Rapid Development Environments for Therapy Games: Looking Glass Therapy Games for Cerebral Palsy Treatment Utilizing the Kinect

Cerebral palsy is a group of neurological disorders that impair body movement, muscle coordination, hearing, vision, and cognitive function. Symptoms vary but can include muscle weakness, muscle and joint tightness, abnormal or unsteady gait, seizures, learning disabilities, speech problems, as well as hearing or vision problems [1]. Although cerebral palsy cannot be cured, treatments such as physical and occupational therapy can greatly help affected children develop motor skills needed to increase mobility and foster independence [2]. Computer based therapy games have shown promise in helping stroke survivors recover from stroke [3]. Initially, stroke therapy games developed in Looking Glass utilized Nintendo Wii remotes (informally known as Wiimotes) to sense user’s movements. Challenges unfolded with stroke patients who were unable to grasp Wiimotes, thereby limiting and inhibiting game development and the user experience [3]. In this paper, I describe my efforts to integrate the Microsoft Kinect with Looking Glass and build therapy games that utilize the Kinect to track user movements. I detail the Kinect integration and discuss its advantages of seated skeletal tracking with no hand held devices required by the user

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

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

Balancing the playing field: collaborative gaming for physical training.

BACKGROUND: Multiplayer video games promoting exercise-based rehabilitation may facilitate motor learning, by increasing motivation through social interaction. However, a major design challenge is to enable meaningful inter-subject interaction, whilst allowing for significant skill differences between players. We present a novel motor-training paradigm that allows real-time collaboration and performance enhancement, across a wide range of inter-subject skill mismatches, including disabled vs. able-bodied partnerships. METHODS: A virtual task consisting of a dynamic ball on a beam, is controlled at each end using independent digital force-sensing handgrips. Interaction is mediated through simulated physical coupling and locally-redundant control. Game performance was measured in 16 healthy-healthy and 16 patient-expert dyads, where patients were hemiparetic stroke survivors using their impaired arm. Dual-player was compared to single-player performance, in terms of score, target tracking, stability, effort and smoothness; and questionnaires probing user-experience and engagement. RESULTS: Performance of less-able subjects (as ranked from single-player ability) was enhanced by dual-player mode, by an amount proportionate to the partnership's mismatch. The more abled partners' performances decreased by a similar amount. Such zero-sum interactions were observed for both healthy-healthy and patient-expert interactions. Dual-player was preferred by the majority of players independent of baseline ability and subject group; healthy subjects also felt more challenged, and patients more skilled. CONCLUSION: This is the first demonstration of implicit skill balancing in a truly collaborative virtual training task leading to heightened engagement, across both healthy subjects and stroke patients

SUPPORTING THERAPY-CENTERED GAME DESIGN FOR BRAIN INJURY REHABILITATION

Brain injuries (BI) are a major public health issue. Many therapists who work with patients who have had a BI include games to ameliorate boredom associated with repetitive rehabilitation. However, designing effective, appropriate, and engaging games for BI therapy is challenging. The challenge is especially manifested when considering how to consolidate the different mindsets and motivations among key stakeholders; i.e., game designers and therapists. In this dissertation, I investigated the ideation, creation, and evaluation of game design patterns and a design tool, GaPBIT (Game Design Patterns for BI Therapy) that leveraged patterns to support ideation of BI therapy game concepts and facilitate communication among designers and therapists. Design patterns, originated from the work of Christopher Alexander, provide a common design language in a specific field by documenting reusable design concepts that have successfully solved recurring problems. This investigation involved four overlapping phases. In Phase One, I interviewed 11 professional game designers focused on games for health (serious games embedded with health-related goals) to explore how they perceived and approached their work. In Phase Two, I identified 25 therapy-centered game design patterns through analyzing data about game use in BI therapy. Based on those patterns, in Phase Three I created and iterated the GaPBIT prototype through user studies. In Phase Four, I conducted quasi-experimental case studies to establish the efficacy and user experience of GaPBIT in game design workshops that involved both game designers and therapists. During the design workshops, the design patterns and GaPBIT supported exploration of game design ideas and effectively facilitated discussion among designers and therapists. The results also indicated that these tools were especially beneficial for novice game designers. This work significantly promotes game design for BI rehabilitation by providing designers and therapists with easier access to the information about requirements in rehabilitation games. Additionally, this work modeled a novel research methodology for investigating domains where balancing the role of designers and other stakeholders is particularly important. Through a “practitioner-centered” process, this work also provides an exemplar of investigating technologies that directly address the information needs of professional practitioners

Custom-designed motion-based games for older adults: a review of literature in human-computer interaction

Many older adults, particularly persons living in senior residences and care homes, lead sedentary lifestyles, which reduces their life expectancy. Motion-based video games encourage physical activity and might be an opportunity for these adults to remain active and engaged; however, research efforts in the field have frequently focused on younger audiences and little is known about the requirements and benefits of motion-based games for elderly players. In this paper, we present an overview of motion-based video games and other interactive technologies for older adults. First, we summarize existing approaches towards the definition of motion-based video games – often referred to as exergames – and suggest a categorization of motion-based applications into active video games, exergames, and augmented sports. Second, we use this scheme to classify case studies addressing design efforts particularly directed towards older adults. Third, we analyze these case studies with a focus on potential target audiences, benefits, challenges in their deployment, and future design opportunities to investigate whether motion-based video games can be applied to encourage physical activity among older adults. In this context, special attention is paid to evaluation routines and their implications regarding the deployment of such games in the daily lives of older adults. The results show that many case studies examine isolated aspects of motion-based game design for older adults, and despite the broad range of issues in motion-based interaction for older adults covered by the sum of all research projects, there appears to be a disconnect between laboratory-based research and the deployment of motion-based video games in the daily lives of senior citizens. Our literature review suggests that despite research results suggesting various benefits of motion-based play for older adults, most work in the field of game design for senior citizens has focused on the implementation of accessible user interfaces, and that little is known about the long-term deployment of video games for this audience, which is a crucial step if these games are to be implemented in activity programs of senior residences, care homes, or in therapy

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

Academic methods for usability evaluation of serious games: a systematic review

In the last years, there has been an increasing interest in the design of video games as a tool for education, training, health promotion, socialization, etc. Usability, which is a key factor in any video game, becomes even more important in these so-called Bserious games^, where the users’ special characteristics should be considered, and the game efficacy depends on the users’ adherence and engagement. However, evaluation of the usability of this kind of games requires a redefinition of techniques, methods and even terminology. In this paper, we elicit six research questions and conduct a systematic review of the scientific literature, which resulted in the selection of 187 papers that contained the most relevant responses. The conclusions of this systematic review illustrate the general status of current academic usability evaluations of these games and the main trends in the selection of methodologies and how are they applied. This view may be a very valuable foundation for future researchMinisterio de Ciencia e Innovación PROCUR@-IPT-2011-1038-90000