Games for Health Journal最新文献

Objective: Pain, decreased muscle strength, regression in activities of daily living (ADL), narrowing of joint range of motion (ROM), impairment of proprioceptive sense, and deterioration in static-dynamic balance are frequently observed in knee osteoarthritis (KOA). The aim of this study is to examine the effect of nonimmersive virtual reality (NIVR) application on muscle excitability and motor neuron pool activation level around the knee, balance, proprioception, physical function level, independence levels in ADL, muscle endurance, and patient satisfaction in patients with KOA. Materials and Methods: Forty patients with KOA were randomized to an experimental group (EG; n = 20) and a sham-controlled group (SG; n = 20). The EG received 45 minutes of traditional physiotherapy and 30 minutes of NIVR-based exercises for 3 weeks, 5 days a week, while the SG received traditional physiotherapy and a sham virtual reality (VR) application for 30 minutes for the same period. Primary outcomes were muscle excitability (maximal voluntary contraction [MVC]), motor neuron pool activation level, and balance. Secondary outcomes included proprioception, endurance, independence in ADL, pain level, physical functional condition (Western Ontario and McMaster Universities Arthritis Index [WOMAC]), and treatment satisfaction. Results: Findings showed a significant difference in endurance, pain level, and independence in ADL scores in favor of the EG (all values, P < 0.05). Moreover, WOMAC, static and dynamic balance (differences timed up and go [TUG]: EG: -4.75, SG: -2.10, P = 0.02, d = 0.907), MVC, and proprioception scores also showed the highest differences (most values, P < 0.001). Conclusion: Nonimmersive VR applications are a feasible approach for KOA and are effective approaches for increasing muscle excitability, static and dynamic balance, muscle endurance, proprioception, independence in ADL, treatment satisfaction, and reducing pain intensity in KOA.

Background: This study aimed to evaluate the effectiveness of serious game, exergame, and structured exercises in pes planus rehabilitation. Methods: Sixty-nine individuals with pes planus were included in this study. Individuals were randomly divided into three groups: a structured exercise group (SEG), an exergame group (EGG), and a serious game group (SGG). The average age of the participants was 21.02, and their body mass index was 21.91 kg/m². Interventions were performed three times a week for 6 weeks. Navicular drop, plantar pressure analysis, femoral anteversion, balance, and muscle strength were evaluated pre- and post-treatment. A small effect size of 0.2 was applied for navicular drop, balance, and plantar pressure analysis, and a medium effect size of 0.5 for femoral anteversion and muscle strength analysis. Results: Navicular drop and muscle strength improved significantly in all groups (P < 0.05). The strength of the inverter, plantar flexor, and dorsiflexor muscles was found to be significantly greater in the SGG than in the other groups (P < 0.05). Balance showed significant improvement only in EGG and SGG (P < 0.05). The decrease in medial plantar pressure was found to be significant in both feet in SGG and only in the left foot in the SEG (P < 0.05). The subtalar angle improved significantly in both feet in the SGG and only in the right foot in the SEG (P < 0.05). No significant change was observed in the EGG (P > 0.05). Femoral anteversion did not change in any of the three groups (P > 0.05). Conclusion: Individuals with pes planus obtained more improvements in plantar pressure analysis, subtalar angle, and muscle strength after serious games rather than structured exercises and exergame. It was considered that serious game exercise programs would be used in pes planus.

Introduction: Virtual reality (VR) offers a multidimensional simulated reality built with digital formats and can be characterized as semi-immersive (single projection screen) or fully-immersive (head-mounted display). Although VR is an emerging intervention for the rehabilitation of individuals with neurological disorders, research on fully-immersive technologies and the patient experience is limited. Purpose: To evaluate the feasibility, acceptability, and tolerability of using off-the-shelf, fully-immersive VR with adults following neurological impairment. Methods: Mixed-methods study including 18 participants with a mean standard deviation (SD) age of 67.11 (12.12) years, asked to complete 20 minutes of dynamic rhythm-based VR activity in sitting. Outcomes included the pre- and postactivity VR Sickness Questionnaire (VRSQ), physiological data (maximum heart rate and Borg Rating of Perceived Exertion [RPE]), the User Satisfaction Evaluation Questionnaire (USEQ), and a structured interview. Quantitative analysis consisted of descriptive and inferential statistics. VRSQ scores were compared using a Wilcoxon signed-rank test. Qualitative analysis consisted of thematic analysis of interviews. Results: Median interquartile range (IQR) pre- and postactivity VRSQ scores were 7.50 (0-19.58) and 7.92 (0-19.38), respectively. Differences in scores were not statistically significant (Z = 0, P = 1.00). The median USEQ score was 27.50 (25.00-28.25). The mean percentage of maximal heart rate achieved was 63 (10) %, with a median RPE score of 10.50 (8.25-12.75). Qualitative analysis revealed themes of enjoyment and beneficial therapeutic challenges as facilitators of VR use. Conclusion: A single session of fully-immersive off-the-shelf VR yielded promising integrated findings related to the feasibility, acceptability, and tolerability of this type of intervention for a sample of individuals with a variety of neurological conditions.

Purpose: Despite increasing research on blind and visually impaired (BVI) gamers, little is known about their motivations, gaming time, and the social benefits of online games. This study investigated gaming motivation and gaming time of BVI players, as well as their associations with well-being, using a popular massively multiplayer online role-playing game (MMORPG) as an example. It also examined the relationships between different types of visual impairments, gaming motivation, time, and well-being. Methods: Based on a review of existing literature on the potential effects of online games on people with BVI, this study used a mixed-methods approach. Semi-structured interviews with 21 participants were conducted to gather in-depth qualitative insights. Questionnaires were administered to a total sample of 209 participants, both online and offline, to collect quantitative data. Results: A motivation scale specific to BVI gamers in MMORPG was developed and validated. Six motivations were identified and verified: fun, relationship initiation, relationship maintenance, venting emotions, killing time, and achievement. Fun and killing time positively predicted well-being, whereas venting emotions and relationship maintenance negatively predicted well-being. Total gaming time was positively associated with self-esteem. Totally blind and those with acquired impairments tend to spend more time on gaming, highlighting interesting nuances in gaming behaviors within the BVI community. Conclusions: This study provides insight into the relationship between online gaming and well-being of BVI individuals. These findings underscore the importance of further research and the development of inclusive gaming environments that enhance the well-being of BVI players.

Background: Amyotrophic lateral sclerosis (ALS) is characterized by a significant decrease in mobility due to its neurodegenerative etiology. Throughout the progression of ALS, patients lose independence in their motor control. An electromyography (EMG) interface that enables control of a powered wheelchair can restore autonomous movement. The use of serious game-based training that mimics EMG-temporalis wheelchair controls can be used as training prior to wheelchair usage in the real world. Purpose: Limbitless Runner, a forearm EMG training game, found improved player performance with no significant difference noted between the free and structured play training. This study aims to investigate the generalizability of this finding when applied to a temporalis EMG system. Methods: Participants were given Limbitless Runner's quantifiable, structured training mode, the "ring challenge," for a scored pretest. Participants were then assigned to one of three cohorts for training: Limbitless Journey, Limbitless Runner "free play mode," or the Limbitless Runner "ring challenge." To assess improvement in user's performance, the ring challenge was repeated and scored. Quantitative surveys, including the Game User Experience Satisfaction Scale (GUESS) and the System Usability Scale (SUS), were given to gauge users' perceptions of the games. Results: All cohorts showed a user score improvement; however, the ring challenge (Cohort 2) showed the highest improvement, from an average of 22.9 rings in the pretest to 31.1 rings posttraining. The SUS and GUESS scores were not significantly different between the two different video games, demonstrating that both versions can be satisfying or acceptable platforms for users.

Obesity and overweight among young adults are becoming public health concerns. Active video games (AVGs) have been demonstrated by previous studies as a healthy and enjoyable exercise, which may assist young people in weight management (WM). This review aims to critically assess the literature on the effects of AVGs on young adults in terms of energy expenditure (EE) and WM. Five international databases (PubMed, Scopus, ScienceDirect, Cochrane, and Web of Science) were searched with keywords up to 2025. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and randomized controlled trial (RCT) studies investigating the effects of AVGs on EE and WM in young adults aged 18-25 were included. Data from all studies were extracted using a preprepared structured form, and pre- and postintervention differences were compared between the AVG intervention groups and the control/comparison groups. Thousand one hundred twenty-nine articles were retrieved, of which 14 RCT studies (n = 668, 47.5% female) met the inclusion criteria. Ten studies measured EE while playing AVGs, and nine of these found that playing AVGs could achieve moderate physical activity. Four parallel-design RCTs measured body weight or body mass index (BMI), with only one of these found a significant reduction (-0.29 kg/m², P = 0.043) in BMI in the AVG group. The differences in study design and methodological quality among the included literature make it challenging to simply summarize the results, and the findings need to be interpreted with caution. Overall, AVGs could achieve moderate physical activity and serve as an effective alternative to traditional exercise. However, the results related to WM are mixed. Future research should adhere to more rigorous methodological standards, such as larger sample sizes and stricter dietary controls, to investigate the long-term effects of AVGs on body composition.

Background: Physical activity is beneficial and recommended to improve outcomes for patients with heart failure (HF). Exergaming combines gaming technology with physical activity. Therefore, we developed a mobile exergame in a co-design process, the exergame would engage participants in physical activity anywhere and anytime. This study aims to assess the feasibility of a newly developed mobile exergame, heart farming, for patients with HF. Methods: A total of 14 participants with HF used the exergame on their smartphones for one month (9 Swedish and 5 Spanish participants; 9 males, mean 72 years, range 61-82 years). Participants were provided an introduction to the exergame, and follow-up was carried out regularly by telephone. Participants were advised to increase the daily walking duration by 10 minutes a day, based on the number of meters walked in the 6-minute walk test (6MWT). Areas of feasibility identified were acceptability, demand, implementation, and practicality, which were examined during telephone follow-ups and interviews, and data downloaded from the exergame. Results: Participants found the farming theme appealing, and coaching encouraged them to perform the exergame on a regular basis (acceptability). Based on the 6MWT, the personal goal for daily walking was set (mean of 704 meters, range 250-900 meters). Participants reported that daily goals and tasks were manageable. The exergame was perceived as appropriate to decrease sedentary time, and participants reported improved physical health (demand). The exergame was perceived as easy to learn and use, and adjustable to individual needs (implementation). Exergaming while walking and conversing with others was described as less convenient (practicality). Conclusion: Participants with HF valued personalized support and the exergame's farming theme was appealing. The goal to increase walking by 10 minutes a day was seen as a realistic way to reduce sedentary behavior. When introducing the exergame, it is essential to emphasize the importance of proper lighting, so meters walked are accurately recorded.

Background: Active video games may be beneficial for improving gross motor outcomes when used to augment traditional physical therapy for children and youth with cerebral palsy (CP). However, their effectiveness for improving gross motor outcomes is unclear. The purpose of this systematic review and meta-analysis was to determine the effectiveness of active video game interventions combined with physical therapy compared to physical therapy alone for improving gross motor outcomes for children with CP. Materials and Methods: MEDLINE, CINAHL, Scopus, EMBASE (Ovid), PsycINFO, and SPORTDiscus databases were searched for relevant literature published prior to January 27, 2023. Eligible studies (a) were published in English, (b) used a randomized study design comparing active video games plus physical therapy to physical therapy alone, (c) included children and/or adolescents with CP (aged 5-18 years), and (d) measured gross motor outcomes. Included articles were assessed for bias (Cochrane risk-of-bias tool-version 2) (RoB-2), outcomes across studies were evaluated for evidence certainty using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and meta-analyses were conducted on outcomes when at least two studies used the same outcome measure. Results: Twelve articles met the inclusion criteria. Very low certainty evidence supported the use of active video games as an augmentative intervention for improving gross motor function (Z = 3.33; P < 0.001). Meta-analyses focused on other gross motor outcomes (i.e., balance and walking speed/distance) were not statistically significant. Conclusion: Active video games may be beneficial in combination with regular physical therapy for improving gross motor function. However, current evidence is weak, and high-quality research is required.

Background: Gait impairments are among the most common and disabling symptoms of Parkinson's disease and are especially aggravated in dual-task conditions. Interventions with conventional physical therapy improve gait cadence and speed, cognition, fear of falling, and freezing of gait. However, exergames have attracted interest in the treatment of people with Parkinson's disease due to the characteristics of the training that benefit neuroplasticity and motor learning. Objective: The aim of this study was to analyze the effects of training based on Kinect exergames compared to conventional physiotherapeutic training based on core areas of the European physiotherapy guideline on functional mobility, gait, and cognitive functions. Materials and Methods: Thirty-eight people with idiopathic Parkinson's disease were randomized into two groups and underwent 14 intervention sessions, twice a week, for 60 minutes each. The primary outcome was postural stability in gait, which was evaluated using the Functional Gait Assessment. Secondary outcomes were functional mobility and impact of the dual task assessed using the Timed & Up and Go Test; gait speed by the 10-meter Walk Test in single and dual task; and cognitive functions assessed through the Montreal Cognitive Assessment. Results: After training, there was an improvement in the Functional Gait Assessment and Timed & Up and Go Test. Conclusion: Interventions based on Kinect AdventuresTM games and conventional physiotherapy based on the central areas of the European guideline promoted similar improvements in gait stability and functional mobility of people with Parkinson's disease, without differences between them. However, the benefits did not extend to cognitive function and other gait parameters.

Objective: This pilot study explores the potential of the serious game Kamferhjemmet in training health care professionals in Norway on the use of the Malnutrition Universal Screening Tool (MUST). Materials and Methods: Using a multimethods approach, the research involved pre- and postgame surveys, interviews, and observations with 29 participants from two health care institutions. Results: The findings revealed that while participants generally exhibited high digital literacy and had a positive attitude toward game-based learning, there were notable challenges, including game repetitiveness, interface issues, and the difficulty of integrating the game into busy work schedules. Despite these challenges, the majority of participants believed the game enhanced their proficiency with MUST. Conclusion: The study concludes that while Kamferhjemmet shows promise as an educational tool, further refinements to the game design and structured implementation within health care training programs are needed. Future research should explore a comparison with traditional training methods to fully assess the effectiveness of serious games in health care education.