Muscle activation during Exergame playing

Exergames may provide low-cost solutions for playing, training and rehabilitation. Exergame user research (EUR), studies the interaction between an Exergame and users, in order to provide feedback for game developers and safe and meaningful gameplay. Detailed evaluations and a coding system based on muscle activation levels are necessary to characterize Exergames. This is important when it comes to use exergames in purposes other than fun. The purpose of this chapter was to characterize the muscle activation during a swimming Exergame as an example and to compare the level of activation during different conditions. Healthy subjects played bouts of Exergame using Xbox360 and Kinect. Muscle activation was monitored for desired muscles on dominant upper limb using wireless electromyographic system. Preliminary resutls showed that upper trapezius was the most active muscle in all techniques. An investigation of muscular coordination was also conducted to provide an activation sequences of studied muscles. Results can provide insights for practitioners to have a baseline on application of exergames in their routines

The Use of digital games to enhance the physical exercise activity of the elderly : a case of Finland

According to the World Health Organization (WHO), population ageing is a global phenomenon, which brings both challenges and opportunities for society. The current longer expected lifespan can create opportunities for the elderly to contribute in many ways to their families and communities. However, it greatly depends on their quality of life, which is affected by many factors, including physical and functional health, social well-being, and cognitive abilities. The WHO (2012) states that physical health is one of the indicators for the elderly’s quality of life, and it declines with increasing age. Participation in regular physical exercises can help the elderly improve their physical and mental health, and this has been aided by the use of modern technologies to promote the elderly’s physical and functional health. Of these latest technologies, digital games have shown promise to improve and enhance the elderly’s physical activities through fun and engaging gameplay. The literature highlights that some commercial games in the market (e.g. Microsoft Kinect- Sports and Nintendo Wii Sports games) have the potential to improve the elderly’s physical health such as gait, balance, and fall prevention. However, researchers argue that these commercial games are not designed specifically for the elderly and their physical exercise activities. They state that most commercial games are not user-friendly for the elderly whose functional and physical abilities are limited due to their advanced years. The literature points out that more studies need to be undertaken to understand the usability and usefulness of digital games for physical exercise activities so that game designers can create elderly-friendly digital games in the future. In Finland, the government has been focusing on promoting healthy ageing and increasing home care services for the elderly. In recent years, Finnish researchers have used digital games to promote older Finns’ healthy and active ageing. The existing literature, whilst showing the potential of digital games for elderly Finns’ physical health, also acknowledges further research is needed particularly in the context of Finland. Thus, in this study, we aimed at investigating digital games to specifically assess their applications for older Finns’ physical activities, focusing on the quality of users’ experiences, and their reported ease of use and perceived usefulness. We used the mixed methods approach, which applies both qualitative and quantitative research methods. The study design included four stages: requirements gathering, analysis and design, prototyping, and evaluation. Firstly, we conducted pre-studies to elicit users’ requirements. This was followed by the analysis of the resulting data to identify trends and patterns, which fuelled ideas in the brainstorming game design and development phases. The final product was a digital game-based physical exercise called the Skiing Game. We then evaluated the Skiing Game in Finland with 21 elderly Finns (M=7, F=14, Average Age =76). By using questionnaires, observation, and interviews, we investigated user experiences, focusing on the game’s usability, and usefulness for enhancing the physical activity and wellbeing of the elderly. We also conducted a comparative test of the Skiing Game in Japan with 24 elderly Japanese participants (M=12, F=12, Average Age = 72) to further understand non-Finnish elderly users’ experiences. The findings from the usability study of the Skiing Game in Finland demonstrated that elderly Finns had a positive experience in the gameplay, and their motivation was noticeably high. It also confirmed that elderly Finns have a genuine interest in digital game-based exercises and strong intentions to play digital games as a form of physical exercise in the future. Although prior to the study most of them had negative views and misconceptions about digital games, after the gameplay their attitudes were decidedly positive. They acknowledged that whilst playing digital games could be an alternative way of exercising for them their use would primarily be when they don’t have access to their usual non-digital physical exercise. The Japanese usability of the Skiing Game showed that the elderly Japanese people also had positive user experiences in playing digital games, and also intend to use them in the future. Similarly, after playing the game they reported that their attitudes towards digital games become positive, and indicated playing digital games could be an alternative way of exercising. Although the comparison of the two studies suggests that the elderly Finns had relatively more positive experiences whilst playing the Skiing Game, compared to their Japanese counterparts, in general, both groups had a positive experience in the gameplay and showed interest in digital games as an alternative exercise. Based on the usability lessons learned from these two studies, recommendations for practitioners and designers regarding improvements in game design and development are made in this report. Implementing these modifications into future designs and further development of digital games for the elderly will improve their commercial viability and user uptake. The findings from this study can provide valuable insights, particularly for Finnish policymakers and healthcare practitioners who are keen to introduce digital games into the aged-care sector in Finland. The studies have also provided valuable insights into the optimal methods for introducing Finnish digital games to international markets, in particular, digital games tailored specifically for the physical exercise needs and motivations of the elderly. By taking into consideration the limitations of the study, we provide our future studies and further improvements of the game to be conducted

New techniques for neuro-rehabilitation: Transcranial Electric Stimulation and Virtual Reality

Recovery of motor and cognitive performances after a neurological illness remains a significant challenge for rehabilitation specialists. The traditional rehabilitative interventions are usually delivered using a multidisciplinary approach, whose results are not always satisfactory. These limitations in functional recovery have led researchers to consider alternative approaches. The hypothesis of providing new therapeutic possibilities in the different patients treated is, as a rehabilitator, very rewarding and represents a challenge for the future. The application of simple and low-cost techniques, defined by the literature as "unconventional" or “novel”, can provide new ideas not only in the field of research but above all of application in clinical reality.A suitable approach to improve the rehabilitation outcome is to utilize these novel rehabilitation techniques that act as a substitute or an addition to the traditional ones. In this context, some recent approaches have been proposed that might increase the effectiveness of a traditional treatment. Among them, two techniques have been demonstrated to be very promising, namely non-invasive brain stimulation (NIBS) and Virtual Reality (VR).In light of the foregoing, my thesis has been divided into two main lines of research, namely: a) the study of the effects of transcranial direct current stimulation (tDCS) in different neurological conditions; b) the application of VR (used alone or combined with tDCS) in the treatment of some neurocognitive disorders. A semi-immersive VR tool (ReMOVES system) has been used as a user-friendly platform providing activities based on exergames

How can the technology be integrated in Outdoor Movement Education for children and the youth with special needs?

The technological innovations of the last decade have caused countless changes to everyone's lifestyle, especially in the number of hours spent in front of a screen. These generational differences are even more marked if the new generations of students are taken into consideration, in fact, even at the school level, technological innovations have brought changes. Just as lifestyle and teaching have changed, what is considered as the "needs" of pupils and how they live and relate both in formal and informal environments have also changed. Considering the emergency period caused by the COVID-19 pandemic, greater attention has been paid to the importance of exercising and everyone has also re-evaluated the beauty and benefits of exercising outdoors. Outdoor Movement Education in this sense can be a key that allows the new generations to experience the emotions and sensations that can be felt during outdoor moving activities. This work is a reflection on how technology can be a tool to increase the benefits in Outdoor Movement Education considering children and youth with special needs. The results of this work have shown how the use of technology in Outdoor Movement Education brings numerous advantages both under the didactic profile (i.e., life skills) and with regard to the cognitive (i.e., attention and concentration), motor (i.e., motor skills, fundamental movement skills) and affective (i.e., enjoyment) domains of learning respectively

Fatigue-Aware gaming system for motor rehabilitation using biocybernetic loops.

Esta tesis tiene como objetivo proponer una terapia de rehabilitación complementaria basada en paradigmas de interacción humano-computadora (HCI) que exploran i) Técnicas de rehabilitación virtual, integrando tecnologías de realidad virtual (VR) sofisticadas y (hoy en día) accesibles, ii) sensores fisiológicos de bajo costo, a saber, electromiografía de superficie (sEMG) y iii)sistema inteligente, a través de adaptación biocibernética, para proporcionar una nueva técnica de rehabilitación virtual..

Sports in Digital Era

The thesis's primary purpose is to demonstrate the growth of the digital era on the sports industry for awareness and better management. Moreover, it aims to explain the digital technology revolution and its effect on physical activities and sports. The paper presents a social analysis of sports regarding the effects of the IV Industrial Revolution, driven by an unprecedented level of development in materials sciences, digital technology, and biology. The future views on the evolution of the sports industry and options for the sports manager in the phase of digital transition are illustrated. The conclusion summarizes the implications and represents the direction of the sports industry.O objetivo desta tese é demonstrar o crescimento da era digital na indrústia desportiva para a consciencialização e uma melhor gestão. Além disso, visa explicar a revolução tecnológica digital e a sua influência na atividade física e desporto. O documento apresenta uma análise social do desporto em relação aos efeitos da IV Revolução Industrial, impulsionada pelo sem precedente nível de desenvolvimento nas ciências materiais, tecnologia digital e biologia. O futuro da evolução da indústria do desporto e as opções dos gestores desportivos na fase de transição do digital. A conclusão resume as implicações e reflete a direção da indústria do desporto

Clinical Decision Support Systems with Game-based Environments, Monitoring Symptoms of Parkinson’s Disease with Exergames

Parkinson’s Disease (PD) is a malady caused by progressive neuronal degeneration, deriving in several physical and cognitive symptoms that worsen with time. Like many other chronic diseases, it requires constant monitoring to perform medication and therapeutic adjustments. This is due to the significant variability in PD symptomatology and progress between patients. At the moment, this monitoring requires substantial participation from caregivers and numerous clinic visits. Personal diaries and questionnaires are used as data sources for medication and therapeutic adjustments. The subjectivity in these data sources leads to suboptimal clinical decisions. Therefore, more objective data sources are required to better monitor the progress of individual PD patients. A potential contribution towards more objective monitoring of PD is clinical decision support systems. These systems employ sensors and classification techniques to provide caregivers with objective information for their decision-making. This leads to more objective assessments of patient improvement or deterioration, resulting in better adjusted medication and therapeutic plans. Hereby, the need to encourage patients to actively and regularly provide data for remote monitoring remains a significant challenge. To address this challenge, the goal of this thesis is to combine clinical decision support systems with game-based environments. More specifically, serious games in the form of exergames, active video games that involve physical exercise, shall be used to deliver objective data for PD monitoring and therapy. Exergames increase engagement while combining physical and cognitive tasks. This combination, known as dual-tasking, has been proven to improve rehabilitation outcomes in PD: recent randomized clinical trials on exergame-based rehabilitation in PD show improvements in clinical outcomes that are equal or superior to those of traditional rehabilitation. In this thesis, we present an exergame-based clinical decision support system model to monitor symptoms of PD. This model provides both objective information on PD symptoms and an engaging environment for the patients. The model is elaborated, prototypically implemented and validated in the context of two of the most prominent symptoms of PD: (1) balance and gait, as well as (2) hand tremor and slowness of movement (bradykinesia). While balance and gait affections increase the risk of falling, hand tremors and bradykinesia affect hand dexterity. We employ Wii Balance Boards and Leap Motion sensors, and digitalize aspects of current clinical standards used to assess PD symptoms. In addition, we present two dual-tasking exergames: PDDanceCity for balance and gait, and PDPuzzleTable for tremor and bradykinesia. We evaluate the capability of our system for assessing the risk of falling and the severity of tremor in comparison with clinical standards. We also explore the statistical significance and effect size of the data we collect from PD patients and healthy controls. We demonstrate that the presented approach can predict an increased risk of falling and estimate tremor severity. Also, the target population shows a good acceptance of PDDanceCity and PDPuzzleTable. In summary, our results indicate a clear feasibility to implement this system for PD. Nevertheless, long-term randomized clinical trials are required to evaluate the potential of PDDanceCity and PDPuzzleTable for physical and cognitive rehabilitation effects