Mobile exergaming in adolescents’ everyday life—contextual design of where, when, with whom, and how: the SmartLife case

Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential playing time, but need to be engaging and integrated in everyday life. The goal of the present study was to examine the context of gameplay for mobile exergaming in adolescents’ everyday life to inform game design and the integration of gameplay into everyday life. Eight focus groups were conducted with 49 Flemish adolescents (11 to 17 years of age). The focus groups were audiotaped, transcribed, and analyzed by means of thematic analysis via Nvivo 11 software (QSR International Pty Ltd., Victoria, Australia). The adolescents indicated leisure time and travel time to and from school as suitable timeframes for playing a mobile exergame. Outdoor gameplay should be restricted to the personal living environment of adolescents. Besides outdoor locations, the game should also be adaptable to at-home activities. Activities could vary from running outside to fitness exercises inside. Furthermore, the social context of the game was important, e.g., playing in teams or meeting at (virtual) meeting points. Physical activity tracking via smart clothing was identified as a motivator for gameplay. By means of this study, game developers may be better equipped to develop mobile exergames that embed gameplay in adolescents’ everyday life

Custom-designed motion-based games for older adults: a review of literature in human-computer interaction

Many older adults, particularly persons living in senior residences and care homes, lead sedentary lifestyles, which reduces their life expectancy. Motion-based video games encourage physical activity and might be an opportunity for these adults to remain active and engaged; however, research efforts in the field have frequently focused on younger audiences and little is known about the requirements and benefits of motion-based games for elderly players. In this paper, we present an overview of motion-based video games and other interactive technologies for older adults. First, we summarize existing approaches towards the definition of motion-based video games – often referred to as exergames – and suggest a categorization of motion-based applications into active video games, exergames, and augmented sports. Second, we use this scheme to classify case studies addressing design efforts particularly directed towards older adults. Third, we analyze these case studies with a focus on potential target audiences, benefits, challenges in their deployment, and future design opportunities to investigate whether motion-based video games can be applied to encourage physical activity among older adults. In this context, special attention is paid to evaluation routines and their implications regarding the deployment of such games in the daily lives of older adults. The results show that many case studies examine isolated aspects of motion-based game design for older adults, and despite the broad range of issues in motion-based interaction for older adults covered by the sum of all research projects, there appears to be a disconnect between laboratory-based research and the deployment of motion-based video games in the daily lives of senior citizens. Our literature review suggests that despite research results suggesting various benefits of motion-based play for older adults, most work in the field of game design for senior citizens has focused on the implementation of accessible user interfaces, and that little is known about the long-term deployment of video games for this audience, which is a crucial step if these games are to be implemented in activity programs of senior residences, care homes, or in therapy

Rehabilitative devices for a top-down approach

In recent years, neurorehabilitation has moved from a "bottom-up" to a "top down" approach. This change has also involved the technological devices developed for motor and cognitive rehabilitation. It implies that during a task or during therapeutic exercises, new "top-down" approaches are being used to stimulate the brain in a more direct way to elicit plasticity-mediated motor re-learning. This is opposed to "Bottom up" approaches, which act at the physical level and attempt to bring about changes at the level of the central neural system. Areas covered: In the present unsystematic review, we present the most promising innovative technological devices that can effectively support rehabilitation based on a top-down approach, according to the most recent neuroscientific and neurocognitive findings. In particular, we explore if and how the use of new technological devices comprising serious exergames, virtual reality, robots, brain computer interfaces, rhythmic music and biofeedback devices might provide a top-down based approach. Expert commentary: Motor and cognitive systems are strongly harnessed in humans and thus cannot be separated in neurorehabilitation. Recently developed technologies in motor-cognitive rehabilitation might have a greater positive effect than conventional therapies

Younger adolescents’ perceptions of physical activity, exergaming, and virtual reality:qualitative intervention development study

Background. Novel strategies to promote physical activity (PA) in adolescence are required. The vEngage study aims to test whether a virtual reality (VR) exergaming intervention can engage younger adolescents (13-15 year old) with physical activity. Objective: This study aimed to gather adolescents’ views of using VR to encourage PA and identify the key features they would like to see in a VR exergaming intervention via interviews. Methods: Participants were recruited through two schools in London, UK. Semi-structured interviews were conducted with adolescents about their views on PA and what might work to increase PA, technology, knowledge and experience of VR, and desired features in a VR exergaming intervention. Data were analysed using Framework Analysis. Results: 31 13-15 year olds (58% female, 62% from non-white ethnicities) participated in this interview study. The vast majority had no awareness of government PA recommendations, but felt they should be more thoroughly informed. All participants were positive about the use of VR in PA promotion. Rewards, increasing challenges and a social/multiplayer aspect were identified by participants as crucial aspects to include in a VR exercise game. Barriers were related to cost of high-end systems. Being able to exercise at home was very appealing. VR exergaming was viewed as a way to overcome multiple perceived social and cultural barriers to PA, particularly for girls. Conclusions: Key elements that should be incorporated into a VR for health intervention were identified and described. These also included the use of rewards, novelty and enjoyment in immersive game play, multi-player options, real-world elements, as well as continual updates and new challenge levels. The use of VR to promote PA in adolescents is promising, but some barriers were raised

Augmenting the Task of Exercise Gamification: An Expert View on the Adoption of a New Technology for Deploying Existing Virtual Environments in Virtual Urban Exergames

Exergames commonly denote serious games and gamified systems that were developed for the sake of improving health and exercise adherence. One of the recent trends in exergaming are urban games. They are defined as “highly interdisciplinary digital games which root in such diverse fields as architecture and urban planning, healthcare sciences, and serious games research” (Knoell et al., 2014). Besides having various ‘physical benefits’, such as promoting movement patterns, urban exergames have the core task of psychologically motivating players to exercise more and inspire them to be physically active. While offering an innovative and an immersive way to exercise, urban games come also with the typical drawbacks which outdoor exercising generally has (e.g. being dependent on good weather and intimidation problems for obese people). A possible solution would be simulating urban games for indoor exercise. On top of augmenting the sedentary game input to a motion-based one, designing and developing 3D environments for virtual urban games is not an obvious task and it takes a vast amount of knowledge, time and budget to create a realistic world with a “tremendous appeal and a powerful attraction”. To bypass this challenge, we introduce in this work a new technology for accessing and gamifying existing game environments. Furthermore, we validate our approach by presenting the results of a qualitative research that we have conducted with the help of gamification experts and exergame designers

Multi-user virtual environments for physical education and sport training

For effective learning and training, virtual environments may provide lifelike opportunities, and researchers are actively investigating their potential for educational purposes. Minimal research attention has been paid to the integration of multi-user virtual environments (MUVE) technology for teaching and practicing real sports. In this chapter, the authors reviewed the justifications, possibilities, challenges, and future directions of using MUVE systems. The authors addressed issues such as informal learning, design, engagement, collaboration, learning style, learning evaluation, motivation, and gender, followed by the identification of required elements for successful implementations. In the second part, the authors talked about exergames, the necessity of evaluation, and examples on exploring the behavior of players during playing. Finally, insights on the application of sports exergames in teaching, practicing, and encouraging real sports were discussed

Exergame design for elderly users: the case study of SilverBalance

In this paper, we discuss chances and challenges of game design for an elderly audience with a focus on the development of safe and usable exertion games for frail senior citizens. Based on an analysis of theoretical constraints, we conducted a case study which implements different balance tasks for elderly players featuring the Nintendo Wii Balance Board which encourages users to actively engage in game play. Furthermore, we tested the feasibility of the board as input device for our case study SilverBalance. Our results indicate that age-related impairments influence the use of video games among frail elderly in many respects, hence their needs have to be considered during the design process. In this context, our paper provides a foundation for future research regarding digital games for the elderly. © 2010 ACM

DESIGNING BETTER EXERGAMES: APPLICATION OF FLOW CONCEPTS AND THE FITT PRINCIPLE TO FULL BODY EXERTION VIDEO GAMES AND FLEXIBLE CHALLENGE SYSTEMS

Exercise video games have a recognized potential for widespread use as tools for effective exercise. Current exergames do not consistently strike a successful balance between the “fun gameplay” and “effective exercise” aspects of the ideal exergame. Our research into the design of better exergames applies existing gameflow research and established exercise guidelines, such as those published by the American College of Sports Medicine, to a collection of four custom exergames: Astrojumper, Washboard, Sweet Harvest and Legerdemain implement full-body motion mechanics that support different types of exercise, and vary in intended duration of play, game complexity, and level of physical challenge. Each game also implements a difficulty adjustment system that detects player performance from in-game data and dynamically adjusts game difficulty, in order to balance between a player’s fitness level and the physical challenge presented by the game. We have evaluated the games produced by our design approach through a series of user studies on players’ physiological and psychological responses to gameplay, finding that balance between challenge types (cognitive or physical) is an important consideration along with challenge-skill balance, and further, that game mechanics able to support creativity of movement are an effective means of bridging between gameplay and exercise in order to improve the player experience

Usability and Acceptance of Exergames Using Different Types of Training among Older Hypertensive Patients in a Simulated Mixed Reality

Virtual and augmented reality (VR/AR) exergames are promising tools for increasing training motivation. However, the use of exergames with mixed reality (MR) headsets remains under-researched. Older adults with hypertension could also benefit from the increased training adherence associated with MR. Endurance and strength endurance exercises are recommended for this group to lower blood pressure. The aim of the preliminary study (n = 22) was to compare the usability and acceptance of two exergames, which represent two different training types-strength endurance training (SET) and endurance training (ET). The developed exergame prototypes were applied in "simulated MR" using a VR head-mounted display. We examined the following outcomes: usability (TUI), intention to use (TUI), subjective task load (NASA-TLX), frustration (NASA-TLX), and presence (PQ). The results showed that frustration was significantly greater in the ET than in the SET (p = 0.038). Presence was significantly higher in the SET (p = 0.002). No significant differences in usability and acceptance were found in the exergames. The results indicate that usability and acceptance are not related to the type of training when utilizing MR exergames. Whether the results are transferable with a real MR headset must be determined in further research