Immersive Exergames Research Articles

Move, React, Repeat! The Role of Continuous Cues in Immersive Exergames

Immersive virtual reality (VR) exergames blend playful environments with physical activities. In such games, providing continuous cues, i.e., real-time indications of how the movements are being performed, can guide players and improve the execution of movements. However, research about how continuous cues impact player performance and experience in VR exergames remains sparse. To this end, we conducted a within-participants study (N=32) with four conditions: (i) no, (ii) audio, (iii) visual, and (iv) audiovisual cueing. The results show that both unimodal and bimodal cueing improve the player experience without causing cybersickness, while bimodal cueing improves pose accuracy. We provide three main design implications for VR exergames: (i) considering the granularity of cues, (ii) exploring different continuous cue designs, and (iii) underlining the use of continuous cues in other immersive experiences.

A systematic review of exergame usability as home-based balance training tool for older adults usability of exergames as home-based balance training.

Exergames are a fun, viable, attractive, and safe way to engage in physical exercise for most patient populations, including older adults. Their use in the home environment enables an expanded understanding about its applicability and its impact on clinical outcomes that can contribute to improved functionality and quality of life in this population. This systematic review aimed to synthesize the evidence on the usability of exergames as a tool for home-based balance training in older adults. The search was realized in 6 electronic databases and were included 1) randomized controlled trials with exergames home-based training as intervention, 2) studies involving older adults (aged 60 years or older) described as having impaired static or dynamic balance, 3) that compared the effects of exergames to usual care, health education or no intervention, and 4) reported usability and balance outcomes. The Cochrane Risk of Bias tool for randomized trials version 2 and the Grading of Recommendations Assessment, Development, and Evaluation were used to evaluate the methodological quality of studies and levels of evidence for outcomes. After screening 1107 records, we identified 4 trials were included. The usability score of exergames was classified as an acceptable, good, and feasible tool. The pooled effect indicated improvements in favor of the exergame group for functional balance by TUG test (MD = -5.90; 95%CI = -10.29 to -1.51) with low-certainty evidence and Tinetti scale (MD = 4.80; 95%CI = 3.36 to 6.24) with very low-certainty evidence. Analyzing the different immersion level, it was observed a significant difference in the experimental group for the immersive exergames (MD = -9.14; 95%CI = -15.51 to -2.77) with very low-certainty evidence. Exergames applied at home showed good usability and had significant effects on functional balance compared to usual care or no intervention, especially in the immersive modality. PROSPERO registration number: CRD42022343290.

Lessons Learned from a Human-Centered Design of an Immersive Exergame for People with Dementia

Cognitive-physical exercises can reduce the progression of dementia. However, traditional methods often induce problems (e.g., lack of motivation), whereas the success of recent virtual reality (VR) exergames such as Beat Saber may provide a playful, motivational, and immersive alternative. Yet, until now, it remains unclear which game mechanics, concepts, and designs work best for people with dementia, and how to implement exergames for and with this user group. In this paper, we adapted a human-centered design approach to address the specifics of developing VR exergames for people with dementia. This includes semi-structured interviews with stakeholders and contextual inquiries to better analyze the user requirements. Based on our analysis, we present Memory Journalist VR - a novel VR exergame specifically designed for people with dementia in a participatory design process. We report the qualitative evaluation based on the feedback gathered in five focus group sessions. Finally, we discuss the lessons learned, which provide important insights for the design of future VR exergames for people with dementia: (i) creating social gaming activities with a focus on shared aspects, (ii) support of an inverse game flow channel addressing decline and variance in cognitive-physical abilities, and (iii) ensuring a safe VR exergame experience.

Exergaming Executive Functions: An Immersive Virtual Reality-Based Cognitive Training for Adults Aged 50 and Older.

Prior research suggests that both exergaming and virtual reality (VR)-based training programs could improve executive functions in older adults. However, few studies investigated whether combining exergaming with VR would be more effective. This study seeks to (a) investigate whether playing exergames in an immersive virtual environment (IVE) would yield differential outcomes in selected executive functions, including inhibition, task switching, and working, and (b) examine the role of feeling of presence as a potential mediator between immersive exergaming and cognitive improvement in specific domains. Thirty-three participants over 50 years of age (mean age = 62) participated in a 4-week training program and were randomly assigned into an IVE and non-IVE to play an exergame (Fruit Ninja) for eight sessions within 4 weeks. The results revealed a significant effect of the IVE on the Stroop Test and Trail Making Test after the 4-week training. Furthermore, the impacts of the IVE exergaming on these two tasks were mediated by the feeling of presence. These findings suggested that the immersive experience of exergaming would elicit the feeling of presence, which later contributes to improved cognitive performances in inhibition and task switching. For the theoretical implications, this study extends previous research by showing that (a) feeling of presence could contribute to older adults' cognitive improvement, and (b) the impacts of immersive exergame training on executive functions vary across individual domains. Additionally, this study provides practical implications such that the design of exergames could emphasize the game features requiring mental simulation, which can serve as a novel strategy for preventing cognitive decline in midlife and old age.