Games for Health Journal最新文献

Background: Physical training to improve balance in the elderly has shown excellent results, but maintaining consistent participation in such programs is challenging. Objective: To address this, a laterolateral balance simulation game controlled by a biaxial force platform was developed to support balance rehabilitation and encourage regular training. Method: The game was created using the Unity engine, with 3D models designed in Blender, including the "Relaxed Man Character" asset for the avatar. The player's objective is to maintain balance on a virtual board supported by a cylinder, controlled via the biaxial force platform. Validation involved structural tests, usability testing (System Usability Scale), and a pilot test with 10 healthy young volunteers. Statistical analysis was conducted using the Shapiro-Wilk and t-Student tests (P < 0.05) in Jamovi software. Results: Results indicated that the game performed as expected, and the usability test yielded an excellent score (81.5 points) from experts. The pilot test revealed that individualized calibration allowed for personalized training, with volunteers' scores improving by 17.6% in the second session of day 1, 26% in the first session of day 2, and 8.5% in the second session of day 2. Conclusion: The balance simulation effectively replicated the foot pressure movements needed to control an avatar on a virtual board. This personalized approach made the game accessible and easy to use for players. Future work will involve testing the game with the target elderly population, increasing the number of sessions, and analyzing muscle activation to fully determine the game's impact.

Objective: The aim of this study was to examine the effect of technology-based rehabilitation on grip strength, functionality, and disease activity in rheumatic diseases with hand involvement, and to compare these effects with the effects of conventional hand rehabilitation and with a control group that continued routine life. Materials and Methods: The study included 45 patients, with a mean age of 52.24 ± 10.03 years, who were diagnosed with rheumatic disease involving the hand. The patients were randomized to an intervention group (n = 15), conventional group (n = 15), and control group (n = 15). A virtual reality (VR) application with a leap motion controller (LMC) device was applied to the intervention group and stretching and strengthening exercises were applied to the conventional exercise group twice a week for 8 weeks. Evaluations were made using the Disease Activity Score-28, dynamometer, pinch meter, Michigan hand outcome test, Duruöz Hand Index, Jebsen hand function test, and 9-hole peg test. Results: A significant difference was determined in favor of the LMC group in terms of the Jebsen Hand Function test, 9-hole peg test and grip strength after the intervention (P < 0.05). Conclusion: For patients with rheumatic diseases with hand involvement, VR rehabilitation via LMC under the guidance of a physiotherapist has positive effects on the patients' grip strength and hand functions. Developing approaches that will maintain patients' motivation for exercise during the treatment process may help increase and maintain these effects.

Objective: Language learning through computer games has been suggested to enhance language abilities compared with traditional learning methods. Training in language skills may also improve self-control and reduce problematic behaviors in children and adolescents. We hypothesized that computer game-based language training could be more effective than classical language instruction. Furthermore, we propose that the enhanced language skills obtained through computer game language training could correspond with improvements in problematic behaviors within this group. Materials and Methods: This was an 8-week crossover trial consisting of 4 weeks of gaming rounds and 4 weeks of control rounds for two groups. Wise-Ax English is a casual digital game developed for English vocabulary education targeting Korean children. The game incorporates 500 English words selected from a pool designated by the Korean Ministry of Education. The study included 38 Korean students. At the 4-week and 8-week marks, all students were assessed with English competency tests. Results: Over 80% of the participants expressed satisfaction with the digital game-based English education, noting significant improvements in their English abilities compared with those achieved using traditional English classes. During the gaming rounds, children with problematic behaviors demonstrated improvement in test scores relative to their peers without such behaviors. Conclusion: The educational game Wise-Ax English can effectively enhance English language skills among Korean elementary school students. Notably, the effectiveness of Wise-Ax English was more pronounced in students exhibiting higher levels of problematic behavior and anxiety.

Objective: GripAble is a novel upper limb motor function assessment and exergaming device. In this study, we aimed to (1) establish its test-retest reliability and precision and (2) determine which method of reporting (i.e., based on one, two, or three trials) yields the greatest reliability and precision when testing hand grip strength (HGS) in healthy-handed adults. Materials and Methods: Purposeful sampling was used to recruit a diverse sample of adults according to sex, age, and race. Data were collected during two sessions approximately 2 weeks apart. During each session, three trials of maximal HGS were taken bilaterally. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC), and precision was assessed using the standard error of measurement and the minimal detectable change (MDC). Results: Thirty-six healthy-handed adults completed the study protocol. Across all methods of reporting, ICC values were ≥0.85. The highest reliability (ICC values for dominant and nondominant hands = 0.97 and 0.94, respectively) and precision (MDC% for dominant and nondominant hands = 12.9 and 18.2, respectively) were observed when the average of three trials was calculated. Conclusions: The GripAble device has excellent reliability and acceptable precision when used to assess maximal HGS in healthy-handed adults. Recording three trials and reporting their average yields the highest test-retest reliability and precision. Relevance: We present early evidence to support the use of GripAble as an HGS assessment device. Future research should include establishing HGS reference values and testing GripAble's reliability and precision in different clinical populations. Its efficacy as an exergaming intervention also warrants exploration.

The use of exergames in the rehabilitation of patients with upper limb dysfunctions has increased significantly. This scoping review aimed to investigate the game controllers (GCs) employed in exergame systems used for rehabilitation, offering insights into the platforms, sensors, and techniques used in their development, implementation, and utilization. We conducted a comprehensive search of Scopus and PubMed databases, encompassing articles published between February 2013 and February 2023. The eligibility criteria included studies on upper limbs (UL) rehabilitation using exergames published in English-language journals, resulting in the identification of 175 pertinent articles. Seven key categories were identified: pathology, participants' conditions, dosage of sessions, GCs, sensors, specific part of the UL rehabilitated, and ergonomics. Stroke (55.4%) and cerebral palsy (6.3%) were the most frequently addressed medical conditions in the exergame-based rehabilitation. The number of participants in the reviewed articles was from one to several hundred. Three types of participants were identified: patients, specialists, and volunteers. Randomized controlled trial (RCT) studies consistently featured a controlled number of sessions (ranging from 6 to 40) lasting an average of 20 minutes, while non-RCT studies displayed more variability. Commercial platforms were favored, accounting for 74.3% of GCs, with physical controllers (57.1%) surpassing virtual ones. Cameras were the predominant sensors (50.3%), although a wide array of sensor types including IMUs, push buttons, and force sensors were also used. Rehabilitation focuses 68% on general UL, 20.6% on hands, 4% on elbows, and 3.4% on arms and shoulders. Notably, only 26.3% of the studies considered ergonomics in the rehabilitation system. Although exergame systems are advancing rehabilitation treatments, there remains a need for further development and research on various aspects, such as ergonomics, controller design, and sensor integration, to enhance their suitability for patient use.

Background: Being able to choose elements of an exercise session, known as autonomy support, improves motor performance and psychological responses. Virtual reality (VR) programs provide many options for embedding autonomy support in exercise sessions. The purpose of this study was to investigate the effects of autonomy support in a VR setting on physiological and psychological responses to self-regulated rowing exercise. Methods: Using a repeated-measures crossover design, healthy untrained men and women (N = 20, age = 23.0 ± 7.4) completed exercise sessions on a rowing ergometer coupled with a head-mounted immersive VR application. In the Choice condition, participants chose the virtual environment, and in the Control condition, the environment was assigned to the participant. Participants were instructed to complete 1500 m as quickly as possible in both conditions, while ratings of perceived exertion, affective valence, and heart rate were recorded throughout the trials. Finishing time and remembered pleasure were assessed at the end of each session. Repeated-measures analyses with an alpha level of 0.05 were used for all variables as appropriate, with Bonferroni adjustments applied for any post hoc tests. Results: There was a main effect of condition on affective valence which was higher in Choice (2.07 ± 1.67) than Control (1.64 ± 2.12, P = 0.03, η² = 0.22). No other differences were detected between conditions for finishing time or the remaining variables. Conclusion: During self-regulated exercise accompanied by an immersive VR application, being able to choose the virtual environment oneself leads to a more positive affective state without compromising exercise effort, physiological strain, or performance.

Objective: In this study, we aimed to investigate and compare the acute effects of exergames (EXG) and core stability exercises (CSEs) on cognitive factors, pain, mood, and fear-avoidance beliefs (FAB) in individuals with chronic low back pain (CLBP). Materials and Methods: In a single-blinded clinical trial, 40 participants with CLBP were randomly assigned to either the EXG group or the CSEs group. The EXG group engaged in a single session of exergames using the Xbox Kinect device, while the CSEs group completed a single session of common core stability exercises. Measurements of attention, working memory, pain intensity, mood states, and FAB were taken before and after each intervention. Results: The results showed that a single session of EXG was significantly more effective than CSEs in improving cognitive reaction time, pain intensity, FAB, and positive mood states (P ≤ 0.05). Additionally, participants reported lower perceived exertion due to exercising following EXG compared with CSEs. Conclusion: EXG may have potential therapeutic advantages over traditional exercise interventions for CLBP.

In this systematic review, we explored the literature on both online gamification and language learning in older adults aged 50 and older. Studies describing either digital gamified cognitive training or language learning interventions and include objective outcomes relating to the cognition of the participants were highlighted as suitable to be included as part of the review. In accordance with the established studies, we analyzed the aim and outcomes of the two separate types of interventions, the study design used, the modalities utilized for the respective interventions, as well as the cognitive outcomes obtained. A focus on the Asian context is included to better understand the effects of such interventions on Asian older adults. Mixed findings have been noted in both online gamified and language learning trainings, especially for language learning. However, results lean toward improvements in the cognitive abilities of older adults following gamified interventions, especially gamified cognitive trainings.

Background: Poststroke hemiparesis presents with motor asymmetry and decreased postural control leading to functional limitations. Serious games (SG) for balance rehabilitation of people with stroke may improve motor recovery, and the visual and auditory feedback provided by the SGs helps to explain the therapeutic benefits. However, the contribution of SG combined with kinesthetic and verbal cues during balance training has not been investigated. The aim of this study is to compare the effects of two feedback conditions for an SG balance intervention, with or without the addition of kinesthetic and verbal cues, on balance performance of people with stroke. Methods: Thirty people with chronic poststroke hemiparesis and balance impairment participated in this randomized controlled trial and performed 14 individual SG training sessions combined with kinesthetic and verbal cues provided by the physical therapist or with SG's feedback only. Outcomes were assessed before training (pre), 1 week after the end of training (post), and 8 weeks after the end of training, which were adopted as the follow-up period, using the Balance Evaluation Systems Test, Lower Limb Subscale of Fugl-Meyer, six-minute walk test, and Stroke-Specific Quality of Life Scale. Results: The results showed that SG combined with kinesthetic and verbal cues improved outcomes relating to lower limb function and some balance domains (biomechanical constraints and limits of stability outcomes) better than with SG's feedback only. Both groups had similar significant improvement in quality of life and long-distance walking performance. Conclusion: This study is the first to directly compare two feedback conditions for SG-based balance intervention. The addition of kinesthetic and verbal cues during the SG balance improved aspects of postural control better than without this form of feedback.

Objective: This study reports the process evaluation of a randomized controlled trial of the MyHeartMate app for patients with coronary heart disease (CHD). Materials and Methods: Data were collected on engagement in the intervention group from the app platform logs and self-reported usage and via interviews for perspectives of usefulness and acceptability. Participants' (n = 194) data logs showed 80.4% entered baseline data. Tracking (≥30 days) occurred for body mass index (23.2%), blood pressure (BP) (21.1%), and exercise (23.7%). Missions completed on ≥4 days were 47.5% for healthy eating and 30.9% for exercise; 50.5% used the word game. One quarter (26.8%) was classified as "engaged" (tracked exercise and/or BP ≥5 times and completed ≥18 missions in the first 30 days). There were no differences between participants who were "engaged" or not in baseline characteristics or 6-month outcomes, although engaged users were more likely to meet 4/5 recommended risk factor guideline levels (30.8% vs. 17.6%, P = 0.03). Results: Participants perceived tracking, prompts, and rewards as useful for recovery and risk factor-related lifestyle change, and games were enjoyed. Engagement decreased with time. Acceptability was limited when app processes were difficult to understand, not personalized enough and/or the overall game concept was disliked. Conclusions: Insight into user's perceptions and use of gamified app components is essential to address barriers to uptake and optimize potential health benefits. The target audience for a serious game app for CHD remains uncertain.