Closing the loop in exergaming - Health benefits of biocybernetic adaptation in senior adults

Exergames help senior players to get physically active by promoting fun and enjoyment while exercising. However, most exergames are not designed to produce recommended levels of exercise that elicit adequate physical responses for optimal training in the aged population. In this project, we developed physiological computing technologies to overcome this issue by making real-time adaptations in a custom exergame based on recommendations for targeted heart rate (HR) levels. This biocybernetic adaptation was evaluated against conventional cardiorespiratory training in a group of active senior adults through a floor-projected exergame and a smartwatch to record HR data. Results showed that the physiologically-augmented exergame leads players to exert around 40% more time in the recommended HR levels, compared to the conventional training, avoiding over exercising and maintaining good enjoyment levels. Finally, we made available our biocybernetic adaptation software tool to enable the creation of physiological adaptive videogames, permitting the replication of our study.info:eu-repo/semantics/publishedVersio

Who's Watching Me?: Exploring the Impact of Audience Familiarity on Player Performance, Experience, and Exertion in Virtual Reality Exergames

Familiarity with audiences plays a significant role in shaping individual performance and experience across various activities in everyday life. This study delves into the impact of familiarity with non-playable character (NPC) audiences on player performance and experience in virtual reality (VR) exergames. By manipulating of NPC appearance (face and body shape) and voice familiarity, we explored their effect on game performance, experience, and exertion. The findings reveal that familiar NPC audiences have a positive impact on performance, creating a more enjoyable gaming experience, and leading players to perceive less exertion. Moreover, individuals with higher levels of self-consciousness exhibit heightened sensitivity to the familiarity with NPC audiences. Our results shed light on the role of familiar NPC audiences in enhancing player experiences and provide insights for designing more engaging and personalized VR exergame environments.Comment: 10 pages, 5 figures, IEEE International Symposium on Mixed and Augmented Reality (ISMAR) 202

Wearable Computing for Health and Fitness: Exploring the Relationship between Data and Human Behaviour

Health and fitness wearable technology has recently advanced, making it easier for an individual to monitor their behaviours. Previously self generated data interacts with the user to motivate positive behaviour change, but issues arise when relating this to long term mention of wearable devices. Previous studies within this area are discussed. We also consider a new approach where data is used to support instead of motivate, through monitoring and logging to encourage reflection. Based on issues highlighted, we then make recommendations on the direction in which future work could be most beneficial

Serious Gaming for Behaviour Change: A Systematic Review

Over the years, there has been a significant increase in the adoption of game-based interventions for behaviour change associated with many fields such as health, education, and psychology. This is due to the significance of the players’ intrinsic motivation that is naturally generated to play games and the substantial impact they can have on players. Many review papers measure the effectiveness of the use of gaming on changing behaviours; however, these studies neglect the game features involved in the game design process, which have an impact of stimulating behaviour change. Therefore, this paper aimed to identify game design mechanics and features that are reported to commonly influence behaviour change during and/or after the interventions. This paper identified key theories of behaviour change that inform the game design process, providing insights that can be adopted by game designers for informing considerations on the use of game features for moderating behaviour in their own games

Sustainable Technology and Elderly Life

The coming years will see an exponential increase in the proportion of elderly people in our society. This accelerated growth brings with it major challenges in relation to the sustainability of the system. There are different aspects where these changes will have a special incidence: health systems and their monitoring; the development of a framework in which the elderly can develop their daily lives satisfactorily; and in the design of intelligent cities adapted to the future sociodemographic profile. The discussion of the challenges faced, together with the current technological evolution, can show possible ways of meeting the challenges. There are different aspects where these changes will have a special incidence: health systems and their monitoring; the development of a framework in which the elderly can develop their daily lives satisfactorily; and in the design of intelligent cities adapted to the future sociodemographic profile. This special issue discusses various ways in which sustainable technologies can be applied to improve the lives of the elderly. Six articles on the subject are featured in this volume. From a systematic review of the literature to the development of gamification and health improvement projects. The articles present suggestive proposals for the improvement of the lives of the elderly. The volume is a resource of interest for the scientific community, since it shows different research gaps in the current state of the art. But it is also a document that can help social policy makers and people working in this domain to planning successful projects

Improving personalized elderly care: an approach using cognitive agents to better assist elderly people

Tesis por compendio de publicaciones[ES]El envejecimiento de la población a nivel global es una constante cada vez más presente en el día a día y las consecuencias derivadas de este problema son cada vez más impactantes para el correcto funcionamiento y estructuración de la sociedad. En este contexto, hablamos de consecuencias a nivel de crecimiento económico, estilos de vida (y jubilación), relaciones familiares, recursos disponibles por el gobierno a la franja etaria más anciana e inevitablemente la prevalencia de enfermedades crónicas. Es ante esta realidad que surge la necesidad de desarrollo y promoción de estrategias eficaces en el acompañamiento, prevención y estímulo al envejecimiento activo y saludable de la población para garantizar que las personas ancianas continúen teniendo un papel relevante en la sociedad en lugar de someterse al aislamiento y fácil deterioro de las capacidades físicas, cognitivas, emocionales y sociales. De esta forma, tiene todo el sentido aprovechar todos los desarrollos tecnológicos verificados en los últimos años, principalmente en lo que se refiere a avances en las áreas de dispositivos móviles, inteligencia artificial y sistemas de monitoreo y crear soluciones capaces de brindar apoyo diariamente al recopilar datos e indicadores del estado de salud y, en respuesta, proporcionar diversas acciones personalizadas que motiven la adopción de mejores hábitos de salud y medios para lograr este envejecimiento activo y saludable. El desafío consiste en motivar a esta población a conciliar su día a día con el interés y la voluntad de utilizar aplicaciones y sistemas que brinden este apoyo personalizado. Algunas de las abordajes recientemente explorados en la literatura con este objetivo y que han alcanzado resultados prometedores se basan en la utilización de técnicas de gamificación e incentivo al cumplimiento de desafíos a nivel de salud (como si la persona estuviera jugando un juego) y la utilización de interacciones personalizadas con objetos (ya sean físicos como robots o virtuales como avatares) capaces de brindar feedback más personal, creando así una conexión más cercana entre ambas entidades. El trabajo aquí presentado combina estas ideas y resulta en un enfoque inteligente para la promoción del bienestar de la población anciana a través de un sistema de cuidados de salud personalizado. Este sistema incorpora diversas técnicas de gamificación para la promoción de mejores hábitos y comportamientos, y la utilización de un asistente virtual cognitivo capaz de entender las necesidades e intereses del usuario para posibilitar un feedback e interacción personalizados con el fin de ayudar y motivar al cumplimiento de los diferentes desafíos y objetivos que se identifiquen. El enfoque propuesto fue validado a través de un estudio con 12 usuarios ancianos y se lograron resultados significativos en términos de usabilidad, aceptación y efectos de salud. Específicamente, los resultados obtenidos permiten respaldar la importancia y el efecto positivo de combinar técnicas de gamificación e interacción con un asistente virtual cognitivo que traduzca el progreso del estado de salud del usuario, ya que se lograron mejoras significativas en los resultados de salud después de la intervención. Además, los resultados de usabilidad obtenidos mediante la cumplimentación de un cuestionario de usabilidad confirmaron la buena adhesión a el enfoque presentado. Estos resultados validan la hipótesis de la investigación estudiada en el desarrollo de esta disertación

Towards Balancing Fun and Exertion in Exergames: Exploring the Impact of Movement-Based Controller Devices, Exercise Concepts, Game Adaptivity and Player Modes on Player Experience and Training Intensity in Different Exergame Settings

Physical inactivity remains one of the biggest societal challenges of the 21st century. The gaming industry and the fitness sector have responded to this alarming fact by introducing game-based or gamified training scenarios and thus established the promising trend of exergaming. Exergames – games controlled by active (whole) body movements – have been extolled as potential attractive and effective training tools. However, the majority of the exergames do not meet the required intensity or effectiveness, nor do they induce the intended training adherence or long-term motivation. One reason for this is that the evaluated exergames were often not co-designed with the user group to meet their specific needs and preferences, nor were they co-designed with an interdisciplinary expert team of game designers (to ensure a good gaming experience) and sports scientists (for a great training experience). Accordingly, the research results from studies with these exergames are rather limited. To fully exploit the potential of these innovative movement tools and to establish them as attractive and effective training approach, it is necessary to understand and explore both the underlying interdisciplinary theories and concepts as well as possible design approaches and their impact on the game and training experience. This dissertation aims to contribute to a better understanding of well-balanced exergame design. It explores and evaluates how different movement-based control devices, exercise concepts, game adaptations, and player modes influence the attractiveness and effectiveness of exergames. The work provides theoretical and practical contributions to the problem area of effective and attractive exergames. For this purpose, a research and development (R&D) approach with iterative phases was followed. As preliminary work for the contributions of this dissertation, exergames were approached from a theoretical perspective. Underlying multidisciplinary theories and concepts of exergames from relevant fields were analyzed and a generic framework was built, which structured the findings based on three interdependent dimensions: the player, the game controller, and the virtual game scenario. Some commercially available exergames were explored to verify the theory-based assumption that the interposition of technology brings specific transformations in the coupling of perception and action that do not occur in real sports situations. Among other things, the comparative pilot study showed that two different controllers (one gesture-based and one haptic device), which allowed for different physical input, were likely to induce diverse gameplay experiences (e.g., higher feeling of flow and self-location when playing with the haptic device) with differently skilled players. However, certain design-specific differences in the two exergame conditions meant that these results could only be interpreted as a first trend. To overcome the limitations of this preliminary study approach (e.g., unequal game design of the commercial exergames and very sports-specific movement concept), Plunder Planet, an adaptive exergame environment, was iteratively designed with and for children and allowed for a single- and cooperative multiplayer experience with two different controller devices. The user-centered design was further informed by insights from the growing body of related R&D work in the field of exergames. The first study presented in this dissertation compared the subjectively experienced attractiveness and effectiveness of Plunder Planet when played with different motion-based controllers. Besides a generally great acceptance of the exergame, it was found that the haptic full-body motion controller provided physical guidance and a more cognitively and coordinatively challenging workout, which was more highly rated by experienced gamers with fewer athletic skills. The gesture-based Kinect sensor felt more natural, allowed more freedom of movement, and provided a rather physically intense but cognitively less challenging workout, which was more highly rated by athletic players with less gameplay experience. Furthermore, experiments were made with an exploratory adaptive algorithm that enabled the cognitive and the physical challenge of the exergame to be manually adapted in real-time based on the player’s fitness and gaming skills. The first and the second study also compared an adaptive with a non-adaptive single player version of Plunder Planet. It could be shown that the (well-balanced) adaptive version of the exergame was better valued than the non-adaptive version with regard to the experienced and measured attractiveness (motivation, game flow, spatial presence experience, balance of cognitive and physical challenge) and effectiveness (heart rate, physical exertion, balance of cognitive and physical challenge) by differently skilled players. Finally, and contrary to the findings from related work, the results of the third study proved that the specifically designed controller technology could be used as an “enabler”, “supporter” and “shaper” of bodily interplay in social exergaming. Based on these promising findings, the goal became to further explore the effectiveness of exergames, refine the adaptive game difficulty algorithm, and explore further attractiveness- and motivation-boosting design approaches. Therefore, the ExerCube, a physically immersive and adaptive fitness game setting, was developed. It was iteratively designed with and for adults and allowed for cooperatively and competitive exergame experiences. With its physically immersive game setup, the ExerCube combines a mixed version of the advantages of both previously tested controllers. A coordinatively and cognitively challenging functional workout protocol with scalable intensity (moderate to high) was developed and the subjective experience of the ExerCube training was compared with a conventional functional training with a personal trainer. The fourth study showed that the game-based training gave signs of reaching a similar intensity to the personal training, but was more highly rated for flow, motivation, and enjoyment. Based on this exploratory comparison of the ExerCube with a personal trainer session, valuable avenues for further design could be identified. Among other things, it could be proved that the player’s focus during the ExerCube session was more on the game than on the own body. Players experienced stronger physical exertion and social pressure with the personal trainer and a stronger cognitive exertion and involvement with the ExerCube. Furthermore, a refined version of the previously tested adaptive game difficulty algorithm was implemented and automated for the first time for purpose of this study. Again it was shown that the adaptive version had benefits with regard to subjectively experienced attractiveness (motivation, game flow, balance of cognitive and physical challenge) and effectiveness (physical exertion, balance of cognitive and physical challenge) compared to the non-adaptive version. In order to further enhance the gaming experience, experiments were also conducted with sound designs and an adaptive audio design with adaptive background music and sound feedback was implemented. It was found to be a promising and beneficial add-on for a user-centered attractive exergame design. To inform the design of a multiplayer version of the ExerCube, different social play mechanics were explored in the fifth study. This resulted in differently balanced experiences of fun, and in physical as well as cognitive exertion. As the preliminary comparative evaluation of the subjectively experienced effectiveness and attractiveness of an ExerCube session and a personal trainer session could prove the general feasibility of the concept and revealed the first indications of the intensity of the ExerCube’s training concept, the objectively measured effectiveness of a single ExerCube session with a functional high-intensity interval training (fHIIT) with a personal trainer was compared in a final sixth study, and after another design iteration. Again, the subjectively experienced attractiveness of both conditions was assessed. It could be shown that the ExerCube is a feasible training device for training at fHIIT-level. While physical exertion was slightly lower than in the conventional fHIIT condition, the ExerCube condition’s average heart rate values reached the fHIIT threshold and also yielded significantly better results for flow, enjoyment, and motivation. The ExerCube training also resulted in a subjectively experienced higher cognitive load (dual-domain training). To sum up, it can be stated that this dissertation provides valuable and fundamental research contributions to the promising field of exergames as attractive and effective training tools. Furthermore, important contributions to design questions in this field could be developed. Since this field is still relatively unexplored, the work presented creates a sound basis for future R&D work in this area

Digital Human Representations for Health Behavior Change: A Structured Literature Review

Organizations have increasingly begun using digital human representations (DHRs), such as avatars and embodied agents, to deliver health behavior change interventions (BCIs) that target modifiable risk factors in the smoking, nutrition, alcohol overconsumption, and physical inactivity (SNAP) domain. We conducted a structured literature review of 60 papers from the computing, health, and psychology literatures to investigate how DHRs’ social design affects whether BCIs succeed. Specifically, we analyzed how differences in social cues that DHRs use affect user psychology and how this can support or hinder different intervention functions. Building on established frameworks from the human-computer interaction and BCI literatures, we structure extant knowledge that can guide efforts to design future DHR-delivered BCIs. We conclude that we need more field studies to better understand the temporal dynamics and the mid-term and long-term effects of DHR social design on user perception and intervention outcomes