JMIR Serious Games最新文献

{"title":"Home-Based Virtual Reality Training for Enhanced Balance, Strength, and Mobility Among Older Adults With Frailty: Systematic Review and Meta-Analysis.","authors":"Hammad Alhasan, Elaf Alandijani, Lara Bahamdan, Ghofran Khudary, Yara Aburaya, Abdulaziz Awali, Mansour Abdullah Alshehri","doi":"10.2196/67146","DOIUrl":"10.2196/67146","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a geriatric syndrome associated with increased risk of falls, hospitalization, and reduced quality of life. Traditional exercises may be unsuitable for older adults with frailty due to mobility issues and accessibility barriers. Virtual reality (VR) offers an engaging, home-based alternative by providing interactive training with real-time feedback. VR interventions have shown potential benefits for improving balance, strength, and mobility.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the effectiveness of VR-based home training programs in improving balance, strength, and mobility among older adults with frailty and prefrailty.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, and Web of Science from inception to November 1, 2023, using terms related to older adults, frailty, virtual reality, balance, mobility, and strength. Eligible studies included randomized and nonrandomized trials involving adults with frailty or prefrailty aged ≥65 years who received home-based VR interventions aimed at improving balance, strength, or functional mobility. Comparator groups included no intervention, traditional exercise, or standard care. Studies involving participants with neurological or cognitive disorders were excluded. Study quality was assessed using the Physiotherapy Evidence Database scale. A random-effects meta-analysis was performed to calculate pooled mean differences (MD) and 95% CIs for 3 primary outcomes: Berg Balance Scale, Timed Up and Go, and Chair Stand.</p><p><strong>Results: </strong>A total of 1063 records were identified, with 1023 screened after duplicate removal. Six studies met the inclusion criteria, involving 407 participants (mean age 75.2, SD 6.4 y), of whom 198 were allocated to VR interventions and 159 to control groups. VR interventions lasted a mean of 13.3 (SD 7.7) weeks, with an average of 39.6 (SD 5.2) sessions lasting 25.3 (SD 5) minutes. Methodological quality was high in 5 studies (mean Physiotherapy Evidence Database score=5.6, SD 1.3). Four studies were included in the meta-analysis. Significant improvements were observed in balance, as measured by the Berg Balance Scale (MD=3.62; 95% CI 2.29-4.95; P<.001; I²=0%). No significant effects were found for mobility (Timed Up and Go: MD=-0.37; 95% CI -1.16 to 0.41; P=.35; I²=0%) or strength (Chair Stand: MD=-0.20; 95% CI -1.70 to 1.29; P=.79; I²=21%).</p><p><strong>Conclusions: </strong>VR-based home exercise interventions show promise in improving balance among older adults with frailty and prefrailty. However, their effects on strength and functional mobility remain unclear. Variability in study designs and outcome measures limits the generalizability of current findings. Further high-quality research is needed to determine optimal VR training protocols and assess long-term adherence and clinical effectiveness.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67146"},"PeriodicalIF":4.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Immediate and Long-Term Effects of Immersive Virtual Reality on Behavioral and Psychological Symptoms of Dementia and Caregiver Burden: Longitudinal Observational Study.","authors":"Ling-Chun Huang, Ching-Fang Chien, Yuan-Han Yang","doi":"10.2196/73044","DOIUrl":"10.2196/73044","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) interventions are emerging as promising nonpharmacological strategies for people with dementia, aiming to prevent cognitive decline, reduce behavioral and psychological symptoms of dementia (BPSD), and alleviate caregiver burden. Although some studies have reported beneficial effects, findings remain inconsistent, and little is known about the duration and sustainability of these effects, particularly in real-world care settings.</p><p><strong>Objective: </strong>This study aimed to examine both the immediate and long-term effects of an immersive VR reminiscence intervention on BPSD and caregiver burden in people with dementia attending day care centers.</p><p><strong>Methods: </strong>This longitudinal observational study was conducted in 10 dementia day care centers in Kaohsiung, Taiwan. A total of 82 participants with dementia were enrolled. The VR intervention consisted of twice-weekly sessions over one month, featuring culturally familiar live-action 360° scenes filmed in well-known Taiwanese locations. Each session lasted approximately 10-12 minutes and included interactive elements. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory Questionnaire, and caregiver burden was assessed using the Zarit Caregiver Burden Interview. Measurements were taken at 3 time points: preintervention, immediately postintervention, and 2 months after the intervention ended. The Wilcoxon signed-rank test was used for statistical comparisons, and rank-biserial correlation was calculated as the effect size.</p><p><strong>Results: </strong>Significant improvements were observed after 1 month of VR intervention in both caregiver burden (Z=-3.095, P=.002, r=0.34) and neuropsychiatric symptoms (Z=-2.929, P=.003, r=0.32). At the two-month follow-up, neuropsychiatric symptoms remained significantly improved (Z=-4.327, P<.001, r=0.48), although caregiver burden returned to preintervention levels. Regarding specific neuropsychiatric symptoms, significant improvements were observed immediately after the intervention in dysphoria or depression, anxiety, and sleep or nighttime behaviors. These effects were sustained over time, with additional long-term improvements noted in euphoria or elation, apathy or indifference, irritability or lability, aberrant motor behavior, and appetite or eating behaviors.</p><p><strong>Conclusions: </strong>A 1-month immersive VR reminiscence intervention appears to improve neuropsychiatric symptoms and temporarily reduce caregiver burden in people with dementia, with some symptom improvements lasting up to 2 months. These findings suggest that VR may offer a meaningful therapeutic option in day care settings. Future studies with control groups, including nonimmersive 2D conditions, and comparisons to traditional reminiscence therapy are needed to validate and expand upon these findings.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73044"},"PeriodicalIF":3.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exergaming System for Exercise-Based Cardiac Rehabilitation in Patients With Heart Failure: Development and Usability Assessment Study of a Device Prototype.","authors":"Carles Blasco-Peris, Juan Pedro Alcolea Garrido, Barbara Seguí, Rocio Zaragoza, Vicente Climent-Paya, Laura Fuertes-Kenneally, Agustín Manresa-Rocamora, Ana Sanz-Rocher, Sabina Baladzhaeva, José M Sarabia","doi":"10.2196/71385","DOIUrl":"10.2196/71385","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Heart failure (HF) is a growing global health concern, and adherence to early cardiac rehabilitation (CR) remains suboptimal. Exergaming is a promising alternative to conventional exercise programs for patients with HF. However, existing research has limitations, and the integration of exergaming into clinical practice remains challenging. Most notably, current studies often rely on commercially available systems that are not tailored to needs specific to patients with HF, lack long-term adherence strategies, and have limited evaluation in the initial phases of cardiac rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to design, develop, and assess the usability of a novel exergaming prototype (ie, HEFMOB), integrating immersive virtual reality (VR), real-time biometric monitoring, and autonomous session management to support early-phase, exercise-based CR in patients with HF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multidisciplinary team developed HEFMOB through iterative prototyping. The final system included a pedal-based VR cycling game and an upper-limb mobilization minigame, with real-time monitoring of heart rate, blood pressure, and peripheral capillary oxygen saturation. Usability was assessed in two phases: (1) an expert evaluation and refinement phase and (2) a single-session usability phase involving 10 patients with HF (4 female). The sessions were recorded and individually evaluated by 2 researchers using the Serious Game Usability Evaluator tool. After each session, the participants completed the System Usability Scale (SUS) and a subscale of Intrinsic Motivation Inventory (IMI) to rate the usability of the exergaming prototype and enjoyment, respectively. Descriptive statistics were reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The participants had a mean age of 64.8 (SD 8.4) years, BMI of 26.7 (SD 4.6) kg/m2, and left ventricular ejection fraction of 40.5% (SD 7.4%). All participants completed the session without adverse events. The SUS score averaged 71.5, SD 17.8 (indicating good usability) and IMI scores indicated very high enjoyment (mean 25.1, SD 3.5). A total of 136 gameplay-related events were recorded: negative (n=76, mostly confusion), neutral (n=49), and positive (n=11). Interface-related issues (n=61) were most common, followed by design (n=52) and hardware (n=23).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;HEFMOB appears to be a promising, engaging, and well-tolerated tool for delivering tailored exergaming interventions in patients with HF. High usability and enjoyment ratings support its acceptability, while structured user experience analysis provided valuable insights for system refinement. This study marks a critical step toward integrating personalized, gamified exercise in inpatient settings, especially where early mobilization is lacking. Building on these findings, future research will assess long-term usability and clinical impact through a multicenter randomized controlled tr","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e71385"},"PeriodicalIF":3.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Virtual Reality Force Control Training System on Brain Activation: Functional Near-Infrared Spectroscopy (fNIRS) Study.","authors":"Luigi Gan, Chien-Ju Lin, Hsiao-Feng Chieh, Kai-Nan An, Fong-Chin Su","doi":"10.2196/63874","DOIUrl":"10.2196/63874","url":null,"abstract":"<p><strong>Background: </strong>Aging can bring upon several effects that can hinder one's quality of life. One of the effects is the decline in one's ability to perform activities of daily living, which is caused by the loss of hand function due to aging. To mitigate this, several virtual reality (VR)-based training or rehabilitation systems that use hand tracking were developed. Although these systems are effective, immersive, and can promote motivation, they are mostly limited to providing range of motion exercises. The addition of a force control component to the hand tracking of these systems could make them even more effective at improving or restoring hand function, as the majority of activities of daily living require a degree of force control.</p><p><strong>Objective: </strong>This study aimed to compare the effects of 2 VR input systems: regular hand tracking and the novel VR input system in this study, which incorporate force control to regular hand tracking on the brain activity of younger and older adults. The degree of cortical activity during a training or rehabilitation task is linked to better functional outcomes and improvements of neuroplasticity.</p><p><strong>Methods: </strong>Twelve younger adults (mean age 25.00, SD 4.50 years) and 12 older adults (mean age 73.00, SD 3.6 years) were recruited to play a game specifically developed for this study using 2 VR input systems. Brain activity during gameplay was recorded using functional near-infrared spectroscopy over the following cortical regions: prefrontal cortex (PFC), premotor cortex (PMC), supplementary motor area (SMA), and primary motor cortex (M1).</p><p><strong>Results: </strong>Compared with the regular hand-tracking system, adding a force control component increased average oxygenated hemoglobin (HbO) concentrations and decreased deoxygenated hemoglobin (HbR) concentrations in key brain regions. In young adults, these changes were observed in the right PMC and right M1. In older adults, higher HbO and lower HbR concentrations appeared in the right PFC, bilateral M1, and right SMA (HbR only). The force control component also led to more widespread activity across all ROIs.</p><p><strong>Conclusions: </strong>The novel input system in this study can be used for improving or restoring hand function. The results of this study can be used as a reference for the development of better VR-based training or rehabilitation systems.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e63874"},"PeriodicalIF":3.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Resource-Efficient, High-Dose, Gamified Neurorehabilitation Program for Chronic Stroke at Home: Retrospective Real-World Analysis.","authors":"Spencer A Arbuckle, Anna Sophie Knill, Michelle H Chan-Cortés, Gabriela Rozanski, Anastasia Elena Ford, Louis T Derungs, John W Krakauer, Naveed Ejaz, David Putrino, Jenna Tosto-Mancuso, Meret Branscheidt","doi":"10.2196/69335","DOIUrl":"10.2196/69335","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence and medical guidelines recommend high-dose neurorehabilitation for recovery after stroke. The reality, however, is that most patients receive a fraction of this dose, with therapist availability and costs of delivery being major implementational barriers.</p><p><strong>Objective: </strong>This study aimed to explore a potential solution by conducting a retrospective analysis of a real-world enhanced clinical service that used gamified self-training technologies at home under remote therapist supervision.</p><p><strong>Methods: </strong>Data from 17 patients who completed a 12-18 week full-body, high-dose neurorehabilitation program entirely at home were analyzed. Program delivery relied primarily on patients training independently (asynchronously) with the MindMotion GO (MindMaze) gamified-therapy solution. Accompanying telerehabilitation training sessions with a therapist occurred weekly while therapists used a web application to continuously monitor and manage the program remotely. Effectiveness of the program was assessed through measured active training time, a measure that more closely reflects delivered dosage as opposed to scheduled dose. Patient recovery was evaluated with standardized impairment and functional clinical measures and patient self-reported outcome measures. Finally, a cost model was computed to evaluate the resource efficiency of the program.</p><p><strong>Results: </strong>Patients maintained high training adherence throughout the program and reached an average total active training time of 39.7 (SD 21.4) hours, with the majority delivered asynchronously (mean 82.2%, SD 10.8%). Patients improved in both upper-limb (Fugl-Meyer Upper Extremity, mean 6.4, SD 5.1; P<.001) and gait and balance measures (Functional Gait Assessment, mean 3.1, SD 2.6; P<.001; Berg Balance Scale, mean 6.1, SD 4.4; P<.001). Overall, the program was viewed very favorably among patients who completed a post-program survey, with 73.7% (14/19) of respondents being satisfied or very satisfied, while 63.2% (12/19) of respondents reported subjective improvements in physical abilities. Per-patient therapist costs approximated US $338, representing a resource-efficient alternative to delivering the same dose via one-on-one in-person training sessions (US $1903).</p><p><strong>Conclusions: </strong>This work demonstrates effective high-dose neurorehabilitation delivery via gamified therapy technologies at home. The approach shows that training time can be successfully decoupled from therapist-presence without compromising adherence, outcomes, or patient satisfaction over an extended program period. Given growing concerns over therapist availability and increasing health care costs, this resource-efficient approach can help achieve medical guidelines and complement existing clinic-based approaches.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69335"},"PeriodicalIF":3.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamification Integration in Technological Devices for Motor Rehabilitation in Parkinson Disease: Scoping Review.","authors":"Pere Bosch-Barceló, Oriol Martínez-Navarro, Maria Masbernat-Almenara, Carlos Tersa-Miralles, Anni Pakarinen, Helena Fernández-Lago","doi":"10.2196/69433","DOIUrl":"10.2196/69433","url":null,"abstract":"<p><strong>Background: </strong>Parkinson disease (PD) is a rapidly growing neurological condition worldwide. While physiotherapy and exercise are effective interventions, the addition of motivational aspects that improve adherence could be beneficial for people with PD. Incorporating technological devices into motor rehabilitation, coupled with gamification elements, could enhance the relevance of rehabilitation and alleviate motor symptoms.</p><p><strong>Objective: </strong>The aim of this scoping review was to identify and classify the technological devices that integrate gamification elements used in motor rehabilitation in PD, and to describe the justification behind the use of these devices and elements in this context.</p><p><strong>Methods: </strong>We conducted a scoping review following the framework proposed by Joanna Briggs Institute, along with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Major health science databases (MEDLINE, EMBASE, Scopus, Cochrane, Web of Science, PsycINFO, and Epistemonikos) were systematically searched. Relevant studies were included if they used technological interventions with gamification elements for motor symptom rehabilitation in PD. Gamification elements were extracted and categorized based on established frameworks, and content analysis was used to review the justifications for the use of technologies integrating gamification.</p><p><strong>Results: </strong>A total of 4451 studies were retrieved from the search. After the abstract and full-text screening, 81 studies were eligible for data extraction. The analysis identified 453 gamification elements across studies, with development and accomplishment being the most prominent core drive. Progress/feedback was the most frequently used element (79/81, 98% of studies), followed by points (70/81, 86%) and levels/progression (66/81, 81%). Other notable elements included badges, leaderboards, and customization, while several core drives, like ownership and possession, lacked reported elements. Most interventions were delivered through commercial video game consoles (33/81, 41%), followed by computer-based systems (32/81, 40%). Tablet-based applications and integrated rehabilitation platforms were used in 11% (9/81) and 10% (8/81) of the studies, respectively. The expected roles of technology were clear, but intentional use of gamification was scarce.</p><p><strong>Conclusions: </strong>This scoping review highlights the widespread adoption of technologies integrating gamification elements for motor symptom rehabilitation in individuals with PD. However, it also underscores a critical gap in understanding and justifying gamification mechanics. The current landscape relies heavily on commercial video games and emphasizes performance-based experiences, lacking theoretical grounding.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69433"},"PeriodicalIF":4.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FITLIGHT Training and Its Influence on Visual-Motor Reactions and Dribbling Speed in Female Basketball Players: Prospective Evaluation Study.","authors":"Ahmed K Hassan","doi":"10.2196/70519","DOIUrl":"10.2196/70519","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Basketball exists as a team-based sport played on a court involving intense physical demands because players need continuous movement between offensive and defensive zones.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the current research was to investigate the impact of a training program implementing FITLIGHT (FITLIGHT Corp) technology on female basketball players' visual-motor interactions and dribbling speed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study included 28 female basketball players. Participants were divided into 2 groups, experimental group (EG; n=14, mean age 18.29, SD 0.99 y; mean height 174.50, SD 2.10 cm; mean weight 75.36, SD 2.10 kg; mean training 5.64, SD 0.50 y) and control group (CG; n=14, mean age 18.50, SD 0.65 y; mean height 175.64, SD 1.55 cm; mean weight 75.57, SD 1.79 kg; mean training 5.43, SD 0.51 y), in a random manner. Pre- and post-measurements were used, and FITLIGHT training was conducted for 10 weeks with 4 sessions per week. The FITLIGHT training program targeted the elements of visual-motor interactions and dribbling speed for the EG. The CG experienced the same training regimen, but did not participate in the FITLIGHT training. The tests that were adopted and administered were the reaction time in the right hand and left hand, the reactive time (t test), and the reactive time with dribbling (t test D) tests. Statistical analysis included the calculation of descriptive statistics for minimum and maximum values and mean and SD, which were used for paired t tests for within-group comparison alongside independent t tests for between-group differences. Effect sizes (Cohen d) measured small effects at less than 0.2, medium effects at 0.2-0.5, and large effects at greater than 0.8 at P&lt;.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All the EG improvements were statistically significant (P&lt;.001), with reaction time in the right hand improving by 0.04 ms more than that in CG (0.016 ms; effect sizes d=0.87 for the EG and d=0.79 for the CG). The reaction time in the left hand of the EG was 0.05 ms faster (d=0.97), compared with a difference of 0.019 ms in the CG (d=0.71). Participants in the EG had 1.90 seconds more reactive time (d=0.98) than those in the CG, who had 0.85 seconds (d=0.97). For dribbling in the EG, reactive time improved by 4.08 seconds (d=0.98), much better than the improvement seen in the CG of 1.71 seconds (d=0.93) when compared with using effect sizes. The analysis of the data is finished, showing that the EG had much larger effects than the CG. Study participants achieved large effect sizes during reaction time in the right hand (d=0.51), reaction time in the left hand (d=0.71), reactive time (d=0.84), and reactive time with dribbling (d=0.88).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A pairwise comparison between the EG and the CG also revealed a statistically significant difference in the EG, which proved that the EG outperformed the CG. This study provides evidence for the enhanc","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e70519"},"PeriodicalIF":4.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Efficacy of a Gamified Mobile App for Promoting Self-Health Management Among Nurses in the Post-COVID Era: Single-Group Pre-Post Study.","authors":"Shao Huan Hsu, Li Jung Lu, Pei Chin Chou","doi":"10.2196/66262","DOIUrl":"10.2196/66262","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has significantly affected health care professionals, especially nurses, who have experienced elevated levels of stress, burnout, and physical health challenges. In the postpandemic era, supporting their well-being is crucial. Gamification, which is the application of game design elements in nongame contexts, has emerged as a promising strategy to promote engagement in health behaviors. This study explores the use of a gamified mobile app to support self-health management among nurses recovering from the COVID-19 experience.</p><p><strong>Objective: </strong>This study aimed to evaluate the preliminary efficacy of a gamified mobile app for promoting self-health management among nurses who experienced the COVID-19 pandemic. The study examined whether gamification could enhance engagement, improve physical health outcomes, and encourage sustainable behavior change.</p><p><strong>Methods: </strong>A single-arm pre-post intervention study was conducted using a user-centered design. The app was developed based on the Octalysis framework and goal-setting theory, incorporating personalized exercise prescriptions and health monitoring features. Nurses from a regional hospital in Hsinchu, Taiwan, participated in the 8-week intervention. Data were collected through interviews, pre- and postintervention surveys, and app usage analytics. Key outcomes included changes in step counts, BMI, and user engagement.</p><p><strong>Results: </strong>After the intervention, BMI classification improved significantly. The proportion of participants classified as obese decreased from 38.5% (90/234) to 13.7% (32/234), and the proportion of those classified as overweight increased from 24.8% (58/234) to 34.6% (81/234). Overall, the combined proportion of overweight or obese participants declined from 63.2% (148/234) to 48.3% (113/234), and that of participants with normal BMI increased from 18.4% (43/234) to 33.8% (79/234) (χ²₄=29.98; P<.001). Octalysis tool results showed strong motivational engagement, with the highest scores in development and accomplishment (mean 7.29), epic meaning and calling (mean 7.05), and empowerment of creativity and feedback (mean 6.55).</p><p><strong>Conclusions: </strong>The gamified mobile app demonstrated promising efficacy in enhancing self-health management among nurses in the post-COVID era by increasing physical activity and improving BMI. Gamification elements, such as achievement, purpose, and feedback, were effective in sustaining engagement. Further studies are recommended to assess long-term outcomes and broader applicability.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66262"},"PeriodicalIF":3.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Virtual Reality Illusions on Balance Performance and Immersive User Experience in Young Adults: A Within-Subject Experimental Study.","authors":"R Achintha M Abayasiri, Antonio Padilha Lanari Bo, Taylor J M Dick, Nilufar Baghaei","doi":"10.2196/70376","DOIUrl":"10.2196/70376","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation interventions to improve standing balance are often tedious and complex, limiting user engagement and increasing the burden of the clinicians delivering them. Virtual reality (VR) has been incorporated into such practices as a solution and VR illusions have emerged as a method for perturbing balance within interventions. However, the influence of VR illusions on balance performance, such as center of pressure (CoP), and user experience metrics remain under explored.</p><p><strong>Objective: </strong>This study aimed to evaluate the impact of the VR illusions on standing balance and immersive user experience in young adults.</p><p><strong>Methods: </strong>Young healthy adults (N=15, aged 18-35 years) played a VR table tennis game while standing on a force plate and were provided with eight directional and magnitude-based VR illusions scaled according to participants' heights. VR illusions were generated by offsetting the position of the playing hand in VR and were provided through 8 trials for each participant. Each VR illusion was delivered throughout final 50 seconds of each 70-second trial. Absolute CoP displacements, directional tendency of CoP displacement, and game performance were analyzed to evaluate the impact of the VR illusions. Responses to the User Experience Questionnaire, Slater-Usoh-Steed Presence Questionnaire, NASA Task Load Index, and Virtual Reality Sickness Questionnaire were analyzed to assess the immersive user experience.</p><p><strong>Results: </strong>Both the magnitude of VR illusion and changes in VR illusion direction led to significantly greater CoP displacements, with high illusion magnitudes, and anterior and posterior directional illusions associated with higher CoP displacements. Conversely, those illusion magnitudes and directions were associated with low game performance. The directional tendency of the CoP displacements varied across the illusion directions but showed a significant association with the illusion directions. Questionnaire responses showed that participants had moderate to high immersive user experience within the VR illusion paradigm.</p><p><strong>Conclusions: </strong>This study provides a novel approach for the future development of more effective VR-based balance rehabilitation interventions. The results provide inspiration for the development of future VR-based exergames that can perturbate CoP direction and magnitude. By adjusting the difficulty level through directional and magnitude changes in VR illusions, exergames could provide a personalized rehabilitation experience.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e70376"},"PeriodicalIF":4.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents' and Parents' Perspectives on Using the MedSMARxT Families Intervention in Emergency Departments for Opioid Medication Safety Education: Mixed Methods Study.","authors":"Olufunmilola Abraham, Sara Nadi, Irene Hurst","doi":"10.2196/68814","DOIUrl":"10.2196/68814","url":null,"abstract":"<p><strong>Background: </strong>The opioid crisis has significantly impacted adolescents and their families. This is attributed in part to increased opioid prescriptions in pediatric emergency departments (EDs) due to acute pain conditions and injuries. Although EDs frequently prescribe opioids, no effective preventative interventions have been implemented to educate adolescents and their families on safe opioid use. This study evaluates the MedSMA℞T Families intervention, which consists of an engaging serious game, Adventures in PharmaCity, and a personalized Family Medication Safety Plan (FMSP) with the aim of reducing opioid misuse and promoting opioid medication safety. The MedSMA℞T Families intervention was developed to educate adolescents and adults prescribed opioids on safe practices such as opioid storage and disposal.</p><p><strong>Objective: </strong>This study aimed to explore and characterize adolescents' and parents' experiences and perspectives on implementing the MedSMA℞T Families intervention in the ED to improve opioid education and safety among adolescents.</p><p><strong>Methods: </strong>A total of 93 participants, including 16 children and 77 parents, were recruited from the pediatric ED at a tertiary academic hospital to play the MedSMA℞T game in the ED. A total of 16 participants, including 8 children and 8 parents, were followed up with interviews to gather qualitative feedback. Participants engaged with the MedSMA℞T game-Adventures in PharmaCity-and the FMSP. Data were collected through gameplay observation and 75-minute semistructured interviews via Zoom. Quantitative in-game data were analyzed using descriptive analysis and qualitative data were analyzed using thematic analysis with NVivo (version 14; Lumivero).</p><p><strong>Results: </strong>Parents spent an average of 22.16 (SD 4.97) minutes playing the game, while children spent an average of 21.99 (SD 8.06) minutes. Families appreciated the game's design and noted usability challenges and suggested enhancements for clearer gameplay instructions. Participants reported increased knowledge of opioid safety, highlighted the importance of communication with health care providers, and a desire for a mobile app to assist with medication management. The FMSP was perceived as valuable for promoting awareness of safe practices and connected well to the knowledge gained from the game.</p><p><strong>Conclusions: </strong>The MedSMA℞T Families intervention was well received as a beneficial educational tool to educate adolescents and their families on safe opioid use. Additionally, it highlights a clear need for more accessible digital tools to increase opioid education. This feedback indicates a strong interest in improving educational resources to ensure safe opioid management within families.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e68814"},"PeriodicalIF":3.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}