Efficacy of augmented reality-based virtual hiking in cardiorespiratory endurance: a pilot study

Exergames can be used to overcome a sedentary lifestyle. Virtual Reality (VR) has made exergames successful, and they can be used to increase heart rate, but some limitations are found, such as the adaptation of the heart rate in exergames to the player's fitness profile. VR technology has been used to simulate virtual cycling and walking experiences. We designed and developed an exergame' Virtual Levadas' in a cave-based VR environment to simulate the Levadas hiking tracks. They are the main attraction for tourists in Madeira Island, Portugal. This study's main objective was to assess player exertion, usability, participation, and realism of the simulation of the Levadas tracks. We performed this study with 13 participants who played Virtual Levadas for 6 minutes and found a significant increase in player's average physical activity and heart rate. Overall, our results demonstrate that Virtual Levada's exergame provides a higher exertion level, immersion, and realism of the virtual environment than the literature.info:eu-repo/semantics/publishedVersio

Understanding older adults’ perceptions of and attitudes towards exergames

Purpose Maintaining physical activity is a key component of successful aging and has benefits for both physical and cognitive functioning in the older adult population. One promising method for engaging in physical activity is through exergames, which are video games designed to promote exercise. Exergames have the potential to be used by a wide range of people, including older adults, in a variety of settings, such as at home, in community living environments, or senior centers. However, exergames have not been designed for older adults (e.g., with respect to their attitudes, needs). Thus, older adults may not adopt these systems if they perceive them as not useful or relevant to them. Method Twenty older adults (aged 60-79) interacted with two exergames, and were then interviewed about their perceptions of the system’s ease of use and usefulness, as well as their general attitudes towards the system. Results Participants identified the potential for exergames’ usefulness for various goals, such as to increase their physical activity. However, they also reported negative attitudes concerning the system, including perceiving barriers to system use. Overall, participants said they would use the system in the future and recommend it to other people at their age for improving health, despite these use challenges. Conclusion The older adults were open to adopting exergames, which could provide opportunities to increase physical activity. Given the participants’ overall positive perceptions of the usefulness of exergames, designers must address the perceived challenges of using these systems. Understanding barriers and facilitators for older adults’ use of exergames can guide design, training, and adoption of these systems

Modulation of physiological responses and activity levels during exergame experiences

Exergames are exercise-oriented games that offer opportunities to increase motivation for exercising and improving health benefits. However, Exergames need to be adaptive and provide accurate feedback for physiologically correct exercising, sustaining motivation and for better personalized experiences. To investigate the role of physiological computing in those aspects, we employed a repeated measures design exploring changes in physiological responses caused by the gaming and exercising components of an Exergame intervention. Seventeen older adults (64.5±6.4 years) interacted with a videogame in two modes (Control, Exergaming) in different difficulty levels. Electrocardiography, Electrodermal and Kinematic data were gathered synchronously with game data. Findings show that Exercise intensities and heart rate changes were largely modulated by game difficulty, and positive feedback was more likely to produce arousal responses during Exergaming than negative feedback. A heart rate-variability analysis revealed strong influences of the interaction mode showing that Exergaming has potential to enhance cardiac regulation. Our results bring new insights on the usefulness of psychophysiological methods to sustain exercising motivation and personalizing gameplay to the individual needs of users in Exergaming experiences.info:eu-repo/semantics/publishedVersio

The feasibility and potential effectiveness of a conventional and exergame intervention to alter balance-related outcomes including fall risk: a mixed methods study

Introduction: Fall risk, occurrence and injury is increasing as the world ages, and Africa and other emerging regions will not be spared. Similarly, the rise of noncommunicable diseases, compressed morbidity and lack of physical activity present major challenges. This novel feasibility study explored the use of an exergaming technology compared with a conventional, evidence-based exercise programme (Otago Exercise Programme) to reduce fall risk by improving balance, and to inform a large-scale randomised control trial. Methodology: Mixed methods study in independent older adults with established fall risk. The quantitative component employed feasibility RCT methodology. Cluster randomisation assigned interventions to sites. Single blinding was used. Both interventions were offered for six months. A variety of balance-related endpoints (e.g., Timed Up and Go, Dynamic Gait Index, Mini-BESTest) were used to find the most applicable. Patient-centred variables included questionnaires regarding depression, physical activity levels, quality of life and estimates of self-efficacy for exercise. Qualitative focus groups explored participants' experiences of falls and the exergaming intervention using a phenomenology lens. Results: Site and participant recruitment was simple and readily achievable, with low numbers need to screen required. Eligibility criteria were confirmed and more added. Adherence and attrition were major challenges. Cluster randomisation appeared to exacerbate between-group differences at baseline. The exergaming intervention produced preliminary evidence in its favour, with results approaching Minimal Clinically Important Difference compared with the evidence-based intervention. The experience of the exergaming intervention was regarded as positive by focus group participants. Barriers and facilitators are reported. Discussion: Methodological issues in the literature have prevented firm consensus on the use of exergaming in falls prevention, although studies are abundant. The current study used rigorous methodology in the novel context of a developing region, which offers numerous challenges for older adults. Implications for a large-scale, fully funded RCT are discussed. Lessons learned can be used to scale up service delivery for an under-served population; and promote the aim of well-being for all at all ages

Technology-assisted healthcare: exploring the use of mobile 3D visualisation technology to augment home-based fall prevention assessments

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonFalls often cause devastating injuries which precipitate hospital and long-term care admission and result in an increased burden on health care services. Fall prevention interventions are used to overcome fall risk factors in an ageing population. There is an increasing need for technology-assisted interventions to reduce health care costs, whilst also lessening the burden that an ageing population increasingly has on health care services. Research efforts have been spent on reducing intrinsic fall risk factors (i.e. functional ability deficits and balance impairments) in the older adult population through the use of technology-assisted interventions, but relatively little effort has been expended on extrinsic risk factors (i.e. unsuitable environmental conditions and lack of assistive equipment use), considering the drive for healthcare outside of the clinical setting into the patients’ home. In the field of occupational therapy, the extrinsic fall-risk assessment process (EFAP) is a prominent preventive intervention used to promote independent living and alleviate fall risk factors via the provision of assistive equipment prescribed for use by patients in their home environment. Currently, paper-based forms with measurement guidance presented in the form of 2D diagrams are used in the EFAP. These indicate the precise points and dimensions on a furniture item that must be measured as part of an assessment for equipment. However, this process involves challenges, such as inappropriate equipment prescribed due to inaccurate measurements being taken and recorded from the misinterpretation of the measurement guidance. This is largely due to the poor visual representation of guidance that is provided by existing paper-based forms, resulting in high levels of equipment abandonment by patients. Consequently, there is a need to overcome the challenges mentioned above by augmenting the limitations of the paper-based approach to visualise measurement guidance for equipment. To this end, this thesis proposes the use of 3D visualisation technology in the form of a novel mobile 3D application (Guidetomeasure) to visualise guidance in a well-perceived manner and support stakeholders with equipment prescriptions. To ensure that the artefact is a viable improvement over its 2D predecessor, it was designed, developed and empirically evaluated with patients and clinicians alike through conducting five user-centred design and experimental studies. A mixed-method analysis was undertaken to establish the design, effectiveness, efficiency and usability of the proposed artefact, compared with conventional approaches used for data collection and equipment prescription. The research findings show that both patients and clinicians suggest that 3D visualisation is a promising development of an alternative tool that contains functionality to overcome existing issues faced in the EFAP. Overall, this research makes a conceptual contribution (secondary) to the research domain and a software artefact (primary) that significantly improves practice, resulting in implications and recommendations for the wider healthcare provision (primary).The Engineering and Physical Sciences Research Council (EPSRC)