Closing the loop in exergaming - Health benefits of biocybernetic adaptation in senior adults

Exergames help senior players to get physically active by promoting fun and enjoyment while exercising. However, most exergames are not designed to produce recommended levels of exercise that elicit adequate physical responses for optimal training in the aged population. In this project, we developed physiological computing technologies to overcome this issue by making real-time adaptations in a custom exergame based on recommendations for targeted heart rate (HR) levels. This biocybernetic adaptation was evaluated against conventional cardiorespiratory training in a group of active senior adults through a floor-projected exergame and a smartwatch to record HR data. Results showed that the physiologically-augmented exergame leads players to exert around 40% more time in the recommended HR levels, compared to the conventional training, avoiding over exercising and maintaining good enjoyment levels. Finally, we made available our biocybernetic adaptation software tool to enable the creation of physiological adaptive videogames, permitting the replication of our study.info:eu-repo/semantics/publishedVersio

System development guidelines from a review of motion-based technology for people with MCI or dementia

As the population ages and the number of people living with dementia or mild cognitive impairment (MCI) continues to increase, it is critical to identify creative and innovative ways to support and improve their quality of life. Motion-based technology has shown significant potential for people living with dementia or MCI by providing opportunities for cognitive stimulation, physical activity and participation in meaningful leisure activities, while simultaneously functioning as a useful tool for research and development of interventions. However, many of the current systems created using motion-based technology have not been designed specifically for people with dementia or MCI. Additionally, the usability and accessibility of these systems for these populations has not been thoroughly considered. This paper presents a set of system development guidelines derived from a review of the state of the art of motion-based technologies for people with dementia or MCI. These guidelines highlight three overarching domains of consideration for systems targeting people with dementia or MCI: (i) cognitive, (ii) physical, and (iii) social. We present the guidelines in terms of relevant design and use considerations within these domains and the emergent design themes within each domain. Our hope is that these guidelines will aid in designing motion-based software to meet the needs of people with dementia or MCI such that the potential of these technologies can be realized

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

Exergames for motor rehabilitation in older adults: an umbrella review

Background: Exergames have been used as an innovative motor rehabilitation method with the main aim of improving motivation and exercise. As research interest in exergaming for rehabilitation is rapidly growing, a review of existing systematic reviews is important to synthesize the available evidence and provide recommendations. Objectives: In this article, we systematically synthesized the information from reviews that have examined the effects if exergames on different body movement parameters in older adults with and without specific pathologies. Method: Searches were conducted in Web of Science, Scopus, PsycARTICLES, PsycINFO, Psychology and Behavioural Sciences Collection, PubMed, SciELO, B-On and Google Scholar, articulating different terms and Boolean operators. Systematic reviews, meta-analysis and literature reviews published until May 2017 that investigated exergame interventions on physical outcomes, such as balance, gait, limb movements, muscle strength, in healthy and non-healthy older adults. Results: Based on prior reviews, exergaming, as a standalone intervention, has a positive effect on balance, gait, muscle strength, upper limb function, and dexterity. When compared to traditional physiotherapy, exergaming has at least similar effects on these outcomes. Many of the investigated studies indicated low methodological quality for the evaluation of the effects of exergames on different outcomes related to motor rehabilitation. Conclusions: Exergames could be used as a complement to traditional forms of motor rehabilitation, but future individual studies and reviews should follow more rigorous methodological standards in order to improve the quality of the evidence and provide guidelines for the use of exergames in motor rehabilitation.info:eu-repo/semantics/acceptedVersio

Confronto tra exergames ed esercizio aerobico. Valutazione degli effetti sulle emozioni e le funzioni esecutive

The study presented aims to investigate the impact of a balance training conducted by exergames on some domains of a cognitive and affective nature, in a sample of university students (average age 28 ± 6). In this sense, executive functions, selective attention and subjective emotional state were evaluated. These constructs were chosen because of their centrality in fostering learning processes. The effects of exergaming were compared with those obtained through aerobic training of the same duration (20 min). The results showed a similar impact of the two types of training on the cognitive domains under analysis, while a statistically difference was observed with respect to higher levels of dominance (<0.05) in the post-test exergames measured. through the SAM (Self-Assessment Manikin). The research carried out has allowed to highlight the opportunity to use these tools in the implementation of positive affectivity in young adults. On the basis of the results obtained, it is therefore possible to set future research directions relating to the study of the effects of exergames on constructs related to the dominance, such as self-esteem and self-efficacy and the relationship of these with high-level cognitive functions, whose integration is necessary for the structuring of learning programs in different training contexts.Lo studio presentato ha la finalità di indagare l’impatto di un training dell’equilibrio condotto mediante exergames su alcuni domini di natura cognitiva e affettiva in un campione di studentesse universitarie (età media 28± 6). In tal senso, sono state valutate le funzioni esecutive, l’attenzione selettiva e lo stato emotivo soggettivo. Tali costrutti sono stati scelti per la loro centralità nel favorire i processi di apprendimento. Gli effetti del training mediante exergaming sono stati confrontati con quelli ottenuti attraverso un allenamento aerobico di pari durata (20 min). I risultati ottenuti hanno mostrato un impatto similare delle due tipologie di allenamento sui domini cognitivi in analisi, mentre è stata osservata una differenza statisticamente significativa rispetto a più alti livelli di percezione del controllo (< 0,05) nel post-prova exergames misurato attraverso il SAM (Self Assessment Manikin). La ricerca condotta ha permesso di fornire un’evidenza sull’opportunità di utilizzare questi strumenti nell’implementazione dell’affettività positiva nei giovani adulti. Sulla base dei risultati ottenuti è, quindi, possibile impostare direzioni di indagine future relative allo studio degli effetti degli exergames su costrutti correlati alla percezione di controllo, come l’autostima e l’autoefficacia e la relazione di questi con funzioni cognitive di alto livello, la cui integrazione è necessaria per la strutturazione di programmi di apprendimento in diversi contesti formativi

Use of serious games with older adults: systematic literature review

The aim of this paper is to qualitatively synthesise literature on empirical research into video games and older adults. A total of 108 studies were analysed, with the participation of 15,902 individuals aged over 60. The framework of Search, Appraisal, Synthesis, and Analysis (SALSA) was used, with screening by three independent reviewers and phrase searching and combining search terms. The results indicate a majority of studies with a quantitative approach conducted in the European context in which a total of 125 scales were identified for the assessment of different geriatric aspects related to domains for the improvement of physical health and functional quality, improvement of cognitive, psychological and mental health, and improvement of physical and cognitive functions from a combined approach.info:eu-repo/semantics/publishedVersio

Tailored virtual reality and mobile application for motor rehabilitation

The present work presents a measurement system and methodology for hand and finger motor rehabilitation. The interaction with serious games developed in Unity 3D game engine is performed using a natural user interface based on Leap Motion Controller. The storage and management of data related to patient identification, established training plans and training results in LeaPhysio system, is realized in a client server architecture. The stored information can be accessed through a developed LeaPhysio App for Android OS platform, which also allows configuration of training plan by a therapist. Different metrics were included in the measurement system to provide to users the possibility to evaluate in an objective way the motor rehabilitation. The tests have shown that the developed system can provide accurate data on hand and finger movements in a meaningful and motivating exercise environment.info:eu-repo/semantics/acceptedVersio

Sustainable Technology and Elderly Life

The coming years will see an exponential increase in the proportion of elderly people in our society. This accelerated growth brings with it major challenges in relation to the sustainability of the system. There are different aspects where these changes will have a special incidence: health systems and their monitoring; the development of a framework in which the elderly can develop their daily lives satisfactorily; and in the design of intelligent cities adapted to the future sociodemographic profile. The discussion of the challenges faced, together with the current technological evolution, can show possible ways of meeting the challenges. There are different aspects where these changes will have a special incidence: health systems and their monitoring; the development of a framework in which the elderly can develop their daily lives satisfactorily; and in the design of intelligent cities adapted to the future sociodemographic profile. This special issue discusses various ways in which sustainable technologies can be applied to improve the lives of the elderly. Six articles on the subject are featured in this volume. From a systematic review of the literature to the development of gamification and health improvement projects. The articles present suggestive proposals for the improvement of the lives of the elderly. The volume is a resource of interest for the scientific community, since it shows different research gaps in the current state of the art. But it is also a document that can help social policy makers and people working in this domain to planning successful projects

Augmented Human Assistance (AHA)

Aging and sedentarism are two main challenges for social and health systems in modern societies. To face these challenges a new generation of ICT based solutions is being developed to promote active aging, prevent sedentarism and find new tools to support the large populations of patients that suffer chronic conditions as result of aging. Such solutions have the potential to transform healthcare by optimizing resource allocation, reducing costs, improving diagno ses and enabling novel therapies, thus increasing quality of life. The primary goal of the “AHA: Augmented Human Assistance” project is to de velop novel assistive technologies to promote exercise among the elderly and patients of motor disabilities. For exercise programs to be effective, it is essential that users and patients comply with the prescribed schedule and perform the ex ercises following established protocols. Until now this has been achieved by hu man monitoring in rehabilitation and therapy session, where the clinicians or therapists permanently accompany users or patient. In many cases, exercises are prescribed for home performance, in which case it is not possible to validate their execution. In this context, the AHA project is an integrative and cross-discipli nary approach of 4 Portuguese universities, the CMU, and 2 Portuguese industry partners, that combines innovation and fundamental research in the areas of hu man-computer interaction, robotics, serious games and physiological computing (see partner list in Appendix A). In the project, we capitalize on recent innova tions and aim at enriching the capabilities and range of application of assistive devices via the combination of (1) assistive robotics; (2) technologies that use well-understood motivational techniques to induce people to do their exercises in the first place, and to do them correctly and completely; (3) tailored and relevant guidance in regard to health care and social support and activities; and (4) tech nologies to self-monitoring and sharing of progress with health-care provider enabling clinicians to fine-tune the exercise regimen to suit the participant’s ac tual progress. We highlight the development of a set of exergames (serious games controlled by the movement of the user’s body limbs) specifically designed for the needs of the target population according to best practices in sports and human kinetics sciences. The games can be adapted to the limitations of the users (e.g. to play in a sitting position) so a large fraction of the population can benefit from them. The games can be executed with biofeedback provided from wearable sensors, to pro duce more controlled exercise benefits. The games can be played in multi-user settings, either in cooperative or competitive mode, to promote the social rela tions among players. The games contain regional motives to trigger memories from the past and other gamification techniques that keep the users involved in the exercise program. The games are projected in the environment through aug mented reality techniques that create a more immersive and engaging experience than conventional displays. Virtual coach techniques are able to monitor the cor rectness of the exercise and provide immediate guidance to the user, as well as providing reports for therapists. A socially assistive robot can play the role of the coach and provide an additional socio-cognitive dimension to the experience to complement the role of the therapist. A web service that records the users’ per formances and allows the authorized therapists to access and configure the exer cise program provides a valuable management tool for caregivers and clinical staff. It can also provide a social network for players, increasing adherence to the therapies. We have performed several end-user studies that validate the proposed ap proaches. Together, or in isolation, these solutions provide users, caregivers, health professionals and institutions, valuable tools for health promotion, disease monitoring and prevention.info:eu-repo/semantics/publishedVersio