Subject: Computer Science And Mathematics, Other Keywords: tele-rehabilitation; serious games; human-computer interaction
Online: 13 May 2021 (13:03:14 CEST)
Background: Tele-rehabilitation has grown significantly in the past years, especially in 2020 when it has been a crucial tool for supporting patients during the COVID-19 pandemic. Within the context of tele-rehabilitation, serious games have a significant role. However, realizing software for serious games capable of responding to the variety of user needs is resource demanding. Methods: we present Proteo, a modular framework for developing serious games from scratch, but with the ability of providing a high-level interface for game customization by therapists and researchers. We also present two serious game implementation examples with analysis of end user’s and therapists/researchers’ satisfaction. Results: by involving a group of 11 specialized therapists and 9 end users we analyzed the Proteo user’s satisfaction. We found that therapists and end users scored high level of involvement, and the therapists scored also high level of suitability. More in depth, both groups showed significant differences between positive and negative feeling, with positive feeling scoring higher than negative ones. Finally, concerning Users’ level of suitability the condition of successfulness of the system, ability to control, clarity and helpfulness were reported as high while the difficulty of the system and the difficulty of the task were reported as low. Conclusions: the proposed framework is a step forward in providing a comprehensive open-source, modular framework, to develop serious games for tele-rehabilitation. Proteo is distributed with a MIT license and available to researchers on GitHub and has been well accepted by the users we involved in the evaluation tests.
REVIEW | doi:10.20944/preprints202011.0280.v1
Subject: Social Sciences, Education Keywords: serious games; science education; games in education; augmented reality
Online: 9 November 2020 (11:29:49 CET)
Keeping in mind the increasing trend and need for serious games in science education, we have done a systematic literature review. These papers show the trends and patterns of research carried out in this field from the year 2011 to 2020. Specifically, we investigated country-wise concentration and the most common evaluation methods. Literature is reviewed from IEEEexplore, Springer, and Scopus. Moreover, we discussed the role of Augmented Reality(AR) games in teaching physics. Lastly, we have discussed the positive and negative aspects of serious games in science education in particular, and the trend of using serious games in the past decade in education in general.
ARTICLE | doi:10.20944/preprints202205.0242.v1
Subject: Computer Science And Mathematics, Information Systems Keywords: Virtual Reality; Augmented Reality; Serious Games; IoT; Web App; Blender; Unity3D
Online: 18 May 2022 (10:46:25 CEST)
The use of games for non-ludic purposes, the serious games, is an interesting branch of science that has shown important results. With the advent of the pandemic that has made access to rehabilitation centres more problematic for patients with cognitive rehabilitation needs, the importance of being able to exercise these patients safely in their own homes has emerged strongly. Many studies show that immediate action and appropriate, specific rehabilitation can guarantee satisfactory results. Appropriate therapy is based on key factors to be taken into account such as frequency, intensity and specificity of the exercises. The aim of our work is to define a pathway for the creation of open source digital products that can allow access in any moment to a virtual environment through which patients who have suffered limitations in their cognitive abilities can exercise and recover all or part of these abilities in the shortest possible time. In view of the spread of IoT devices capable of easily monitoring various vital parameters, we propose with our system a low-cost and very efficient solution that can provide the doctor and therapist not only with quantitative data on the exercises performed (number and type of exercises, time spent, results obtained) but also an overview of vital parameters, so as to observe any states of agitation or excessive effort in completing the exercise.
ARTICLE | doi:10.20944/preprints202001.0082.v1
Subject: Social Sciences, Education Keywords: Active learning; professional skills; civic education; higher education; e-learning; serious games; critical thinking; sustainability
Online: 9 January 2020 (11:39:36 CET)
This study assesses the development of professional skills in university students using serious games (SG), from a sustainability perspective. The Sustainable Development Goals (SDGs) were set by the United Nations’ 2030 Agenda for Sustainable Development. Universities are strategic agents in the transformation process towards sustainability. This way, they should be committed to promoting such sustainable values in the students through curricular sustainability, implementing active methodologies and SG for that purpose. Transversal skills are essential for the development of future graduates. The objective of this study was to assess which professional skills should be developed through the SG called The Island, to improve the degree of student satisfaction with the incorporation of a sustainable curriculum. The data were obtained using a questionnaire, and then analysed using linear regression models, with their inference estimated through the goodness of fit and ANOVA. The first results indicated that the implementation of the SG promoted a strengthening of the students' sustainable curriculum through the development of those skills. It was concluded that the key to success in education for sustainable development is improving the development of strategic thinking, collaborative thinking, and self-awareness, in addition to encouraging systemic, critical, and problem-solving thinking.
ARTICLE | doi:10.20944/preprints201901.0187.v1
Subject: Social Sciences, Tourism, Leisure, Sport And Hospitality Keywords: Serious game; free play; hybrid game
Online: 18 January 2019 (12:15:17 CET)
Considering Games with the broad definition proposed by Juul (Juul, 2010), consequences outside of the magic circle can be negotiated. This definition opens up the possibility to define serious games, games developed with an utilitarian goal in mind, in addition to fun. The entertaining and utilitarian objectives may however be contradictory, leading serious games to be, more often than not, less than optimal in at least one of the two dimensions. Another way to play with the boundaries of games is to consider pervasive games, which include alternate reality games, and crossmedia games (Montola, 2005). We question here the limit between game, play and toy in the context of a mixed reality serious game. ‘Pangu’ is a game designed for bachelor students, with biochemistry as the utilitarian objective, and the origin of life as a game theme. The students are asked to play the game on their smartphone, which in turn ask them to build molecules with a tangible balls-and-sticks model typically used in chemistry classes. Pictures taken from the models allow users to ‘scan’ these models and progress in the game. The use of the game was observed in four opportunities. An unanticipated observation is that, in addition to expected behaviors, some students used briefly the models like a toy rather than in the context of the game. It is therefore tempting to speculate that the pervasive nature of the game is blurring the game/non game boundary and, in the context of this serious game, opens a door for fun.
REVIEW | doi:10.20944/preprints201807.0504.v1
Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: app; somatotropin; serious games; gamification; digital; mobile health
Online: 26 July 2018 (04:41:50 CEST)
Growth hormone (GH) deficiency affects up to 1 in 4,000 children and is usually treated with daily injections of GH whilst the child is still growing. With children typically diagnosed around 5 years old, this can mean over 10 years of therapy, which can place a considerable burden on the child and parent. Over three-quarters of children are estimated to be not fully compliant with therapy, which can compromise their chances of attaining their target height. In recent years, interactive mobile health (smart phone or tablet) interventions using game-like concepts, so called ‘gamification’, have increased in popularity and have demonstrated success in promoting positive self-management behaviour in children with chronic conditions, such as diabetes. The application of gamified interventions has the potential to support adherence to therapy and positive behaviour in children with GH deficiency in a number of ways: 1) By providing education in a format that the child understands and accepts (e.g. using behavioural constructs to facilitate explaining why adherence is important); 2) By providing a mechanism to reduce the anxiety and stress associated with administering the injection (e.g. diversion with a virtual pet); and 3) By providing feedback to encourage on-going engagement (e.g. rewards, progression through levels).
ARTICLE | doi:10.20944/preprints202309.1804.v1
Subject: Social Sciences, Psychology Keywords: psychological anti-doping intervention; serious game; sport high school
Online: 27 September 2023 (02:55:45 CEST)
The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., a digital learning based on the game. The experimental design included an intervention group (n=167; F=37.7%; Meanage=17.5 years) and a control group (n=112; F=42%; Meanage=17.6). Both of groups completed the same questionnaire in two different occasions (i.e., time 1 and time 2), for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular, in terms of decrease of doping intention and the strengthening of doping knowledge. Moreover, we demonstrated that the score obtained during the implementation of the Serious Game partially could represent a coherent measure of the participants’ beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions.
ARTICLE | doi:10.20944/preprints201810.0677.v1
Subject: Computer Science And Mathematics, Software Keywords: low back pain; virtual reality; virtual rehabilitation; serious game; gamification
Online: 29 October 2018 (11:38:57 CET)
Low Back Pain (LBP) is one of the most common problems among adults. The usual physiotherapy treatment is to perform physical exercises. However, some LBP patients have false beliefs regarding their pain and they tend to avoid physical movements which might increase their pain and disability. Virtual Reality (VR) has shown to be an effective intervention in improving motor functions and reducing pain perception. Existing VR interventions for LBP rehabilitation were based on a non-immersive VR, whereas to effectively reduce the pain intensity, we need an immersive VR. In this paper, we introduce the development and evaluation of a serious game called RabbitRun with an immersive experience to engage the patients in a virtual environment and distract them from the pain while performing LBP exercises. The initial usability evaluation results suggest that RabbitRun game is enjoyable and acceptable. The game is easy to play and learn and most of the participants are willing to play the game at home. This solution will enhance the rehabilitation outcome since the patients who are suffering from LBP can use the system at their home and train more for long period of time using a smartphone and low-cost virtual reality device such as Google Cardboard.
BRIEF REPORT | doi:10.20944/preprints202005.0143.v1
Subject: Biology And Life Sciences, Virology Keywords: Covid-19; Epidemiology; Chronic diseases; Serious or critical cases; Brazil; Coronavirus
Online: 8 May 2020 (12:33:24 CEST)
Chronic noncommunicable diseases (CNCDs) have been a major public health concern worldwide, especially diabetes, cardiovascular disease, chronic obstructive pulmonary disease, hypertension, in addition to obesity, which is even more worrying when the subject involves the covid-19 pandemic, because such incidences correlate with the need for intensive care units, including the possibility of death of the patient. Therefore, for countries with the highest numbers of critical cases, it is important to assess the incidence of these diseases to guide the public that most needs guidance on public policies for social isolation.
ARTICLE | doi:10.20944/preprints202208.0184.v1
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: Exergames; Kinect; neuromuscular disesase; physical disability; rehabilitation; serious games; Virtual reality rehabilitation
Online: 10 August 2022 (03:24:24 CEST)
This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to different diseases and states of disease. The game is based on motion capturing and integrates four example exercises that can be configured via our therapeutic web platform "Blexer-med". To prove the feasibility for a wide range of different users, evaluation tests were performed on 14 patients with various types and degrees of neuromuscular disorders, classified into three groups based on strength and autonomy. Users were free to choose their schedule and frequency. Game scores and three surveys (before, during, and after the intervention) showed similar experiences for all groups, with the most vulnerable having the most fun and satisfaction. The players were motivated by the story and by achieving high scores. The average usage time was 2.5 times per week, 20 minutes per session. Pure exercise time was about half the game time. The concept has proven feasible and forms a reasonable basis for further developments. The full 3D exercise needs further fine-tuning to enhance fun and motivation.
REVIEW | doi:10.20944/preprints202107.0644.v1
Subject: Social Sciences, Education Keywords: Medical Education; Serious games; Escape room; E-learning; Edutainment; Game-based learning
Online: 29 July 2021 (10:30:44 CEST)
Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.
ARTICLE | doi:10.20944/preprints202312.0594.v1
Subject: Medicine And Pharmacology, Neuroscience And Neurology Keywords: neuromyelitis optica disorder; anti-aquaporin-4; anti-myelin oligodendrocyte glycoprotein; rituximab; serious infection
Online: 8 December 2023 (09:59:09 CET)
Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare immune-mediated relapsing-remitting disease of the central nervous system. The usage of rituximab, to prevent NMOSD relapses, is common in Sweden, but the knowledge on long-term efficacy and risk for severe infections are limited. We performed a retrospective cohort study with medical chart review of rituximab-treated NMOSD patients at the Karolinska University Hospital, Sweden, to assess the occurrence of relapses and severe infectious events (SIE). Furthermore, we collected data on CD19+ lymphocyte, and IgG levels during therapy. A total of 42 NMOSD patients; 24 with aquaporin -4 antibodies (AQP4+), eight with myelin oligodendrocyte glycoprotein antibodies (MOG+) and 10 with absence of antibodies (double-seronegative) were included. During a mean treatment time of 4.4 years, 37% AQP4+, 75% MOG+, and 60% double-seronegative patients experienced 1 relapse. SIEs were common with 46% of AQP4+, 25% of MOG+, and 40% of double-seronegative patients affected. Incomplete CD19+ lymphocyte suppression did not predict a relapse and there was no correlation between IgG levels and SIEs. In conclusion, our data demonstrated a high risk for both relapses and SIEs in rituximab-treated NMOSD patients highlighting the need for close clinical vigilance of disease activity and infections during treatment.
ARTICLE | doi:10.20944/preprints201607.0022.v1
Subject: Social Sciences, Psychology Keywords: Ambient Assisted Living; eHealth; Technology Acceptance, Smart Health, User Diversity, Serious Games for Healthcare
Online: 12 July 2016 (09:39:31 CEST)
Based on the demographic shift and the related challenges resulting from the growing number of elderly and persons with chronic diseases, the idea of smart home that supports its inhabitants in the daily life, gains importance. The purpose of this paper was to examine in a prototypic Ambient Assisted Living environment if users after interaction with different health-supporting applications intend to use such in the future. Two experimental studies exemplary show possible applications of home-integrated technology that can support, assist and accompany the target group in different contexts, and examine to what extent participants are willing to future use such sophisticated technology at home. The results show that people in general, but especially the old and chronically ill ones are quite fascinated of health-supporting ambient technology and the majority intends to use such ambient assistance in the future (study I). Moreover, serious games for healthcare are shown as a hedonic use of technology in smart homes that have a great potential to retain or improve the physical health, mobility and the overall well-being of the inhabitants (study II). The article provides two examples of ambient technology to leverage the demographic change and presents important user factors for facilitating high user acceptance.
ARTICLE | doi:10.20944/preprints202306.0333.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: virtual reality (VR); COVID-19; motor rehabilitation; multidisciplinary; virtual reality activity; serious games; game design; health communication
Online: 5 June 2023 (14:26:52 CEST)
Background: This work presents Com@Rehab, a technological patient-centred activity for individuals needing a physical rehabilitation approach and with a specific loss of functionality. Within this scope, this paper focuses on the description of the activity in virtual reality (VR), its components, design and user profile, and its versatility and future adaptability regarding different ages, pathologies and rehabilitation contexts. Methods: The VR activity has been customised according to the patient's clinical needs while replicating an activity of daily living, namely showering. In addition, to validate and get feedback on the developed system, a validation questionnaire was applied to a group of healthy individuals to test the efficiency of the technology that supports the VR activity. Results: Preliminary results show that 94% of the participants recommended the experience, the performance of the various components of the system was successfully implemented, participants quickly adhered to the VR technology, and the UI assistant’s functionality should be improved. Conclusion: This solution creates a more effective, interactive, humanised rehabilitation approach based on a Virtual Reality (VR) activity. The Com@Rehab Communication Module improves human-human and human-machine communication while contributing to health literacy.
ARTICLE | doi:10.20944/preprints202306.0569.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: red flags; clinical reasoning; back pain; cauda equina syndrome; spinal fracture; spinal infection; malignancy; serious pathology; Spinal pain; low back pain; diagnostic triage
Online: 8 June 2023 (07:25:53 CEST)
Background and Objectives: The relevance of red flags in serious spinal pathology (SSP) evolved throughout the last years. Recently, new considerations have been proposed to expand the consideration of red flags. The purpose of this study was to determine, approve and test a model for the triage and manage-ment process of SSP based on the latest data available in the literature. Materials and Methods: The SSP model was initially built on the basis of a literature re-view. The model was further determined and approved by an expert panel us-ing a Delphi process. Finally, clinical scenario were used to test the applicabil-ity of the model. Results: After three rounds of Delphi process, panellists reached a consensus on a final version of the model. The use of clinical scenari-os by experts bring about reflexive elements both on the determined model and on the evocative SSP of the clinical cases. Conclusions: The validation of the model and its implementation in the clinical field could help assess the skills of first-line practitioners managing spinal painful patients. To this end, the devel-opment of additional clinical scenarios fitting with the determined model should be further considered.