Motivational strategies and approaches for single and multi-player exergames: A social perspective

Background: Exergames have attracted the interest of academics, practitioners, and designers, in domains as diverse as health, human-computer interaction, psychology, and information technology. This is primarily because exergames can make the exercise experience more enjoyable and entertaining, and in turn, can increase exercise levels. Despite the many benefits of exergames, they suffer from retention problems. Thus, the objective of this article was to review theories and game elements that have been empirically examined or employed in an attempt to make exergames more motivating so people engage in sustained physical activity (duration of physical activity) in a repeating pattern over time (frequency of physical activity). Methodology: A literature search and narrative review were conducted. Results: Five major theories and elements were prevalent in the exergaming literature: (1) self-determination theory, (2) gamification, (3) competition and cooperation, (4) situational interest, and (5) social interaction. These theories and elements are important for encouraging long-term play and show promise for designing exergames to promote sustained engagement and motivate physical activity. We discuss their strengths and weaknesses throughout the paper. Conclusions: The long-term effectiveness of exergame interventions is unclear mainly because of the limited amount of long-term studies. Better metrics are also needed to evaluate this effectiveness. We also identified particular attention to social factors and group dynamics, such as multi-player exergames and more effective player matchmaking strategies for increasing social connectedness, as a key area of future research

Working Together in a PhamilySpace: Facilitating Collaboration on Healthy Behaviors Over Distance

Studies have shown that interpersonal relationships such as families and friends are an important source of support and encouragement to those who seek to engage in healthier habits. However, challenges related to geographic distance may hinder those relationships from fully collaborating and engaging in healthy living together. To explore this domain, we developed and deployed a lightweight photo-based application called PhamilySpace with a week-long intervention. Our goal is to examine family members\u27 and friends\u27 engagement and awareness on healthy behaviors while living apart. Our analysis of the semi-structured interviews, pre/post-intervention instruments, and application logs suggests three main benefits of interventions for health promotion in this context: (1) increased awareness on acts of health; (2) reciprocal sharing of health information supports social accountability over distance; and (3) positive dialogue around health enhances support on healthy living. By providing insights into distributed family/friends interactions and experiences with the application, we identify benefits, challenges, and opportunities for future design interventions that promote healthy behaviors

Multi-user Touch Surfaces to Promote Social Participation and Self-efficacy in Upper-limb Stroke Rehabilitation

This thesis addresses the growing incidence of stroke and its impact on long-term disability, emphasizing the importance of post-stroke rehabilitation. Predicting a 34% increase in stroke cases by 2025, this work focuses on factors affecting post-stroke motor rehabilitation, such as depressive symptoms, while recognizing the role of social participation and self-efficacy in modulating these outcomes. To tackle these challenges, we propose the use of a multi-user interactive table for upper limb rehabilitation. This innovative approach involves detecting objects of various sizes and shapes as interfaces for serious games, fostering collective therapeutic activities targeting motor rehabilitation, depressive symptoms, social participation, and self-efficacy. Four exploratory studies informed the development of the interactive table. The studies determined game mechanics, object types, and game features. Three game modes (competitive, co-active, and collaborative) were explored, with the collaborative mode showing higher social engagement and more positive outcomes. Subsequent studies involving stroke survivors confirmed the effectiveness of collaborative gameplay. Feasibility, engagement, and usability were tested using objects of different sizes and shapes, revealing insights into task performance, grasping, and task complexity adjustments. The developed interactive table accommodates up to four participants, using top down object shape tracking and a multi-touch panel. Four serious games were designed to target specific upper limb skills, played in collaborative mode with incorporated features to enhance the overall experience. A pilot study with 12 stroke survivors over four weeks demonstrated significant improvements in motor outcomes, including range of motion, dexterity, strength, and coordination. The participants reported high enjoyment and interest in the system, with good usability scores. The study suggests that a group-based holistic motor rehabilitation approach, as presented, holds potential for enhancing motor outcomes by promoting social interaction and self-efficacy. These results indicate the viability of the proposed system as a promising solution for stroke rehabilitation.Esta tese aborda a crescente incidência do AVC e o seu impacto na funcionalidade a longo prazo, realçando a importância da reabilitação pós-AVC. Prevendo-se um aumento de 34% nos casos de AVC até 2025, este trabalho foca-se em fatores que afetam a reabilitação motora pós-AVC, como os sintomas depressivos, reconhecendo o papel da participação social e do sentimento de auto-eficácia na nestes sintomas. Para enfrentar esses desafios, propomos o uso de uma mesa interativa multi utilizador para reabilitação dos membros superiores. Esta abordagem inovadora envolve a deteção de objetos de vários tamanhos e formas como interfaces para os jogos sérios, permitindo atividades terapêuticas em grupo direcionadas à reabilitação motora, sintomas depressivos, participação social e autoeficácia. Quatro estudos exploratórios suportaram o desenvolvimento da mesa interativa, determinando mecânicas de jogo, tipos de objetos e recursos do jogo. Três modos de jogo (competitivo, co-ativo e colaborativo) foram investigados, com o modo colaborativo mostrando maior envolvimento social e resultados mais positivos. Estudos subsequentes envolvendo sobreviventes de AVC confirmaram a eficácia do jogo colaborativo. Viabilidade, envolvimento e usabilidade foram testados usando objetos de diferentes tamanhos e formas, revelando insights importantes relativos ao desempenho nas tarefas, preensões e ajustes de complexidade da tarefa. A mesa interativa desenvolvida acomoda até quatro participantes, e permite a deteção de objectos para serem usados como interfaces e um painel multi-toque. Quatro jogos sérios foram projetados para reabilitar competências específicas dos membros superiores, desenhados para serem jogados em modo colaborativo e com recursos incorporados para potenciar o processo de reabilitação e a experiência do utilizador. Um estudo piloto com 12 sobreviventes de AVC ao longo de quatro semanas, demonstrou melhorias significativas nos resultados motores, nomeadamente amplitude de movimento, destreza, força e coordenação. Os participantes reportaram níveis altos de prazer e interesse no sistema, e pontuações de usabilidade promissoras. Este trabalho sugere que uma abordagem de reabilitação motora holística e em grupo, como apresentada, tem potencial para melhorar os resultados motores promovendo a interação social e o sentimento de auto-eficácia. Estes resultados sugerem a viabilidade do sistema proposto como uma solução promissora para a reabilitação motora no AVC

Dance, Autism, and Communication: Exploring the Feasibility of a Dance-Based Exergame within the Home and School Environments to Enhance Autistic Children’s Social Communication Skills

Autism spectrum disorder (ASD) is a common neurodevelopmental condition, typically characterised by challenges in social communication and restricted or repetitive patterns of behaviours and interests. Autistic individuals are observed to also display a variety of differences and strengths in cognitive functioning, motor skills, and sensory processing, uniquely impacting individuals. Despite its heterogeneity, enhancing social communication skills and supporting physical well-being are two of the autistic community’s top research priorities. Therefore, the present thesis explores communication challenges observed within autism and the use of physical activity and dance movement therapy (DMT) to enhance autistic children’s social communication skills. Two systematic reviews were conducted. The first suggested the beneficial use of two fundamental DMT techniques, mirroring and rhythm, for enhancing autistic children’s social communication skills. The second highlighted the beneficial effects of exergaming for the autistic population. A subsequent study then investigated common styles of rhythm and music used by dance movement therapists in their sessions with autistic children, suggesting music and rhythms with a 4/4 time signature, moderato tempo, and age-appropriate lyrics were most popular. A mixed-methods approach was later employed to examine the feasibility and potential effectiveness of a dance-based exergame in the home and school environments to enhance autistic children’s social communication skills. Results suggest that the exergame can be implemented by parents and teachers in their respective environments, affords children ownership of their intervention, and is an enjoyable activity. Furthermore, limited-efficacy testing inferred the beneficial effects of the dance-based exergame, enhancing autistic children’s social communication skills. This work advocates that the chosen exergame is an engaging physical activity, which addresses some of the current limitations of traditional interventions for supporting autistic children’s social communication skills. Overall, the findings presented are promising and suggest additional research within this area will prove worthwhile and meaningful for the autistic population

Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data