Study and development of custom “serious games” for patients and users

Video games are part of our culture and permeate several segments of society, from casual entertainment to serious purposes. This research work focuses on the latter, more specifically on the use of Serious Games in the healthcare context. In this sense, Serious Games have been researched through clinical studies, implemented to improve several conditions and have already proved to be efficient and valid, especially due to their ability to captivate and motivate the patient. With this in mind, this research explored the use of Serious Games for physical rehabilitation of stroke impaired patients and how this approach could be implemented in the Portuguese healthcare system. The research started with a thorough literature review of the validity and effectiveness of the use of Serious Games for this type of patients. Then, through surveys and interviews with healthcare professionals and game developers, the main barriers to the implementation and development of Serious Games for physical rehabilitation were accessed. Posteriorly, the feasibility of implementing a business model for this specific niche (in Portugal) was evaluated through a market analysis, abridging social, economic, political and technological aspects that culminated in the design of several hypothetical scenarios that envisioned the possibility of making this approach work. This research allowed to achieve an understanding of what needs to be overcome in order for this technique to be successful: Serious Games are still widely unknown among healthcare professionals and there is an underlying stigma against video games that clouds the possible benefits of using Serious Games. Moreover, the social context of future users will also determine their acceptance and compliance. Nevertheless, the research has evidenced that the implementation of this paradigm is economically viable as it would indirectly allow the monetization of rehabilitation therapies by making them available to a larger slice of the disabled population, which is of utmost importance, mainly during the times we currently live in.Os videojogos fazem parte da nossa cultura e permeiam vários segmentos da sociedade, desde entretenimento casual até propósitos mais sérios. Este trabalho de investigação concentra-se na segunda opção – mais especificamente, no uso de Serious Games no contexto da saúde. Neste sentido, os Serious Games têm sido investigados através de estudos clínicos, implementados para melhorar diversas condições e patologias e já provaram ser eficientes e válidos, principalmente graças à sua capacidade de motivar e cativar o paciente. Tendo isto em conta, esta investigação explorou o uso dos Serious Games para reabilitação física de pacientes pós-AVC e de que forma é que esta abordagem poderia ser implementada no Serviço Nacional de Saúde. A investigação começou com uma revisão bibliográfica completa da validade e eficácia do uso de Serious Games para este tipo de pacientes. De seguida, através de questionários e entrevistas a profissionais de saúde e desenvolvedores de videojogos, as principais barreiras para implementação e desenvolvimento de Serious Games para reabilitação física foram levantadas. Posteriormente, a viabilidade de executar um business plan para esse nicho específico (em Portugal) foi avaliada através de uma análise de mercado, abrangendo aspetos sociais, económicos, políticos e tecnológicos, que culminou no desenho de vários cenários hipotéticos que previam a possibilidade de fazer com que este paradigma se tornasse possível e funcional. Este trabalho de investigação permitiu atingir uma compreensão daquilo que necessita de ser ultrapassado para que esta abordagem tenha sucesso: os Serious Games ainda são amplamente desconhecidos entre os profissionais de saúde e existe um estigma subjacente aos videojogos que obscurece os possíveis benefícios do seu uso. Para além disso, o contexto social dos futuros utilizadores também irá determinar a sua aceitação e adesão. No entanto, esta investigação evidenciou que a implementação deste modelo é economicamente viável, pois iria permitir, de uma forma indireta, a rentabilização de terapias de reabilitação ao fazer com que estas fossem acessíveis a uma fatia mais larga da população debilitada, o que é de extrema importância, principalmente nos dias de hoje

Mixed Reality serious games for post stroke rehabilitation

International audienceIn this paper we propose a mixed reality system (MRS) and an adaptation module for rehabilitation of the upper limb after stroke through serious games. Aim of the system is to increase intensity and number of training session using the fun factor as driver. Although our system is targeting post stroke patient it is necessary to validate and test our approach with valid users at the first stage to provide patients with stable system to use. These studies and their results are described in this paper

Augmenting patient therapies with video game technology

PhD ThesisThere is an increasing body of work showing that video games can be used for more than just entertainment, but can also facilitate positive physical and mental changes. For people suffering debilitating side-effects from illnesses such as stroke, there is need to deliver and monitor effective rehabilitative physical therapies; video game technologies could potentially deliver an effective alternative to traditional rehabilitative physical therapy, and alleviate the need for direct therapist oversight. Most existing research into video game therapies has focussed on the use of offthe- shelf games to augment a patient’s ongoing therapy. There has currently been little progress into how best to design bespoke software capable of integrating with traditional therapy, or how to replicate common therapies and medical measurements in software. This thesis investigates the ability for video games to be applied to stroke rehabilitation, using modern gaming peripherals for input. The work presents a quantitative measurement of motion detection quality afforded by such hardware. An extendible game development framework capable of high quality movement data output is also presented, affording detailed analysis of player responsiveness to a video game delivered therapy for acute stroke. Finally, a system by which therapists can interactively create complex physical movements for their patients to replicate in a video game environment is detailed, enabling bespoke therapies to be developed, and providing the means by which rehabilitative games for stroke can provide an assessment of patient ability similar to that afforded by traditional therapies

Designing engaging experiences with location-based augmented reality games for urban tourism environments.

Gameplay has recently unfolded as playfulness in various cultural forms using mobile technologies. The rapid affordability paired with the latest technology improvements enabled the diffusion of mobile devices among tourists, who are among the most avid users of mobile technologies. The advent of mobile devices has initiated a significant change in the way we perceive and connect with our environment and paved the way for location-based, mobile augmented reality (AR) games that provide new forms of experiences for travel and tourism. With the recent developments like Pokémon Go and a prediction of 420 million downloads per year by 2019, the mobile game market is one of the fastest growing fields in the sector. Location-based AR games for mobile devices make use of players‟ physical location via the GPS sensor, accelerometer and compass to project virtual 2D and 3D objects with the build-in camera in real time onto the mobile game user interface (GUI) in order to facilitate gameplay activities. Players interact with the virtual and physical game world and overcome artificial challenges while moving around in the real environment. Where current mobile games withdraw players from reality, location-based AR games aim to engage players with the physical world by combining virtual and physical game mechanics in an enhanced way that increases the level of interactive educative and entertaining engagement. Despite some recent research on location-based AR games, game designers do not know much about how to address tourism requirements and the development of mediated playful experiences for urban tourism environments. This study explores the use of location-based AR games to create engaging and meaningful experiences with the tourism urban environment by combining interdisciplinary research of social sciences, (mobile) game design and mobile game user research (mGUR) to contribute to experience design in the context of travel and tourism. Objectives of the study are to identify the influence of key game elements and contextual gameplay parameters on the individual game experience (GX). To achieve the aim, the study has taken a pragmatic interpretivist approach to understand the player‟s individual GX in an evolving gameplay process in order to inform location-based game design. The project explores the interaction between the player, the game and the tourism context, which is assessed by a sequential triangulation of qualitative mixed methods. Two games were identified to be relevant for the tourism application that fulfilled the attributes of a location-based AR game. The first game is a role-playing adventure game, set in the time and place of the Cold War, called Berlin Wall 1989. The second game, Ingress, is a fictive, large area, massively multiplayer role-playing game that uses the real world as the battleground between two game fractions. A conceptual framework has been developed that presents the player engagement process with location-based AR games in urban tourism environments. The findings of the study indicate that gameplay is a moment-by-moment experience that is influenced by multiple aspects. The creation of engaging experiences between players, the game and the tourism context is related to six identified engagement characteristics; emotional engagement, ludic engagement, narrative engagement, spatial engagement, social engagement and mixed reality engagement. The study identified that the main motivations of playing a location-based AR game are the exploration of and learning about the visited destination, curiosity about the new playful activity and socialising with other players. Emotions underlie the creation of engagement stimulated by the alteration of playful interactions. The findings revealed that storytelling and simple game mechanics such as walking, feedback and goal orientation are essential elements in the creation of engaging experiences. Augmented reality, as a feature to connect the real with the virtual world, needs to create real added value for the gameplay in order to be perceived as engaging for players. The study proposes serious location-based AR games as an alternative form for tourism interpretation and has showed opportunities to enhance the tourist experience through self-directed, physical and mental interaction between players, the environment and the location-based AR game. The findings of the research illustrate the complexity of designing location-based game experiences. The developed conceptual framework can be used to inform future location-based AR game design for travel and tourism