Serious Games and Mixed Reality Applications for Healthcare

Virtual reality (VR) and augmented reality (AR) have long histories in the healthcare sector, offering the opportunity to develop a wide range of tools and applications aimed at improving the quality of care and efficiency of services for professionals and patients alike. The best-known examples of VR–AR applications in the healthcare domain include surgical planning and medical training by means of simulation technologies. Techniques used in surgical simulation have also been applied to cognitive and motor rehabilitation, pain management, and patient and professional education. Serious games are ones in which the main goal is not entertainment, but a crucial purpose, ranging from the acquisition of knowledge to interactive training.These games are attracting growing attention in healthcare because of their several benefits: motivation, interactivity, adaptation to user competence level, flexibility in time, repeatability, and continuous feedback. Recently, healthcare has also become one of the biggest adopters of mixed reality (MR), which merges real and virtual content to generate novel environments, where physical and digital objects not only coexist, but are also capable of interacting with each other in real time, encompassing both VR and AR applications.This Special Issue aims to gather and publish original scientific contributions exploring opportunities and addressing challenges in both the theoretical and applied aspects of VR–AR and MR applications in healthcare

Bridging The Gap Between Fun And Fitness: Instructional Techniques And Real-world Applications For Full-body Dance Games

Full-body controlled games offer the opportunity for not only entertainment, but education and exercise as well. Refined gameplay mechanics and content can boost intrinsic motivation and keep people playing over a long period of time, which is desirable for individuals who struggle with maintaining a regular exercise program. Within this gameplay genre, dance rhythm games have proven to be popular with game console owners. Yet, while other types of games utilize story mechanics that keep players engaged for dozens of hours, motion-controlled dance games are just beginning to incorporate these elements. In addition, this control scheme is still young, only becoming commercially available in the last few years. Instructional displays and clear real-time feedback remain difficult challenges. This thesis investigates the potential for full-body dance games to be used as tools for entertainment, education, and fitness. We built several game prototypes to investigate visual, aural, and tactile methods for instruction and feedback. We also evaluated the fitness potential of the game Dance Central 2 both by itself and with extra game content which unlocked based on performance. Significant contributions include a framework for running a longitudinal video game study, results indicating high engagement with some fitness potential, and informed discussion of how dance games could make exertion a more enjoyable experience

Exploring Design Opportunities for Technology-Supported Yoga Practices at Home

Department of Human Factors EngineeringYoga is a discipline that integrates mind and bodily exercises practiced for a number of health benefits. Although physical and mental health benefits from practicing yoga are well-known, people address time and cost as the primary barrier to incorporating yoga practices on a regular basis. A cost-effective solution to these limiting factors is adopting at-home practices. However, starting at-home yoga practices is difficult, especially for beginners, due to the lack of feedback on practitioners??? performance. To tackle this challenge, we explore design opportunities for an interactive artifact that can effectively support yoga practices at home that can potentially replace professional personal trainers. Our approach for exploring this design space begins with a user study with a group of yoga practitioners in order to identify design requirements in a yoga practice environment. Based on the results from the user study, we provide some design insights for developing a feedback-based artifact for yoga practice in the home environment. Then, we exemplify how suggested implications can be applied to design with an illustration of a biofeedback-based mat for yoga breathing exercises. Beyond this, we inspect how the mechanism of biofeedback for breathing can be implemented by building a low-cost respiration phase detector to evaluate the quality of breath. The results from the study on the development of phase detector show per-user classifiers can identify respiration phases with mean F-scores of 0.69 for all poses and 0.78 for the baseline pose. This is an acceptable result acknowledging numerous momentary judgments are made to identify each breathing phase. Moreover, per-user classifiers for identifying three yoga poses show promising results, which can expand the application areas of the breathing phase detector. Through this series of context-driven exploratory studies, we demonstrate approaches to investigate design opportunities for technology-supported at-home yoga.clos

Computer-supported movement guidance: investigating visual/visuotactile guidance and informing the design of vibrotactile body-worn interfaces

This dissertation explores the use of interactive systems to support movement guidance, with applications in various fields such as sports, dance, physiotherapy, and immersive sketching. The research focuses on visual, haptic, and visuohaptic approaches and aims to overcome the limitations of traditional guidance methods, such as dependence on an expert and high costs for the novice. The main contributions of the thesis are (1) an evaluation of the suitability of various types of displays and visualizations of the human body for posture guidance, (2) an investigation into the influence of different viewpoints/perspectives, the addition of haptic feedback, and various movement properties on movement guidance in virtual environments, (3) an investigation into the effectiveness of visuotactile guidance for hand movements in a virtual environment, (4) two in-depth studies of haptic perception on the body to inform the design of wearable and handheld interfaces that leverage tactile output technologies, and (5) an investigation into new interaction techniques for tactile guidance of arm movements. The results of this research advance the state of the art in the field, provide design and implementation insights, and pave the way for new investigations in computer-supported movement guidance

GymCam

Worn sensors are popular for automatically tracking exercises. However, a wearable is usually attached to one part of the body, tracks only that location, and thus is inadequate for capturing a wide range of exercises, especially when other limbs are involved. Cameras, on the other hand, can fully track a user's body, but suffer from noise and occlusion. We present GymCam, a camera-based system for automatically detecting, recognizing and tracking multiple people and exercises simultaneously in unconstrained environments without any user intervention. We collected data in a varsity gym, correctly segmenting exercises from other activities with an accuracy of 84.6%, recognizing the type of exercise at 93.6% accuracy, and counting the number of repetitions to within ± 1.7 on average. GymCam advances the field of real-time exercise tracking by filling some crucial gaps, such as tracking whole body motion, handling occlusion, and enabling single-point sensing for a multitude of users.</jats:p

Mobile depth sensing technology and algorithms with application to occupational therapy healthcare

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThe UK government is striving to shift its current healthcare delivery model from clini-cian–oriented services, to that of patient and self–care–oriented intervention strategies. It seeks to do so through Information Communication (ICT) and Computer Mediated Re-ality Technologies (CMRT) as a key strategy to overcome the ever–increasing scarcity of healthcare resources and costs. To this end, in the UK the use of paper–based information systems have exhibited their limitations in providing apposite care. At the national level, The Royal College of Occupational Therapists (RCOT) identify home visits and modifica-tions as key levers in a multifactorial health programme to evaluate interventions for older people with a history of falling or are identified as being prone to falling. Prescribing Assistive Equipment (AE) is one such mechanism that seeks to reduce the risk of falling whilst promoting the continued independence of physical dexterity and mobility in older adults at home. In the UK, the yearly cost of falls is estimated at £2.3 billion. Further evidence places a 30% to 60% abandonment rate on prescribed AE by and large due to a ‘poor fit’ and measurement inaccuracies. To remain aligned with the national strategy, and assist in the eradication of measurement inaccuracies, this thesis employs Mobile Depth Sensing and Motion Track-ing Devices (MDSMTDs) to assist OTs in in the process of digitally measuring the extrin-sic fall–risk factors for the provision of AE. The quintessential component in this assess-ment lies in the measurement of fittings and furniture items in the home. To digitise and aid in this process, the artefact presented in this thesis employs stereo computer–vision and camera calibration algorithms to extract edges in 3D space. It modifies the Sobel–Feldman convolution filter by reducing the magnitude response and employs the camera intrinsic parameters as a mechanism to calculate the distortion matrix for interpolation between the edges and the 3D point cloud. Further Augmented Reality User Experience (AR-UX) facets are provided to digitise current state of the art clinical guidance and over-lay its instructions onto the real world (i.e., 3D space). Empirical mixed methods assessment revealed that in terms of accuracy, the arte-fact exhibited enhanced performance gains over current paper–based guidance. In terms of accuracy consistency, the artefact can rectify measurement consistency inaccuracies, but there are still a wide range of factors that can influence the integrity of the point-cloud in respect of the device’s point-of-view, holding positions and measurement speed. To this end, OTs usability, and adoption preferences materialise in favour of the artefact. In conclusion, this thesis demonstrates that MDSMTDs are a promising alterna-tive to existing paper–based measurement practices as OTs appear to prefer the digital–based system and that they can take measurements more efficiently and accurately

Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data

Design and implementation of an integrative system for configurable exergames targeting the senior population

Exergames have been proposed as a solution for the promotion of physical activity in the senior population. The diversity of needs and limitations of the target users demand that the exergaming systems allow the configuration and adjustment of game parameters according to each user profile. Such systems are ideal to use in nursing homes, senior gymnasiums, or even rehabilitation centers. Health and sports professionals are then the main interacting users with the interface of such exergaming systems. Configuration can be difficult and time-consuming when considering complex systems with a significant amount of parameter choices. Since professionals working on such places already have time constraints, if they face long-time configuration of these systems they might give up of using them. Therefore, there is an evident need for systems that assist professionals in two ways. First, providing management support for training sessions and plans with exergames. Second, providing automatic decision-making processes that assist in game selection and parameters configuration to fit the user needs. The acceptance and effectiveness of such systems can only be achieved if the main prospective interactors with the system are involved in the development process so that the system can fulfill the users’ needs and expectations. This thesis reports on the design, implementation, and usability evaluation of an integrative system using some of the most-known human-centric techniques, such as interviews, card sorting, and paper prototyping. Results of a usability study of the UI and the main functionalities of the system showed a considerable acceptance and interest by the professionals. The usability study revealed to be a great resource to find aspects of the system that should be further considered for improvement in future iterations. Furthermore, the high results of the USE (Usefulness, Satisfaction, and Ease of use) questionnaire confirm that this system is a promising tool that sports professionals may be willing to use in their daily practice.A literatura suporta que os exergames, ou jogos que requerem exercício físico, constituem uma opção válida para promoção da atividade física na população idosa. A diversidade de necessidades e limitações do público-alvo exige que estes exergames sejam configuráveis de forma a permitir ajustar os parâmetros do jogo de acordo com o perfil de cada indivíduo. Estes sistemas personalizáveis são ideais para a utilização em lares, centros de dia, ginásios específicos para idosos ou até mesmo em centros de reabilitação. Os profissionais de saúde e de desporto são, assim, os principais utilizadores a definir as configurações destes exergames. Neste contexto, escolher as definições ideais para cada perfil pode ser um processo difícil e demorado, tendo em conta que a interface destes sistemas apresenta normalmente uma quantidade significativa de opções. Considerando que estes profissionais já têm constrangimentos de tempo na sua prática diária, se forem confrontados com uma interação longa e complexa com estes sistemas, podem acabar por desistir de usá-los. Neste sentido, existe uma clara necessidade de sistemas que auxiliem os profissionais a incluir os exergames na sua prática diária com a população idosa. Este sistema deverá assistir os profissionais de duas maneiras. Primeiro, que permita gerir sessões e planos de treino com os exergames. Segundo, que disponibilize processos de decisão automáticos de forma a auxiliar na escolha dos jogos, bem como nas configurações ideais para cada perfil de utilizador. A aceitação e a eficácia destes sistemas podem apenas ser alcançadas se os profissionais forem envolvidos no processo de desenvolvimento desde o início. Tal permitirá que este possa ser desenhado tendo em conta as suas necessidades e expectativas. Esta dissertação descreve as técnicas aplicadas no desenho, implementação e avaliação de um sistema integrativo para exergames, com base em algumas técnicas bem conhecidas na área de interação homemmáquina, como por exemplo entrevistas, card sorting e prototipagem em papel. Resultados de um estudo de usabilidade da interface do sistema integrativo demonstraram uma considerável aceitação e interesse por parte dos profissionais. O estudo de usabilidade revelou ser um bom recurso para encontrar aspetos do sistema que devem ser considerados para melhoramento em futuras iterações. Além disso, os resultados promissores do questionário USE (Utilidade, satisfação e facilidade de uso) confirmam que os profissionais poderão estar interessados em usar este sistema na sua prática diária