Search Results (215)

Musculoskeletal disorders (MSDs) can significantly impact individuals’ quality of life (QoL), often requiring effective rehabilitation strategies to promote recovery. However, traditional rehabilitation methods can be expensive and may lack engagement, leading to poor adherence to therapy exercise routines. An exergame system can be a solution to this problem. In this paper, we investigate appropriate hand gestures for controlling video games in a rehabilitation exergame system. The Mediapipe Python library is adopted for the real-time recognition of gestures. We choose 10 easy gestures among 32 possible simple gestures. Then, we specify and compare the best and the second-best groups used to control the game. Comprehensive experiments are conducted with 16 students at Andalas University, Indonesia, to find appropriate gestures and evaluate user experiences of the system using the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). The results show that the hand gestures in the best group are more accessible than in the second-best group. The results suggest appropriate hand gestures for game controls and confirm the proposal’s validity. In future work, we plan to enhance the exergame system by integrating a diverse set of video games, while expanding its application to a broader and more diverse sample. We will also study other practical applications of the hand gesture control function. Full article

Background: The COVID-19 pandemic significantly reduced physical activity levels, particularly among older people, negatively impacting their postural balance and increasing the risk of falls and hip fractures. This study aims to assess the effect of a virtual reality-based exergame physical activity protocol at home on improving postural balance in older people. Materials and Methods: A quasi-experimental design was employed with 10 older people (71 ± 9 years) who participated in a virtual reality-based exergame physical activity protocol consisting of eighteen 25 min sessions conducted at home. The protocol incorporated 3D movement tracking using a sensor attached to the participants’ bodies to monitor postural sway in real time. Clinical measurements included the Timed Up and Go test and posturographic measures of center-of-pressure, including sway area, velocity, and standard deviation in the mediolateral and anteroposterior directions under four conditions: static with the eyes open and eyes closed and dynamic voluntary sway in the mediolateral direction following a 30 Hz metronome with the eyes open and eyes closed. Paired t-tests were used to compare pre- and post-intervention data. Results: The intervention led to significant improvements in postural balance as measured using both posturographic measures (p < 0.05) and the Timed Up and Go test (p = 0.04). Conclusion: The virtual reality-based exergame physical activity protocol conducted at home, comprising eighteen 25 min sessions, effectively improves postural balance in older people. Full article

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, characterised by cardinal motor features and a multitude of non-motor manifestations. Among them, cognitive impairment in PD has been recognised as a defined clinical entity, and it might lead to an increased risk of developing dementia. Consequently, the present review aimed to ascertain the available interventions for the training of cognitive abilities in persons with PD (PwPD). Methods: PRISMA guidelines were followed to select studies in the following databases: PubMed, PsycINFO, and Web of Science. Two independent reviewers conducted the different phases of the review, and a third expert was called in to address any doubts/conflicts. Randomised controlled trials and randomised clinical trials concerning cognitive training with cognitive outcomes in PwPD were selected. Results: A total of 28 articles were included. The considered studies applied various experimental interventions for the training of cognitive functions in PwPD: computer-based platforms, exergames, paper-and-pencil programmes, dual-task or treadmill training with action observation therapy, motor imagery, and virtual reality components, interventions targeting precise cognitive domain, tele-rehabilitation, transcranial direct current stimulation, structured cognitive training, and multimodal treatments. Cognitive functions were assessed employing neuropsychological tests, self-report questionnaires, and computerised batteries. Conclusions: Overall, the review reported better performances in the experimental groups compared to the control groups, in several cognitive domains. Structured cognitive training emerged as the most effective strategy to enhance cognitive functioning in PwPD. However, further studies are necessary to determine the most appropriate and useful training and to develop interventions that also consider patients’ quality of life. Full article

Virtual reality (VR) sports games are increasingly becoming important tools for enhancing cognitive and physical health among older adults. However, current research faces several challenges. Many experimental studies utilize existing games designed for general populations, lacking those specifically tailored for older adults; small sample sizes limit the generalizability of results; and issues such as cybersickness and technology adaptability remain challenges, although progress has been made. This literature review employs the PRISMA method to assess the latest research findings on the impact of VR sports games in improving cognitive and physical functions in older adults. We conducted a search in the Web of Science and SCOPUS databases, selecting literature related to VR interventions for balance, muscle strength, memory, and concentration enhancement. From an initial pool of 1705 articles, 12 studies met the inclusion criteria. Results indicate that VR sports games significantly enhance older adults’ exercise motivation through immersive experiences, while real-time feedback promotes the simultaneous improvement of cognitive and physical abilities. Furthermore, the social interaction elements within the VR environment effectively alleviate feelings of loneliness and enhance engagement longevity. Future research should focus on developing personalized and collaborative VR game designs and exploring their applications in home rehabilitation and community care to enhance accessibility and long-term effects. This review provides theoretical and practical support for the innovative application of VR technology in promoting healthy aging. It will benefit technology developers and researchers focused on the cognitive and physical health of older adults. Full article

This article aims to make a scoping review of Validating Questionnaires used in the field of lower limb (LL) rehabilitation in which systems, devices or exergames are used. Its main objective is to provide a more comprehensive understanding of the results obtained in the validation of questionnaires, as well as to identify specific criteria for evaluating systems, devices or exergames in the area of LL rehabilitation, through the analysis of validating instruments and their application in different associated contexts. The article details the methodology employed, a PRISMA ScR method review which included database research and an evaluation of the selected studies. Inclusion and exclusion criteria were applied to select all relevant studies, resulting in 81 studies after initial review based on titles and abstracts. Subsequently, the criteria were again applied to read the full text, resulting in 58 final studies. The document distinguishes between standardized and non-standardized validating questionnaires, emphasizing that standardized validating questionnaires have undergone rigorous statistical processes to ensure their validity, reliability and consistency. The information compiled in the tables provides a solid basis for identifying and evaluating validation questionnaires in the above-mentioned context. This resource constitutes an accurate and reliable reference for selecting the most appropriate instruments for future research and comparisons with similar work. This article is a valuable resource for those interested in the validation of questionnaires used in the field of lower limb rehabilitation systems/devices/exergames. Full article

Objectives: This systematic review with meta-analysis aimed to evaluate the available body of published peer-reviewed studies on the effects of exergaming (EXG) compared to the control group (CG) on morphological variables, biochemical parameters, and blood pressure in children and adolescents with overweight/obesity. Methods: A systematic literature search was conducted until September 2024 using five databases: PubMed, Medline, CINAHL Complete, Scopus, and Web of Science. PRISMA, TESTEX, RoB 2, and GRADE tools assessed the methodological quality and certainty of evidence. Hedge’s g effect sizes (ES) for morphological, biochemical, and blood pressure variables were calculated for meta-analyses. Using a random effects model, potential sources of heterogeneity were selected, including subgroup analyses (age) and single training factor analysis (program duration, training frequency). The protocol was registered in PROSPERO (code: CRD42024626992). Results: Out of 72 records, 6 randomized controlled trials with 191 children and adolescents with overweight/obesity were included. Nine meta-analyses were performed, showing significant decreases in body mass index (p = 0.04), waist circumference (p = 0.03), and systolic blood pressure (p = 0.007). However, no significant improvements were observed in diastolic blood pressure, body fat percentage, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and glucose. Subgroup analyses showed significant decreases in total cholesterol (<15 years, ES = 0.56; p = 0.006), HDL-cholesterol (<15 years, ES = 0.51; p = 0.01), LDL-cholesterol (<15 years, ES = 0.63; p = 0.01), and triglycerides (<15 years, ES = 0.82; p = 0.000). In training duration, only significant decreases in total cholesterol (ES = 0.69; p = 0.02) were presented in favor of <12 weeks vs. ≥12 weeks. While in training frequency only significant decreases in triglycerides (ES = 0.70; p = 0.03) were reported in favor of ≥3 sessions per week vs. <3 sessions per week. Conclusions: EXG significantly decreases body mass index, waist circumference, and systolic blood pressure in children and adolescents with overweight/obesity. Full article

This work presents the design of a new game controller device and the development of two exergames (Peter Jumper and Andromeda) for upper limb rehabilitation. The eJamar controller is a novel electromechanical device designed to measure wrist and hand movements, such as pronation/supination, flexion/extension, and ulnar/radial deviation, enabling users to perform control actions in the exergames. One of eJamar’s most significant features is its ability to measure hand grip strength, a function not available in commercial gaming controllers. The exergame Peter Jumper involves a character jumping over obstacles in various environments, promoting hand grip exercises. The exergame Andromeda involves shooting enemy ships, promoting coordination between hand movements and grip strength, making it suitable for different rehabilitation techniques. A testing protocol was applied with eight healthy participants (5F and 3M), who completed a survey evaluating gameplay, usability, and satisfaction of the system. The results demonstrated that the developed exergames are intuitive and easy to play, with participants reporting that a therapist’s presence is not required for gameplay. Hence, it suggests that the developed system can improve the rehabilitation process, promoting wrist–arm movements and grasping actions. Full article

Background/Objectives: Cancer patients undergoing chemotherapy often face challenges that reduce their physical function and quality of life. Technological resources offer innovative solutions for physical rehabilitation, but the extent of their application in this context remains unclear. This scoping review aims to explore and map the various technological tools used to support physical rehabilitation in cancer patients during chemotherapy, focusing on their potential to improve outcomes and enhance patient care. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines and the PRISMA-ScR framework. Comprehensive searches were performed in the MEDLINE, CINAHL, Scopus, SPORTDiscus, and COCHRANE databases. The included studies focused on the technological resources used in physical rehabilitation for cancer patients undergoing chemotherapy. Data extraction followed the World Health Organization’s “Classification of Digital Health Interventions v1.0” to categorize the technologies. Results: A total of 32 studies met the inclusion criteria. The most commonly used technologies included wearable devices (16 studies), web-based platforms and telerehabilitation systems (7 studies), mHealth applications (6 studies), virtual reality (2 studies), and exergaming (3 studies). These tools were designed to enhance physical function, manage treatment-related symptoms, and improve overall quality of life. Wearable devices were particularly effective for monitoring physical activity, while web-based platforms and mHealth applications supported remote rehabilitation and patient engagement. Conclusions: Technological resources offer significant opportunities for personalized rehabilitation interventions in cancer patients undergoing chemotherapy. However, further research is needed to evaluate the long-term effectiveness, cost-efficiency, and clinical integration of these tools to ensure broader accessibility and sustainable impact. Full article

Background/Objectives: This systematic and bibliographic review examines publications in the field of dementia and video game research from 2004 to 2023. The main objective is to assess developments and trends in video game technology for dementia care and detection. Methods: The PubMed database was the primary source for publications. PRISMA guidelines were applied to structure this review. Ten variables were defined, investigated, and split into three main categories: bibliographic, medical, and technical. Results: The results were synthesized using a quantitative approach to reduce bias through interpretation. Of 209 initial results, 77 publications have been included in the investigation. More studies focus on rehabilitation over assessment and detection of dementia. Clinical trials are typically conducted with limited participants. The most populated trials rarely enrol over 300 subjects. On average, around 38 subjects were enrolled in the trials. These studies are commonly supervised by a trainer or technology specialist, suggesting a technology gap in familiarity in the trial demographic. Conclusions: Most interventions assessed were custom-designed applications with a specific outcome, focusing on physical activity and cognitive exercises. As the first of its kind, this publication focuses on the technical aspects of applied technologies and development methods. Using video games to treat and detect patients with cognitive impairments like dementia can benefit healthcare professionals, caretakers, and patients. Full article

(1) Background: Growth in the use of video games has spurred innovations in the health sector, especially through exergames, which promote physical activity using interactive technologies like augmented reality. Exergames are shown to enhance exercise motivation and engagement, yet enjoyment remains inconsistent across studies. This pilot study aims to provide evidence on how different exergaming doses affect exercise heart rate, perceived exertion, adverse effects, and enjoyment in older adults. (2) Methods: A pilot randomized controlled trial was conducted to compare different doses of exercise through video games (13 vs. 28 min) in older adults living in a nursing home. A single bout of exergaming was provided to assess the outcomes: heart rate, rate of perceived exertion, physical activity enjoyment scale score, and adverse effects. (3) Results: Thirty-two older adults were recruited. This study revealed no significant differences in heart rate between groups (p = 0.1). There is a weak correlation between the rate of perceived exertion and the level of enjoyment (r_s = −0.193) and between the total time of the intervention and the incidence of adverse effects (r_s = 0.295). (4) Conclusions: The use of a higher dose of exergaming is effective in achieving moderate physical intensity. Also, the results suggest the intervention was generally well tolerated and enjoyed by older adults, with no serious adverse effects reported. Full article

Exer-games are interactive experiences in which participants engage in physical exercises to achieve specific goals. Some of these games have a collaborative nature, wherein the actions and achievements of one participant produce immediate effects on the experiences of others. Music serves as a stimulus that can be integrated into these games to influence players’ emotions and, consequently, their actions. In this paper, a framework of music services designed to enhance collaborative exer-games is presented. These services provide the necessary functionality to generate personalized musical stimuli that regulate players’ affective states, induce changes in their physical performance, and improve the game experience. The solution requires to determine the emotions that each song may evoke in players. These emotions are considered when recommending the songs that are used as part of stimuli. Personalization seeds based on players’ listening histories are also integrated in the recommendations in order to foster the effects of those stimuli. Emotions and seeds are computed from the information available in Spotify data services, one of the most popular commercial music providers. Two small-scale experiments present promising preliminary results on how the players’ emotional responses match the affective information included in the musical elements of the solution. The added value of these affective services is that they are integrated into an ecosystem of Internet of Things (IoT) devices and cloud computing resources to support the development of a new generation of emotion-based exer-games. Full article

Physical exercises are crucial for enhancing postural balance and muscle strength in children and adolescents with Down syndrome (DS). Virtual reality-based therapy (VRBT), which utilizes exergames, can favor performing physical activity. The aim of this review was to assess the effectiveness of VRBT in improving balance and muscular endurance in children and adolescents with DS. Since inception up to August 2024, we screened in PubMed Medline, SCOPUS, WOS, CINAHL, and PEDro studies that assessed the effectiveness of VRBT, compared to conventional therapy (CT) or usual care (UC), in improving balance and muscular endurance in DS. Methodological quality was assessed using the PEDro scale. Effect size in meta-analyses was calculated with the Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). Nine studies providing data from 424 participants with good methodological quality (PEDro: 6.3 ± 1.2 points) were included. Our meta-analysis showed that VRBT is more effective than controls in increasing function (SMD = 1.22; 95% CI 0.64 to 1.81; p < 0.001), dynamic balance (SMD = −2.2; 95% CI −3.1 to −1.25; p < 0.001), and muscular endurance (SMD = 1.37; 95% CI 0.58 to 2.2; p < 0.001). This is the first meta-analysis to exclusively focus on children and adolescents with DS, demonstrating the effectiveness of VRBT in enhancing balance and muscular endurance. Full article

Currently, as an increasing number of people have been addicted to using cellular phones, smartphone tenosynovitis has become common from long-term use of fingers for their operations. Hand exercise while playing video games, which is called exergame, can be a good solution to provide enjoyable daily exercise opportunities for its prevention, particularly, for young people. In this paper, we implemented a simple exergame system with a hand gesture recognition program made in Python using the Mediapipe library. We designed three sets of hand gestures to control the key operations to play the games as different exercises useful for tenosynovitis prevention. For evaluations, we prepared five video games running on a web browser and asked 10 students from Okayama and Hiroshima Universities, Japan, to play them and answer 10 questions in the questionnaire. Their playing results and System Usability Scale (SUS) scores confirmed the usability of the proposal, although we improved one gesture set to reduce its complexity. Moreover, by measuring the angles for maximum wrist movements, we found that the wrist flexibility was improved by playing the games, which verifies the effectiveness of the proposal. Full article

Background: Parkinson’s disease is primarily characterized by the degeneration of motor neurons, leading to significant impairments in movement. Initially, physical therapy was predominantly employed to address these motor issues through targeted rehabilitation exercises. However, recent research has indicated that cognitive training can enhance the quality of life for patients with Parkinson’s. Consequently, some researchers have posited that the simultaneous engagement in computer-assisted motor and cognitive dual-task (CADT) may yield superior therapeutic outcomes. Methods: A comprehensive literature search was performed across various databases, and studies were selected following PRISMA guidelines, focusing on CADT rehabilitation interventions. Results: Dual-task training enhances Parkinson’s disease (PD) rehabilitation by automating movements and minimizing secondary task interference. The inclusion of a sensor system provides real-time feedback to help patients make immediate adjustments during training. Furthermore, CADT promotes more vigorous participation and commitment to training exercises, especially those that are repetitive and can lead to patient boredom and demotivation. Virtual reality-tailored tasks, closely mirroring everyday challenges, facilitate more efficient patient adaptation post-rehabilitation. Conclusions: Although the current studies are limited by small sample sizes and low levels, CADT rehabilitation presents as a significant, effective, and potential strategy for PD. Full article

Background: Multiple sclerosis is a chronic, inflammatory, neurodegenerative autoimmune disease caused by myelin loss in the central nervous system, which leads to motor and non-motor problems. The main objective of this study was to explore whether an immersive virtual reality (IVR) exercise programme would be feasible as a form of physical therapy for people with MS (pwMS). Methods: 18 participants (13 women; 45.06 years) were assigned to an experimental group (EG, n = 8) and a control group (CG, n = 10). The EG took part in a twice-weekly IVR exergame physical therapy programme—ExeRVIEM programme. A randomised, single-blind clinical trial was conducted and was registered in clinicaltrials (NCT05870254). Results: The intervention was feasible and safe. The participants completed the programme with no adverse effects (no symptoms on the Simulator Sickness Questionnaire), high usability (System Usability Scale 90.31%), and outstandingly positive post-game experiences (Game Experience Questionnaire 3.10/4). In addition, the GE significantly improved several of their functional capacities: increased lower limb strength (Five Times Sit-to-Stand Test p = 0.042), improved functional mobility, and reduced fall risk (Timed Up and Go Test-simple p = 0.009; Timed Up and Go Test-cognitive p = 0.003). There were no statistically significant differences between the groups. Conclusions: The findings support that the use of exergames and IVR as physical therapy in pwMS is feasible and safe. Furthermore, there is the suggestion of possible benefits to participants’ functional abilities, all of which position IVR as a promising tool for the rehabilitation of this neurodegenerative pathology affecting young adults. Full article