Usability and Acceptance of Exergames Using Different Types of Training among Older Hypertensive Patients in a Simulated Mixed Reality

Virtual and augmented reality (VR/AR) exergames are promising tools for increasing training motivation. However, the use of exergames with mixed reality (MR) headsets remains under-researched. Older adults with hypertension could also benefit from the increased training adherence associated with MR. Endurance and strength endurance exercises are recommended for this group to lower blood pressure. The aim of the preliminary study (n = 22) was to compare the usability and acceptance of two exergames, which represent two different training types-strength endurance training (SET) and endurance training (ET). The developed exergame prototypes were applied in "simulated MR" using a VR head-mounted display. We examined the following outcomes: usability (TUI), intention to use (TUI), subjective task load (NASA-TLX), frustration (NASA-TLX), and presence (PQ). The results showed that frustration was significantly greater in the ET than in the SET (p = 0.038). Presence was significantly higher in the SET (p = 0.002). No significant differences in usability and acceptance were found in the exergames. The results indicate that usability and acceptance are not related to the type of training when utilizing MR exergames. Whether the results are transferable with a real MR headset must be determined in further research

Acceptance and use of virtual reality games: an extension of HMSAM

Virtual reality (VR) is considered as one of the technological megatrends of 2020s, and today, VR systems are used in various settings, digital gaming being among the most popular ones. However, there has been a dearth of understanding regarding the central factors behind VR gaming acceptance and use. The present study therefore aimed to explain the factors that drive the use and acceptance of VR games. We extended the hedonic-motivation system acceptance model with utilitarian and inconvenience factors to capture the pertinent features of VR systems more holistically. We proposed a theoretical model and analyzed it through covariance-based structural equation modeling using an online survey sample of 473 VR gamers. Our findings help explain the role of different antecedents behind VR gaming acceptance and demonstrate that VR gaming is driven more by the hedonic gaming aspects than by the utilitarian health and well-being aspects of VR games, enjoyment being the strongest driver behind VR gaming intention and immersion. Moreover, findings also suggested that use intentions and immersion levels are not significantly diminished by physical discomfort and VR sickness. The findings, which potentially extend to other VR systems as well, also pose important implications for the providers of VR games. As the main contribution, based on our empirical findings, we provide a greater theoretical understanding on VR gaming acceptance and use

The potential of virtual reality (VR) and augmented reality (AR) to engage people with physical activity

Introduction: Sufficient physical activity (PA) reduces the risk of non-communicable diseases (NCDs) and improves physical and psychosocial health. The levels of PA in the UK and elsewhere in the world remain low for all age groups. Novel strategies for engaging people in PA are required to tackle the epidemic of inactivity. Virtual reality (VR) and augmented reality (AR) is computer-generated, interactive 3D environments that offer users unique immersive experiences of PA. / Aims: The aim of this mixed-methods, staged research project (vEngage) was to test the potential of VR and AR to engage people in PA. This work was a Medical Research Council (MRC) funded partnership between academic researchers (UCL, Coventry, and Anglia Ruskin Universities) and an industry partner ‘Six to Start’. / Methods: I surveyed and interviewed the users of the world’s most popular running app Zombies, Run! (ZR) (Studies 1 and 2). I then conducted a scoping review in a form of a qualitative analysis of game reviews on popular VR exercise games (exergames) and described positive and negative features, current players of VR exergames report, as important motivators for exergame playing (Study 3). In parallel, the vEngage team set up a steering committee of adolescents (13-17 years) and their parents and interviewed both groups about PA, VR, AR, and exergaming (Studies 4a and 4b). We used the results from these studies to inform our VR exergame intervention (a game called Walls - Study 5) which we developed together with expert games designers Six to Start. / Results: VR is a promising strategy for engaging adolescents in PA but barriers to use remain, including awareness, availability, affordability, and accessibility. The results showed people have a positive attitude to exergaming, with a preference for narratives (engaging story, role-play). This was particularly supported by both ZR studies, where the narrative was the most motivating factor for engagement in PA for all age groups. VR and AR exergaming can distract people from the negative aspects of performing PA such as pain or repetition. / Conclusions: This research project was the first VR study that used principles of co-design in creating a digital VR exergame intervention for adolescents, by engaging adolescents themselves in the exergame design. AR and VR exergaming has great potential to engage a wide range of people in PA and can be particularly useful as means for PA engagement in a time of world pandemics such as the recent Covid-19 pandemic, where gym and fitness facilities are not accessible for unspecified periods of time

User experience of mixed reality applications for healthy ageing : A systematic review

Mixed reality (MR) technologies are being used increasingly to support healthy ageing, but past reviews have concentrated on the efficacy of the technology. This systematic review provides a synthesis of recent experimental studies on the instrumental, emotional and non-instrumental aspects of user experience of healthy older adults in relation to MR-related applications. The review was listed on PROSPERO, utilised a modified PICOS framework, and canvassed all published work between January 2010 to July 2021 that appeared in major databases (Scopus, PubMed, CINAHL, Web of Science, and the Cochrane Library). The literature search revealed 15 eligible studies. Results indicated that all included studies measured the instrumental quality of their applications, all but two studies measured the emotional reactions triggered by gameplay, and only six studies examined participants’ perception of non-instrumental quality of the applications. All included studies focused on improving a health domain such as cognitive or physical training. This suggests that the instrumental quality of the MR applications remains the focus of user experience studies, with far fewer studies examining the non-instrumental quality of the applications. Implications for game design and future research are discussed

Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke

Spatial neglect is a common and severe cognitive consequence of stroke, yet there is currently no effective rehabilitation tool. Virtual Reality (VR) telerehabilitation tools have the potential to provide multisensory and enjoyable therapies and remotely monitor adherence without the presence of a therapist at all times. Researchers and industry need to better understand end-user perspectives about these technologies to ensure these are acceptable and, ultimately, optimize adherence and efficacy. This study aims to explore end-user perspectives on the use of self-administered VR for spatial neglect in a university environment to identify barriers and facilitators prior to extending its use remotely as a telerehabilitation tool. We used a mixed-method design including focus groups, self-administered questionnaires and interviews with stroke survivors (N = 7), their carers (N = 3) and stroke clinicians (N = 6). End-user perspectives identified clarity of instructions, equipment (cost, available resources) and for some, level of experience with technology as barriers of use. Perceived facilitators were performance feedback, engagement and enjoyment, and psychological benefits associated with self-administered VR telerehabilitation. Overall, end-users were positive and interested in using VR telerehabilitation for spatial neglect. These perspectives enabled us to produce practical recommendations to inform development, enhance engagement and uptake of VR telerehabilitation and inform future studies