Visual complexity, player experience, performance and physical exertion in motion-based games for older adults

Motion-based video games can have a variety of benefits for the players and are increasingly applied in physical therapy, rehabilitation and prevention for older adults. However, little is known about how this audience experiences playing such games, how the player experience affects the way older adults interact with motion-based games, and how this can relate to therapy goals. In our work, we decompose the player experience of older adults engaging with motion-based games, focusing on the effects of manipulations of the game representation through the visual channel (visual complexity), since it is the primary interaction modality of most games and since vision impairments are common amongst older adults. We examine the effects of different levels of visual complexity on player experience, performance, and exertion in a study with fifteen participants. Our results show that visual complexity affects the way games are perceived in two ways: First, while older adults do have preferences in terms of visual complexity of video games, notable effects were only measurable following drastic variations. Second, perceived exertion shifts depending on the degree of visual complexity. These findings can help inform the design of motion-based games for therapy and rehabilitation for older adults

Open Source Virtual Worlds and Low Cost Sensors for Physical Rehab of Patients with Chronic Diseases

For patients with chronic diseases, exercise is a key part of rehab to deal better with their illness. Some of them do rehabilitation at home with telemedicine systems. However, keeping to their exercising program is challenging and many abandon the rehabilitation. We postulate that information technologies for socializing and serious games can encourage patients to keep doing physical exercise and rehab. In this paper we present Virtual Valley, a low cost telemedicine system for home exercising, based on open source virtual worlds and utilizing popular low cost motion controllers (e.g. Wii Remote) and medical sensors. Virtual Valley allows patient to socialize, learn, and play group based serious games while exercising

Virtual Reality Games for Motor Rehabilitation

This paper presents a fuzzy logic based method to track user satisfaction without the need for devices to monitor users physiological conditions. User satisfaction is the key to any product’s acceptance; computer applications and video games provide a unique opportunity to provide a tailored environment for each user to better suit their needs. We have implemented a non-adaptive fuzzy logic model of emotion, based on the emotional component of the Fuzzy Logic Adaptive Model of Emotion (FLAME) proposed by El-Nasr, to estimate player emotion in UnrealTournament 2004. In this paper we describe the implementation of this system and present the results of one of several play tests. Our research contradicts the current literature that suggests physiological measurements are needed. We show that it is possible to use a software only method to estimate user emotion

Future Trends of Virtual, Augmented Reality, and Games for Health

Serious game is now a multi-billion dollar industry and is still growing steadily in many sectors. As a major subset of serious games, designing and developing Virtual Reality (VR), Augmented Reality (AR), and serious games or adopting off-the-shelf games to support medical education, rehabilitation, or promote health has become a promising frontier in the healthcare sector since 2004, because games technology is inexpensive, widely available, fun and entertaining for people of all ages, with various health conditions and different sensory, motor, and cognitive capabilities. In this chapter, we provide the reader an overview of the book with a perspective of future trends of VR, AR simulation and serious games for healthcare

Development and Usability Evaluation of Low-cost Virtual Reality Rehabilitation Games for Patients with Upper Limb Impairment

Stroke is one of the primary causes of long-term disability in adults in the United States which leads to mild to severe sensorimotor impairments. Long-term continuous rehabilitation therapies are needed to facilitate sensorimotor recovery and empower patients in performing daily living activities. Currently, the opportunity of receiving post stroke rehabilitation in the chronic stage (\u3e 6 months post stroke) is limited due to a lack of insurance and the high cost of therapy. Low-cost virtual rehabilitation games with motion tracking devices have tremendous potential to assist physical rehabilitation. Motion tracking devices such as Kinect (Microsoft, Redmond, CA; $100) and P5 Glove (Essential Reality, LLC, NY;$40) have become available to enable development of low-cost virtual rehabilitation games. Such low-cost games may encourage continuous, repeated, and intensive rehabilitation therapies thereby enhancing recovery post stroke. However, current virtual rehabilitation games emphasize on gross arm movements using Kinect or fine finger movements using P5 Glove, but not both at the same time. Since most daily living activities require coordination of the gross shoulder/elbow movement and fine finger movement such as reaching to grasp and transferring a jar to a shelf, effective upper limb rehabilitation must involve coordination of the arm and finger movements. In addition, many virtual rehabilitation games have been developed without user input and feedback, which may be the primary reason why virtual rehabilitation games are not prominently used at home by patients. This thesis presents the development and usability evaluation of low-cost virtual rehabilitation games. In addition to the archery and puzzle games previously developed in the laboratory, a low-cost rehabilitation kitchen game was developed to encourage patients to practice various functional tasks involving coordinated arm and finger movements that were detected by using Kinect and P5 Glove, respectively. Usability of the three games was assessed with ten chronic stroke survivors using pre-game and post-game surveys. The games met patients\u27 expectations of providing challenging movements. The House of Quality analysis revealed that technical characteristic needing the most improvement was device reliability. The future research should address device reliability by developing a better instruction manual to facilitate device set-up and use. In addition, filtering data can also improve quality of virtual arm movements in future versions of the games. In summary, this thesis presents promising evidence for low-cost rehabilitation games using commercially available motion tracking devices of Kinect and P5 Glove together with free Blender software

Design Parameters in Multimodal Games for Rehabilitation

Published under the Liebert "Open Option"Objectives: The repetitive and sometimes mundane nature of conventional rehabilitation therapy provides an ideal opportunity for development of interactive and challenging therapeutic games that have the potential to engage and motivate the players. Certain game design parameters that may encourage patients to actively participate by making the games more enjoyable have been identified. In this article, we describe a formative study in which we designed and evaluated some of these parameters with healthy subjects. Materials and Methods: The ‘‘operant conditioning’’ and ‘‘scoring’’ design parameters were incorporated in a remake of a classic labyrinth game, ‘‘Marble Maze.’’ A group of participants (n = 37) played the game twice: Once in the control condition without both modalities and then with either one of the parameters or with both. Measures of game duration and number of fails in the game were recorded along with survey questionnaires to measure player perceptions of intrinsic motivation on the game. Results: Longer playtimes, higher levels of interest/enjoyment, and effort to play the game were recorded with the introduction of these parameters. Conclusions: This study provides an understanding on how game design parameters can be used to motivate and encourage people to play longer. With these positive results, future aims are to test the parameters with stroke patients, providing much clearer insight as to what influences these parameters have on patients un- dergoing therapy. The ultimate goal is to utilize game design in order to maintain longer therapeutic interaction between a patient and his or her therapy medium.Peer reviewedFinal Published versio

A web-based gamification of upper extremity robotic rehabilitation

In recent years, gamification has become very popular for rehabilitating different cognitive and motor problems. It has been shown that rehabilitation is effective when it starts early enough and it is intensive and repetitive. However, the success of rehabilitation depends also on the motivation and perseverance of patients during treatment. Adding serious games to the rehabilitation procedure will help the patients to overcome the monotonicity of the treatment procedure. On the other hand, if a variety of games can be used with a robotic rehabilitation system, it will help to define tasks with different levels of difficulty with greater variety. In this paper we introduce a procedure for connecting a rehabilitation robot to several web-based games. In other words, an interface is designed that connects the robot to a computer through a USB port. To validate the usefulness of the proposed approach, a researcher designed survey was used to get feedback from several users. The results demonstrate that having several games besides rehabilitation makes the procedure of rehabilitation entertaining.Comment: 2021 International Serious Games Symposium (ISGS

A serious games platform for cognitive rehabilitation with preliminary evaluation

In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients' attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.- This work has been supported by FCT - Fundacao para a Ciencia e Tecnologia in the scope of the projects: PEst-UID/CEC/00319/2015 and PEst-UID/CEC/00027/2015. The authors would like to thank also all the volunteers that participated in the study

A Rehabilitation Gaming System for Cognitive Deficiencies: Design and Usability Evaluation

Patients with Acquired Brain Injuries or ABI experience various cognitive deficiencies that adversely impact their daily lives, as their ability to perform everyday activities, becomes severely limited. These patients would benefit more from engaging in unconventional cognitive rehabilitation, specifically rehabilitation using Serious Games. However, it is difficult to categorize cognitive disabilities due to their heterogeneity; therefore individualized rehabilitation interventions are required. It is also challenging to design games for cognitive rehabilitation, as the complexity and production cost for these games are usually very high. There is an abundance of recent studies on cognitive rehabilitation, particularly game-based interventions. However, some studies explain how to design games that are enjoyable and usable for patients with cognitive disabilities. Hence, this study addresses this issue with a proposed framework for therapeutic game developers targeting patients with cognitive deficiencies. To this end, a prototype Rehabilitation Gaming System (RGS) was developed and evaluated by therapists. A 7-point Likert scale usability questionnaire was used and the mean scores for layout/design (5.94), ease of use (5.40), easy to learn (5.76), usefulness (5.96) and satisfaction (6.1) indicate that RGS has good usability. Therapists are willing to use RGS for rehabilitation purposes. Practitioners, game developers, and patients in the healthcare field will be able to use the proposed framework as a guide and tool for designing and implementing games targeted for cognitive rehabilitation.

Games as Systems for Rehabilitation: A Design Strategy for Game-based Exercise Rehabilitation for Parkinson\u27s Disease

Games are of interest for health interventions including but not limited to physical activity and rehabilitation, behavior change, motor-cognitive training, and mood elevation. Despite increased interest in using games to produce positive health outcomes, the development or selection process of games, or their suitability for a target demographic in a context of health and rehabilitation, remains ad-hoc. As a result, game-based interventions lacking application specificity produce variable outcomes that obscure the true treatment effect of game-based therapies. To address this issue, we present a design strategy for game-based rehabilitation that uses a player-centric approach to develop/select games for specific contexts such as for improving functional deficits in patients with Parkinson’s disease. This strategy establishes a relationship between the exercise rehabilitation regimen and gameplay by incorporating the rehabilitation requirements, patient condition, and player affordances, into the game world. In addition, we present guiding questions to support the application of the design strategy for improving the effectiveness of game-based rehabilitations