Patients With Schizophrenia: Randomized Controlled Trial. 积极的电子游戏改善精神分裂症患者的行为意图和认知功能:随机对照试验。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-01 DOI: 10.2196/69116
Huan-Hwa Chen, Ching-Ching Lin, Man-Ling Yu, Hsiu-Lan Wu, Hui-Chu Shen, Hsiu-Fen Hsieh

Background: Schizophrenia is a severe mental illness that affects the cognitive, social, and daily functions of patients. Physical activity has been found to be important for maintaining these functions in patients with schizophrenia, but many lack the motivation to participate in physical activities.

Objective: This study aimed to explore the efficacy of active video games (AVGs) on the behavioral intention and cognitive function of patients with schizophrenia.

Methods: In this experimental study, 103 participants were recruited from 2 medical centers. All participants were randomly assigned to the experimental or control group, and 82 participants (n=41, 50% in the experimental group and n=41, 50% in the control group) completed all the processes of our protocol. The experimental group was provided with AVGs for 30 minutes twice per week for 6 weeks. The Mini Mental State Examination and a behavioral intention questionnaire were administered before and after playing the AVGs. Data were collected between April 2021 and January 2022. Generalized estimating equations and 2-tailed paired t tests were used for data analysis.

Results: The experimental group showed significant improvements in behavioral intention to participate in AVGs compared with the control group at both T1 (β=4.88; P=.009) and T2 (β=4.24; P=.04). In addition, the experimental group experienced significant improvements in orientation (T2: β=0.66; P=.04) and language (T2: β=0.28; P=.03) among cognitive functions compared to the control group. In contrast, there was no significant change in these variables in the control group.

Conclusions: Playing AVGs can effectively enhance the behavioral intention of patients with schizophrenia to participate in physical activity and exercise and significantly improve their orientation and language. AVGs are inexpensive and easily operated tools for people with mental or physical disabilities.

Trial registration: ClinicalTrials.gov NCT05933356; https://clinicaltrials.gov/study/NCT05933356.

背景:精神分裂症是一种严重的精神疾病,影响患者的认知、社会和日常功能。体力活动对于维持精神分裂症患者的这些功能很重要,但许多人缺乏参加体力活动的动机。目的:探讨主动电子游戏(AVGs)对精神分裂症患者行为意向和认知功能的影响。方法:在本实验研究中,从两个医学中心招募了103名参与者。所有参与者被随机分为实验组和对照组,82名参与者(n= 41,50%为实验组,n= 41,50%为对照组)完成了我们方案的所有过程。实验组给予avg 30分钟,每周2次,连续6周。在玩avg之前和之后分别进行了迷你精神状态检查和行为意向问卷调查。数据收集于2021年4月至2022年1月。采用广义估计方程和双尾配对t检验进行数据分析。结果:实验组在T1 (β=4.88, P= 0.009)和T2 (β=4.24, P= 0.04)时参与AVGs的行为意向均较对照组有显著改善。此外,与对照组相比,实验组在定向(T2: β=0.66, P= 0.04)和语言(T2: β=0.28, P= 0.03)两项认知功能均有显著改善。相比之下,在对照组中,这些变量没有显著变化。结论:玩AVGs能有效增强精神分裂症患者参与体育活动和锻炼的行为意愿,显著提高其定向能力和语言能力。对于有精神或身体残疾的人来说,avg是一种便宜且易于操作的工具。试验注册:ClinicalTrials.gov NCT05933356;https://clinicaltrials.gov/study/NCT05933356。
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引用次数: 0
Refining Open-World Game and Nostalgic Film Interventions for Broader and More Reliable Therapeutic Impact. 完善开放世界游戏和怀旧电影干预,以获得更广泛、更可靠的治疗效果。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-01 DOI: 10.2196/82157
Chenlei Sun, Ke Meng
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引用次数: 0
Author's Reply: Refining Open-World Game and Nostalgic Film Interventions for Broader and More Reliable Therapeutic Impact. 作者回复:完善开放世界游戏和怀旧电影干预,以获得更广泛、更可靠的治疗效果。
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-09-30 DOI: 10.2196/83239
Andreas Benedikt Eisingerich, Annisa Arigayota, Barbara Duffek, Congcong Hou
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引用次数: 0
Improvement of Game Users' Depressive Symptoms via Behavioral Activation in a Massive Multiplayer Online Game: Randomized Controlled Trial. 大型多人在线游戏行为激活对游戏用户抑郁症状的改善:随机对照试验
IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-09-24 DOI: 10.2196/73734
Kenji Yokotani, Masanori Takano, Nobuhito Abe, Takahiro A Kato

Background: Online games developed to improve mental health symptoms are reportedly effective among game users. However, it has not been verified whether massive multiplayer online games (MMOGs) developed for leisure purposes are effective in improving users' mental health symptoms.

Objective: Based on 2 theoretical frameworks, this study examined whether MMOGs improve depression and social anxiety. First, behavioral activation theory posits that depressive symptoms improve through the repetition of reward-linked behaviors. Second, inhibitory learning theory suggests that exposure to social stimuli (eg, being the center of attention) previously perceived as threatening reduces fear responses over time.

Methods: Participants were Pigg Party users with at least 3 months of previous experience. Overall, 1105 participants were randomly assigned to either the experimental (n=548) or waitlist groups (n=557). Participants in the experimental group were instructed to ring a friend's room bell (an action that clearly draws attention) on weekdays and to customize their avatars on weekends. Those completing ≥60% of the tasks received additional monthly rewards. The waitlist group received no interventions but was given random additional rewards. Both groups completed questionnaires on depression (Quick Inventory of Depressive Symptomatology) and social anxiety (Brief Liebowitz Social Anxiety Scale) at baseline, and again at 1, 2, and 3 months.

Results: The experimental group showed a significantly higher frequency of bell ringing compared to that of the waitlist group (standardized mean difference [SMD]=0.13), whereas no significant difference was observed between the groups in avatar customization frequency. As predicted, the experimental group showed a significantly greater reduction in depressive symptoms, with a small effect size observed (SMD=-0.12). However, no significant difference was determined between groups in social anxiety symptoms.

Conclusions: This study demonstrated that MMOGs, when combined with administrator-led interventions, can reduce users' depressive symptoms, albeit with a small effect size. Further studies are needed to test the intervention effects on social anxiety symptoms in MMOGs, with improved exposure scenarios.

背景:据报道,为改善心理健康症状而开发的网络游戏对游戏用户有效。然而,以休闲为目的开发的大型多人在线游戏(mmog)是否能有效改善用户的心理健康症状,尚未得到证实。目的:基于两个理论框架,研究mmog是否能改善抑郁和社交焦虑。首先,行为激活理论认为,抑郁症状通过重复奖励相关行为得到改善。第二,抑制性学习理论认为,暴露于先前被认为具有威胁性的社会刺激(例如,成为注意力的中心)会随着时间的推移减少恐惧反应。方法:参与者为至少有3个月经验的小猪派对用户。总的来说,1105名参与者被随机分配到试验组(n=548)和候补组(n=557)。实验组的参与者被要求在工作日按朋友房间的门铃(一个明显吸引注意力的动作),并在周末定制他们的虚拟形象。完成≥60%任务的参与者每月获得额外奖励。候补组没有接受任何干预,但随机给予额外奖励。两组均在基线时完成抑郁(抑郁症状快速量表)和社交焦虑(简短的Liebowitz社交焦虑量表)问卷调查,并在1、2和3个月时再次完成问卷调查。结果:实验组摇铃频率显著高于候补组(标准化平均差值[SMD]=0.13),而虚拟形象定制频率组间无显著差异。正如预测的那样,实验组在抑郁症状方面表现出明显更大的减轻,观察到的效应量很小(SMD=-0.12)。然而,在社交焦虑症状方面,各组之间没有明显差异。结论:本研究表明,mmog与管理者主导的干预措施相结合,可以减轻用户的抑郁症状,尽管效果较小。需要进一步的研究来测试干预对mmog社交焦虑症状的影响,改善暴露情景。
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引用次数: 0
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