Design and implementation of an integrative system for configurable exergames targeting the senior population

Exergames have been proposed as a solution for the promotion of physical activity in the senior population. The diversity of needs and limitations of the target users demand that the exergaming systems allow the configuration and adjustment of game parameters according to each user profile. Such systems are ideal to use in nursing homes, senior gymnasiums, or even rehabilitation centers. Health and sports professionals are then the main interacting users with the interface of such exergaming systems. Configuration can be difficult and time-consuming when considering complex systems with a significant amount of parameter choices. Since professionals working on such places already have time constraints, if they face long-time configuration of these systems they might give up of using them. Therefore, there is an evident need for systems that assist professionals in two ways. First, providing management support for training sessions and plans with exergames. Second, providing automatic decision-making processes that assist in game selection and parameters configuration to fit the user needs. The acceptance and effectiveness of such systems can only be achieved if the main prospective interactors with the system are involved in the development process so that the system can fulfill the users’ needs and expectations. This thesis reports on the design, implementation, and usability evaluation of an integrative system using some of the most-known human-centric techniques, such as interviews, card sorting, and paper prototyping. Results of a usability study of the UI and the main functionalities of the system showed a considerable acceptance and interest by the professionals. The usability study revealed to be a great resource to find aspects of the system that should be further considered for improvement in future iterations. Furthermore, the high results of the USE (Usefulness, Satisfaction, and Ease of use) questionnaire confirm that this system is a promising tool that sports professionals may be willing to use in their daily practice.A literatura suporta que os exergames, ou jogos que requerem exercício físico, constituem uma opção válida para promoção da atividade física na população idosa. A diversidade de necessidades e limitações do público-alvo exige que estes exergames sejam configuráveis de forma a permitir ajustar os parâmetros do jogo de acordo com o perfil de cada indivíduo. Estes sistemas personalizáveis são ideais para a utilização em lares, centros de dia, ginásios específicos para idosos ou até mesmo em centros de reabilitação. Os profissionais de saúde e de desporto são, assim, os principais utilizadores a definir as configurações destes exergames. Neste contexto, escolher as definições ideais para cada perfil pode ser um processo difícil e demorado, tendo em conta que a interface destes sistemas apresenta normalmente uma quantidade significativa de opções. Considerando que estes profissionais já têm constrangimentos de tempo na sua prática diária, se forem confrontados com uma interação longa e complexa com estes sistemas, podem acabar por desistir de usá-los. Neste sentido, existe uma clara necessidade de sistemas que auxiliem os profissionais a incluir os exergames na sua prática diária com a população idosa. Este sistema deverá assistir os profissionais de duas maneiras. Primeiro, que permita gerir sessões e planos de treino com os exergames. Segundo, que disponibilize processos de decisão automáticos de forma a auxiliar na escolha dos jogos, bem como nas configurações ideais para cada perfil de utilizador. A aceitação e a eficácia destes sistemas podem apenas ser alcançadas se os profissionais forem envolvidos no processo de desenvolvimento desde o início. Tal permitirá que este possa ser desenhado tendo em conta as suas necessidades e expectativas. Esta dissertação descreve as técnicas aplicadas no desenho, implementação e avaliação de um sistema integrativo para exergames, com base em algumas técnicas bem conhecidas na área de interação homemmáquina, como por exemplo entrevistas, card sorting e prototipagem em papel. Resultados de um estudo de usabilidade da interface do sistema integrativo demonstraram uma considerável aceitação e interesse por parte dos profissionais. O estudo de usabilidade revelou ser um bom recurso para encontrar aspetos do sistema que devem ser considerados para melhoramento em futuras iterações. Além disso, os resultados promissores do questionário USE (Utilidade, satisfação e facilidade de uso) confirmam que os profissionais poderão estar interessados em usar este sistema na sua prática diária

Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

Background: There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description and discussion of different game technologies, physical functions targeted, and safety issues related to older adults playing exergames. Objectives: This integrative review provides an overview of the technologies and games used, progression, safety measurements and associated adverse events, adherence to exergaming, outcome measures used, and their effect on physical function. Methods: We undertook systematic searches of SCOPUS and PubMed databases. Key search terms included “game”, “exercise”, and “aged”, and were adapted to each database. To be included, studies had to involve older adults aged 65 years or above, have a pre-post training or intervention design, include ICT-implemented games with weight-bearing exercises, and have outcome measures that included physical activity variables and/or clinical tests of physical function. Results: Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and intervention designs and mostly focused on community-dwelling healthy older adults. The majority of the studies used commercially available gaming technologies that targeted a number of different physical functions. Most studies reported that they had used some form of safety measure during intervention. None of the studies reported serious adverse events. However, only 21 studies (35%) reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical measures of balance were the most frequently used outcome measures. PEDro scores indicated that most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out of 10. Several studies found positive effects of exergaming on balance and gait, while none reported negative effects. Conclusion: Exergames show promise as an intervention to improve physical function in older adults, with few reported adverse events. As there is large variability between studies in terms of intervention protocols and outcome measures, as well as several methodological limitations, recommendations for both practice and further research are provided in order to successfully establish exergames as an exercise and rehabilitation tool for older adults.© 2015 Elsevier Ireland Ltd. All rights reserved. This is the authors' accepted and refereed manuscript to the article. Locked until januar 2017-01-01 due to the copyright restrictions

Videojogos 2019: 11th International Conference on Videogames Sciences and Arts: book of abstracts

Videojogos is an annual conference on videogame sciences and arts, promoted by the Portuguese Society of Video Games Sciences (SPCV). Since its first edition, in 2009, the conference has been promoting the scientific gathering of researchers and professionals in the expanded field of videogames. As in the first edition, Aveiro once again holds the conference. The 11th Conference on Videogame Sciences and Arts – Videojogos 2019 takes place in the University of Aveiro, Portugal, during November 27-29. The event is co-organized by the Department of Communication and Art of the University of Aveiro (DeCA), DeCA’s DigiMedia Research Center and the Portuguese Society of Video Games Sciences (SPCV). This year, 10 years after the first conference, SPCV and the co-organizers decided to convert the conference into a full international event, with English as a working language. As one of the outcomes of this decision, the proceedings of Videojogos 2019 will be published by Springer in their “Communications in Computer and Information Science” (CCIS) book series, part of a post-conference volume with the number 1164. This Book of Abstracts is more than a shortened version of the proceedings. Besides abstracts from the 20 selected papers that will be published in the book series, it contains abstracts from the research posters (8) and videogame demos (9) accepted for the conference, as well synopsis for other activities held at the conference such as keynotes (2) and workshops (3). Thanks to UA Editora, we were able to present this book in time for the conference, providing an overview into the diversity of contributions gathered in the videogame context. We would like to thank the scientific board for their contribution to guarantee and deliver the highest scientific quality, allowing the outstanding relevance of this selection. We also would like to thank the program chairs (demo, poster and workshops) and the organization team for all their concerns and efforts in the organization, an extremely important contribution for the overall success of the Videojogos 2019 Conference. Finally, a note of appreciation to the American Corner of the University of Aveiro, which provided essential logistical support, namely by ensuring the presence of Professor Ernest Adams as Keynote Speaker and to the University of Aveiro publisher, UA Editora, for their support and collaboration in this publication.publishe

E-health for active ageing : a systematic review

Enabling successful active ageing is an international priority to meet the challenges of increasing life expectancy. Digital strategies, such as telemedicine and e-health, offer the potential to deliver active ageing in a cost-effective manner at scale. This article aims to establish the extent to which the research literature considers e-health-based and telemedicine-based active ageing interventions. A systematic review was conducted according to PRISMA standards. Independently, two authors searched the Cochrane, EMBASE & CINAHL databases, with subsequent independent extraction and semi-quantitative analysis. We report a considerable breadth in digital active ageing research, which is truly international in its scope. There is a diverse range of both interventions and technologies, including a reassuring focus on community-based interventions. Whilst there are a number of quantitative studies, sample sizes are small, with a limited amount of statistical testing of the results. There is significant variation in the outcome measures reported and little consensus as to the most effective intervention strategies. Overall, whilst there is considerable breadth to the research published in the literature, there is a clear restriction in the depth of this research. There is little overall consensus. This lack of depth and consensus may be due to the need to recognize the important role of technical research elements alongside more traditional research methodologies, such as randomized controlled trials. Enabling both technical and clinical research methods to be recognized, in tandem, has enormous potential to support individuals, communities, clinicians and policy makers to make more informed decisions in relation to active ageing

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

Development of novel data representations for virtual reality exergames

Being physically active is important to people of all ages for supporting health and wellbeing. Engaging in regular physical activity has been shown to foster growth and development, improve physical and cognitive functions, relieve mental stress and depression, and reduce the risks of developing chronic diseases [1, 2, 3]. However, participation in physical activity can be low, especially among older adults living with dementia (OAwD), due to lack of motivation, safety and cost concerns, physical and cognitive limitations, and poor access to appropriate exercise opportunities [4, 5]. In addition to providing sustainable motivations in promoting physical activity engagement, virtual reality (VR) exergames have the potential to collect quantified, objective, and complementary information about the exergaming sessions through the use of motion-based technologies. While several studies have shown the potential of VR exergames as complementary interventions for exercise therapy in clinical practice, there has been limited research exploring how VR exergames can be used as tools to manage and administer exercise programs using the information collected in exergaming sessions. This research explores metrics related to the performance of a person and creates data visualizations for the information collected through Exerfarm Valley, which is a head-mounted display virtual reality (HMD-VR)exergames system developed in part through this thesis work. The data visualizations resulting from this thesis research are intended to be used by exercise professionals in evaluating the client's performance during an exercise program and manage exercise therapy. The identified metrics for representing the player's performance during exergaming sessions could be applied to other exergames, potentially providing useful information about the client's status and exergaming sessions to exercise professionals. To the author's knowledge, this research represents the first data visualisations to be created for HMD-VR exergames through multi-disciplinary collaboration using user-centered design methods

Gamificação e cicloturismo sénior : design de uma app para a comunidade miOne

As the aging population continues to grow, there has been an increasing interest in the subject of gerontechnology. In the specific case of the digital game industry, senior citizens are becoming better consumers due to their purchasing power and free time, so it is important to focus on the role of games to their wellbeing and meet their needs and preferences. However, there is a general lack of information and products that address physical exercise in the interrelationship of cycling, tourism, games, gamification and senior citizens. The aim of this research is to understand the way gamification interventions can motivate senior citizens to adhere to cyclo-tourism. This dissertation reports on the use of the Development Research Method, deploying a broad array of methods, including focus groups, eye-tracking and interviews. A total of 46 participants (7 focus group participants, 8 participants in eye-tracking and 31 cyclists’ interviewees) were involved in this research. Based on the literature review, related work and the insights from each method, a cyclo-tourism digital app entitled Jizo was co-designed and prototyped. Findings indicate that certain gamification techniques and elements can trigger senior citizens’ motivations towards cyclo-tourism, being essential integrative parts of a digital app in this context. The elements highlighted were social relationships, progression, challenges, competition, feedback and rewards, having an important role in pre-, in loco and post- experience. These data support the view on gamification capability to motivate senior cyclo-tourism.Com o contínuo crescimento do envelhecimento da população, tem havido um interesse progressivo na área da gerontecnologia. No caso específico da indústria dos jogos digitais, os cidadãos seniores fazem parte de um grupo de consumidores com poder de compra e tempo livre, pelo que é essencial compreender o papel dos jogos digitais no seu bem-estar e atender às suas necessidades e preferências. No entanto, continua a prevalecer uma falta de informação e de produtos que abordam o exercício físico nas inter-relações entre o ciclismo, turismo, jogos, gamificação e cidadãos seniores. O objetivo desta investigação é compreender o uso de estratégias de gamificação para motivar os cidadãos seniores a aderirem ao cicloturismo. Esta dissertação reporta a utilização do Método de Investigação de Desenvolvimento, tendo como base os seguintes métodos: grupos de discussão, eye-tracking e entrevistas. Um total de 46 participantes (7 participantes de grupos de discussão, 8 participantes de eye-tracking e 31 ciclistas entrevistados) foram envolvidos nesta investigação. Após a revisão da literatura, trabalho relacionado, e os resultados obtidos de cada método, procedeu-se ao co-design e prototipagem uma app de cicloturismo designada Jizo. Os resultados indicam que certas técnicas e elementos da gamificação podem desencadear as motivações dos cidadãos seniores para o cicloturismo, além de serem partes essenciais e integrantes de um aplicativo deste contexto. Os elementos destacados foram as relações sociais, progressão, desafios, competição, feedback e recompensas, na medida em que eles têm um papel importante na pré, in loco e na pós-experiência. Estes dados suportam a ideia da capacidade da gamificação para motivar o cicloturismo sénior.Mestrado em Comunicação Multimédi

A scoping review of augmented/virtual reality health and wellbeing Interventions for older adults: redefining Immersive virtual reality

Augmented and virtual reality (AR/VR) technologies are regularly used in psychology research to complement psychological interventions and to enable an individual to feel as if they are in an environment other than that of their immediate surroundings. A scoping review was performed to identify how AR/VR was being used with older adult populations to impact their physical and mental health. The review also sought to determine whether the terminology used in AR/VR research was consistent. The results show that 65 studies have been published in the last 20 years that meet the inclusion criteria (virtual/augmented reality) technology to impact older adults’ physical/mental health and wellbeing. Participants included healthy, physically, and cognitively impaired, and emotionally vulnerable older adults. We argue that over 70% of the studies included in this review were mislabeled as VR and only six papers included fully immersive VR/AR. The remaining studies use less immersive variants of virtual reality with their populations, and only one study made use of AR, which prompted the suggestion of a new definition for virtual reality. This paper also calls for an updated taxonomy of augmented and virtual reality definitions to address the lack of consistency found in studies that identify themselves as AR/VR when they are using less immersive technical set-ups, including displaying non-interactive videos on 2D screens