JMIR Serious Games最新文献

{"title":"Personal Protection Equipment Training as a Virtual Reality Game in Immersive Environments: Development Study and Pilot Randomized Controlled Trial.","authors":"Liang Zhou, Haoyang Liu, Mengjie Fan, Jiahao Liu, Xingyao Yu, Xintian Zhao, Shaoxing Zhang","doi":"10.2196/69021","DOIUrl":"https://doi.org/10.2196/69021","url":null,"abstract":"<p><strong>Background: </strong>Proper donning and doffing of personal protection equipment (PPE) and hand hygiene in the correct spatial context of a health facility is important for the prevention and control of nosocomial infections. On-site training is difficult due to the potential infectious risks and shortages of PPE, whereas video-based training lacks immersion which is vital for the familiarization of the environment. Virtual reality (VR) training can support the repeated practice of PPE donning and doffing in an immersive environment that simulates a realistic configuration of a health facility.</p><p><strong>Objective: </strong>This study aims to develop and evaluate a VR simulation focusing on the correct event order of PPE donning and doffing, that is, the item and hand hygiene order in the donning and doffing process but not the detailed steps of how to don and doff an item, in an immersive environment that replicates the spatial zoning of a hospital. The VR method should be generic and support customizable sequencing of PPE donning and doffing.</p><p><strong>Methods: </strong>An immersive VR PPE training tool was developed by computer scientists and medical experts. The effectiveness of the immersive VR method versus video-based learning was tested in a pilot study as a randomized controlled trial (N=32: VR group, n=16; video-based training, n=16) using questionnaires on spatial-aware event order memorization questions, usability, and task workload. Trajectories of participants in the immersive environment were also recorded for behavior analysis and potential improvements of the real environment of the health facility.</p><p><strong>Results: </strong>Comparable sequence memorization scores (VR mean 79.38, SD 12.90 vs video mean 74.38, SD 17.88; P=.37) as well as National Aeronautics and Space Administration Task Load Index scores (VR mean 42.9, SD 13.01 vs video mean 51.50, SD 20.44; P=.16) were observed. The VR group had an above-average usability in the System Usability Scale (mean 74.78>70.0) and was significantly better than the video group (VR mean 74.78, SD 13.58 vs video mean 57.73, SD 21.13; P=.009). The analysis and visualization of trajectories revealed a positive correlation between the length of trajectories and the completion time, but neither correlated to the accuracy of the memorization task. Further user feedback indicated a preference for the VR method over the video-based method. Limitations of and suggestions for improvements in the study were also identified.</p><p><strong>Conclusions: </strong>A new immersive VR PPE training method was developed and evaluated against the video-based training. Results of the pilot study indicate that the VR method provides training quality comparable to video-based training and is more usable. In addition, the immersive experience of realistic settings and the flexibility of training configurations make the VR method a promising alternative to video instructions.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69021"},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Video Games Versus Midazolam in Reducing Perioperative Anxiety in Pediatric Patients: Systematic Review and Meta-Analysis.","authors":"Ziyue Luo, Sisi Deng, Ruihao Zhou, Ling Ye, Tao Zhu, Guo Chen","doi":"10.2196/67007","DOIUrl":"10.2196/67007","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients undergoing surgery frequently experience significant anxiety, which can result in adverse effects such as prolonged sedation and behavioral changes associated with pharmacological interventions such as oral midazolam. Video games offer a nonpharmacological distraction method that shows promise in alleviating procedural anxiety without significant adverse effects. However, the effectiveness of video games compared to midazolam in managing perioperative anxiety remains uncertain.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of video game interventions in reducing perioperative anxiety in pediatric patients undergoing general anesthesia.</p><p><strong>Methods: </strong>We conducted a comprehensive search across PubMed, Embase, Web of Science, and the Cochrane Library, supplemented by reference screening. Primary outcomes included anxiety levels assessed during parent separation and mask induction procedures, while secondary outcomes encompassed emergence delirium, postoperative behavior, and length of stay in the postanesthesia care unit (PACU). The risk of bias was assessed using the Risk of Bias 2 scale. Data were synthesized descriptively and through meta-analysis, with the certainty of the evidence evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.</p><p><strong>Results: </strong>Six randomized controlled trials involving 612 participants were included in the analysis. Children who participated in video game interventions reported significantly lower anxiety levels during parent separation (standardized mean difference, SMD -0.31, 95% CI -0.50 to -0.12; P=.001), with high certainty, and during mask induction (SMD -0.29, 95% CI -0.52 to -0.05; P=.02), with moderate certainty, compared to those receiving oral midazolam. Additionally, significant differences in postoperative behavior changes in children were observed compared to oral midazolam (SMD -0.35, 95% CI -0.62 to -0.09; P=.008). Children in the video game intervention groups also had a shorter length of stay in the PACU (mean difference, MD -19.43 min, 95% CI -31.71 to -7.16; P=.002). However, no significant differences were found in emergence delirium (MD -2.01, 95% CI -4.62 to 0.59; P=.13).</p><p><strong>Conclusions: </strong>Video game interventions were more effective than midazolam in reducing perioperative anxiety among pediatric patients, improving postoperative behavior, and shortening the length of stay in the PACU. However, video games alone did not outperform midazolam in managing emergence delirium. Further high-quality research is needed for more conclusive results.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67007"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596987","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":"Gamified Adaptive Approach Bias Modification in Individuals With Methamphetamine Use History From Communities in Sichuan: Pilot Randomized Controlled Trial.","authors":"Danlin Shen, Jianping Jiao, Liqun Zhang, Yanru Liu, Xiang Liu, Yuanhui Li, Tianjiao Zhang, Dai Li, Wei Hao","doi":"10.2196/56978","DOIUrl":"https://doi.org/10.2196/56978","url":null,"abstract":"<p><strong>Background: </strong>Cognitive bias modification (CBM) programs have shown promise in treating psychiatric conditions, but they can be perceived as boring and repetitive. Incorporating gamified designs and adaptive algorithms in CBM training may address this issue and enhance engagement and effectiveness.</p><p><strong>Objectives: </strong>This study aims to gather preliminary data and assess the preliminary efficacy of an adaptive approach bias modification (A-ApBM) paradigm in reducing cue-induced craving in individuals with methamphetamine use history.</p><p><strong>Methods: </strong>A randomized controlled trial with 3 arms was conducted. Individuals aged 18-60 years with methamphetamine dependence and at least 1 year of methamphetamine use were recruited from 12 community-based rehabilitation centers in Sichuan, China. Individuals with the inability to fluently operate a smartphone and the presence of mental health conditions other than methamphetamine use disorder were excluded. The A-ApBM group engaged in ApBM training using a smartphone app for 4 weeks. The A-ApBM used an adaptive algorithm to dynamically adjust the difficulty level based on individual performance. Cue-induced craving scores and relapses were assessed using a visual analogue scale at baseline, postintervention, and at week-16 follow-up.</p><p><strong>Results: </strong>A total of 136 participants were recruited and randomized: 48 were randomized to the A-ApBM group, 48 were randomized to the static approach bias modification (S-ApBM) group, and 40 were randomized to the no-intervention control group. The A-ApBM group showed a significant reduction in cue-induced craving scores at postintervention compared with baseline (Cohen d=0.34; P<.01; 95% CI 0.03-0.54). The reduction remained significant at the week-16 follow-up (Cohen d=0.40; P=.01; 95% CI 0.18-0.57). No significant changes were observed in the S-ApBM and control groups.</p><p><strong>Conclusions: </strong>The A-ApBM paradigm with gamified designs and dynamic difficulty adjustments may be an effective intervention for reducing cue-induced craving in individuals with methamphetamine use history. This approach improves engagement and personalization, potentially enhancing the effectiveness of CBM programs. Further research is needed to validate these findings and explore the application of A-ApBM in other psychiatric conditions.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e56978"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartwatch-Based Tailored Gamification and User Modeling for Motivating Physical Exercise: A MaxDiff Segmentation Approach.","authors":"Jie Yao, Di Song, Tao Xiao, Jiali Zhao","doi":"10.2196/66793","DOIUrl":"https://doi.org/10.2196/66793","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Smartwatch-based gamification holds great promise for empowering fitness applications and promoting physical exercise, yet existing empirical evidence on its effectiveness remains inconclusive, partly due to \"one-size-fits-all\" design approaches neglecting individual differences. While the emerging research area of tailored gamification calls for more accurate user modeling and better customization of game elements, existing studies relied primarily on rating-scale-based measures and correlational analyses with methodological limitations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to improve smartwatch-based gamification with an innovative approach of user modeling, in order to better motivate physical exercise among different user groups with tailored solutions. It incorporated both individual preferences and needs for game elements into the user segmentation process, and employed the Maximum Difference Scaling (MaxDiff) technique that can alleviate the limitations of traditional methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;With data collected from two MaxDiff experiments on 378 smartwatch users and Latent Class statistical models, the relative power of each of the 16 popular game elements was examined in terms of what users liked and what motivated them to exercise, based on which distinct user segments were discovered. Prediction models were also proposed for quickly classifying future users into the right segments, in order to provide them with tailored gamification solutions on smartwatch fitness applications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We discovered three segments of smartwatch users based on their preferences for gamification, and more important, four segments motivated by goals, immersive experiences, rewards or social comparison respectively. Such user heterogeneity confirmed the susceptibility of the effects of gamification, and indicated the necessity of accurately matching gamified solutions with user characteristics to better change health behaviors through different mechanisms for different targets. Important differences were also observed between the two sets of user segments (i.e., whether based on preferences for or motivational effects of game elements), indicating the gap between what people enjoy using on smartwatches and what can motivate them for physical exercise engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;As far as we know, this study was the first investigation of MaxDiff-based user segmentation for tailored gamification on smartwatches promoting physical exercise, and contributed to a detailed understanding about preferences for and effectiveness of different game elements among different groups of smartwatch users. As existing tailored gamification studies were still exploring ways of user modeling with mostly surveys and questionnaires, this study also supported the adoption of MaxDiff experiments as an alternative method, to better capture user heterogeneity in the health d","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Augmented Reality to Convey Medical Knowledge On Osteoclasts: A User Study.","authors":"Jascha Grübel, Julia Chatain, Claudio Schmid, Violaine Fayolle, Fabio Zünd, Reinhard Gruber, Bernd Stadlinger","doi":"10.2196/64751","DOIUrl":"https://doi.org/10.2196/64751","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Visualization technology is enhancing interactive learning by merging digital content with real-world environments, offering immersive experiences through Augmented Reality (AR) in fields like medical education. AR is being increasingly used in medicine and dental education to improve student learning, particularly in understanding complex concepts such as bone remodeling. Active learning strategies, supported by AR, boost student autonomy, reduce cognitive load, and improve learning outcomes across various disciplines. AR is gaining popularity in higher education as it enhances active learning, reduces cognitive load, and improves cognitive, meta-cognitive, and affective outcomes, particularly in medical and nursing education. The effectiveness of immersive AR in enhancing understanding of complex physiological processes is still unclear, with a lack of rigorous studies on its impact and how to effectively convert academic content into AR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We assess the capacity of AR-enhanced content for learning medical knowledge with a state-of-the-art AR game, published along with a modern cell atlas of the oral cavity. To assess AR-enhanced content for learning, we formulated hypotheses on the general impact on learning (H1), specific improvements in learning (H2) and the long-term retention (H3).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An AR serious game was developed to represent current knowledge on osteoclasts for classroom use. The game was evaluated in an unblinded face-to-face vignette experiment (39 participants): Learning outcomes on \"Osteoclasts\" were compared between the AR game (17 participants) and a textbook-only option (20 participants) conveying the same content. Participants were randomly assigned and learning success was measured at three time-points, immediately after the experiment session, one week later, and one month later, via web-based surveys.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The AR serious game elicited strong interest in the topic (perceived relevance in ARCS, W= 10417; P &lt; .001) and motivated students by increasing self-efficacy (confidence in ARCS, W = 11882.5; P = .023) and satisfaction (in ARCS, W = 4561; P &lt; .001). The learning outcomes were comparable to text-based self-learning (T = 2.0103; PBonferroni = .095). Furthermore, curious students benefited more from interactive learning methods compared to text-only methods and had higher learning success (T = -2.518; P = .019).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Introducing new technology such as AR into teaching requires technological investment, updated curricula, and careful application of learning paradigms. We found support for improved motivation (H1) and some evidence of AR's baseline effectiveness (H2a). While we couldn't confirm AR's impact on visual tasks overall (H2b), we noted an interesting interaction between curiosity and visual task outcomes (H2c), as well as how game design influences student perception ","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects and Acceptability of a 1-Week Home-Based Virtual Reality Training for Supporting the Management of Stress and Anxiety: Randomized Pilot Trial.","authors":"Federica Pallavicini, Eleonora Orena, Lisa Arnoldi, Federica Achille, Stefano Stefanini, Maddalena Cassa, Alessandro Pepe, Guido Veronese, Luca Bernardelli, Francesca Sforza, Sara Fascendini, Carlo Alberto Defanti, Marco Gemma, Massimo Clerici, Giuseppe Riva, Fabrizia Mantovani","doi":"10.2196/50326","DOIUrl":"https://doi.org/10.2196/50326","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is helpful for the management of stress and anxiety. However, current interventions have limitations related to location (ie, therapist's office or hospitals) and content (ie, virtual experiences only for relaxation).</p><p><strong>Objective: </strong>This randomized pilot trial aims to investigate the efficacy and acceptability of a brief remote VR-based training for supporting stress and anxiety management in a sample of Italian health care workers.</p><p><strong>Methods: </strong>A total of 29 doctors and nurses (n=21; 72% female; mean age 35.6, SD 10.3 years) were recruited and randomized to a VR intervention group or a control group in a passive control condition. Participants assigned to the VR intervention group received remote VR-based training consisting of 3 sessions at home delivered in 1 week using the VR psychoeducational experience \"MIND-VR\" and the 360° relaxing video \"The Secret Garden.\" The primary outcome measures were stress, anxiety, depression, and the knowledge of stress and anxiety assessed at baseline and posttreatment. We also evaluated the immediate effect of the remote VR-based training sessions on the perceived state of anxiety and negative and positive emotions. The secondary outcome measure was the usability at home of the VR system and content.</p><p><strong>Results: </strong>The VR intervention significantly reduced stress levels as assessed by the Perceived Stress Scale (6.46, 95% CI 2.77 to 10.5; P=.046) and increased the knowledge of stress and anxiety, as evaluated by the ad hoc questionnaire adopted (-2.09, 95% CI -3.86 to -0.529; P=.046). However, the home-based VR training did not yield similar reductions in stress, anxiety, and depression levels as assessed by the Depression, Anxiety, and Stress Scale-21 items or in trait anxiety as evaluated through the State-Trait Anxiety Inventory Form Y-1. After the home training sessions with VR, there was a significant decrease in anxiety, anger, and sadness and an increase in happiness levels. Analyses of the questionnaires on usability indicated that the health care workers found using the VR system at home easy and without adverse effects related to cybersickness. Of 33 participants, 29 (88%) adhered to the protocol.</p><p><strong>Conclusions: </strong>The results of this randomized pilot study suggest that a week-long home VR intervention, created with content created specifically for this purpose and available free of charge, can help individuals manage stress and anxiety, encouraging further research investigating the potential of remote VR interventions to support mental health.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04611399; https://tinyurl.com/scxunprd.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e50326"},"PeriodicalIF":3.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kangaroo Stimulation Game in Tracheostomized Intensive Care-Related Dysphagia: Interventional Feasibility Study.","authors":"Marjolein Jansen, Ingrid D van Iperen, Anke Kroner, Raphael Hemler, Esther Dekker-Holverda, Peter E Spronk","doi":"10.2196/60685","DOIUrl":"10.2196/60685","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is common in intensive care unit (ICU) patients. Using surface electromyography (sEMG) signals as biofeedback training exercises might offer a promising path to improving swallowing function. The Rephagia biofeedback system uses sEMG to assess muscle strength, stamina, and timing of the swallowing action.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the feasibility of the Rephagia system in ICU patients with dysphagia.</p><p><strong>Methods: </strong>This feasibility study included patients admitted to a 14-bed mixed medical-surgical ICU. All patients underwent a new tracheostomy placement during ICU stay due to persistent aspiration and ICU-acquired weakness, accompanied by verified dysphagia. Following Rephagia training, patients completed a questionnaire assessing comprehension, satisfaction, and motivation. Swallowing characteristics were assessed via mean sEMG peak values during exercise.</p><p><strong>Results: </strong>Twenty patients with a mean age of 69.4 (SD 8.2) years were included. The means of sEMG values at the beginning of a measurement were not significantly different at baseline versus everyone's last measurement (52 µV [23 µV] vs 57 µV [22 µV]; P=.50). The means of sEMG values obtained at the end of a measurement were not significantly different at baseline versus everyone's last measurement (56 µV [18 µV] vs 59 µV [23 µV]; P=.62). However, dysphagia improved in all patients. Patients understood the importance of the game in relation to their swallowing problems (16/80, 89%), which kept them motivated to participate in the training sessions (9/18, 50%).</p><p><strong>Conclusions: </strong>The Rephagia biofeedback system for stimulating swallowing actions in tracheotomized ICU patients with dysphagia is feasible. No relation was found between clinical improvement in swallowing function and sEMG signals.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e60685"},"PeriodicalIF":3.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567103","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":"Effects of a Session of Exergames and Traditional Games on Inhibitory Control in Children With Autism Spectrum Disorder: Randomized Controlled Crossover Trial.","authors":"Juliana Macedo Miranda, Rodrigo Alberto Vieira Browne, Weslley Quirino Alves da Silva, João Paulo Rodrigues Dos Santos, Carmen Silvia Grubert Campbell, Isabela Almeida Ramos","doi":"10.2196/65562","DOIUrl":"10.2196/65562","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is characterized by deficits in executive functions, such as inhibitory control, which affect behavior and social adaptation. Although physical activity-based interventions, such as exergames, have shown potential to improve these functions, their comparative effects with active traditional games remain underexplored, particularly regarding inhibitory control in children with ASD.</p><p><strong>Objective: </strong>We aim to analyze the effects of a session of exergames and active traditional games on inhibitory control in children with ASD.</p><p><strong>Methods: </strong>This randomized controlled crossover trial included 9 male children with ASD (mean age 8.6, SD 1.4 y). Participants completed three 20-minute experimental sessions in random order, with a minimum interval of 48 hours: (1) active traditional games, (2) exergames using Just Dance 2022, and (3) a control session with manual painting activities. Inhibitory control was assessed 5 minutes postsession using a modified flanker task in the E-Prime (version 3.0; Psychological Software Tools Inc) program, recording reaction time (RT) and accuracy in congruent and incongruent phases. Repeated measures ANOVA was used to compare RT and accuracy between experimental and control conditions. Data are presented as means and 95% CIs.</p><p><strong>Results: </strong>There was a statistically significant effect of condition on RT in the incongruent phase (P=.02). RT in the exergame session (849 ms, 95% CI 642 to 1057) was lower compared to the traditional games (938 ms, 95% CI 684 to 1191; P=.02) and control (969 ms, 95% CI 742, 1196 to P=.01) sessions. No significant differences were observed in RT during the congruent phase or in accuracy across either phase.</p><p><strong>Conclusions: </strong>A 20-minute session of exergame improved inhibitory control performance in children with ASD compared to active traditional games and painting activities.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65562"},"PeriodicalIF":3.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573081","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":"Identifying Key Principles and Commonalities in Digital Serious Game Design Frameworks: Scoping Review.","authors":"Raluca Ionela Maxim, Joan Arnedo-Moreno","doi":"10.2196/54075","DOIUrl":"10.2196/54075","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital serious games (DSGs), designed for purposes beyond entertainment and consumed via electronic devices, have garnered attention for their potential to enhance learning and promote behavior change. Their effectiveness depends on the quality of their design. Frameworks for DSG design can guide the creation of engaging games tailored to objectives such as education, health, and social impact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to review, analyze, and synthesize the literature on digital entertainment game design frameworks and DSG design frameworks (DSGDFWs). The focus is on conceptual frameworks offering high-level guidance for the game creation process rather than component-specific tools. We explore how these frameworks can be applied to create impactful serious games in fields such as health care and education. Key goals include identifying design principles, commonalities, dependencies, gaps, and opportunities in the literature. Suggestions for future research include empathic design thinking, artificial intelligence integration, and iterative improvements. The findings culminate in a synthesized 4-phase design process, offering generic guidelines for designers and developers to create effective serious games that benefit society.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 2-phase methodology was used: a scoping literature review and cluster analysis. A targeted search across 7 databases (ACM, Scopus, Springer, IEEE, Elsevier, JMIR Publications, and SAGE) was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Studies included academic or industry papers evaluating digital game design frameworks. Cluster analysis was applied to categorize the data, revealing trends and correlations among frameworks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 987 papers initially identified, 25 (2.5%) met the inclusion criteria, with an additional 22 identified through snowballing, resulting in 47 papers. These papers presented 47 frameworks, including 16 (34%) digital entertainment game design frameworks and 31 (66%) DSGDFWs. Thematic analysis grouped frameworks into categories, identifying patterns and relationships between design elements. Commonalities, dependencies, and gaps were analyzed, highlighting opportunities for empathic design thinking and artificial intelligence applications. Key considerations in DSG design were identified and presented in a 4-phase design baseline with the outcome of a list of design guidelines that might, according to the literature, be applied to an end-to-end process of designing and building future innovative solutions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The main benefits of using DSGDFWs seem to be related to enhancing the effectiveness of serious games in achieving their intended objectives, such as learning, behavior change, and social impact. Limitations primarily seem to be related to constraints associated with the specific co","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e54075"},"PeriodicalIF":3.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Gamified Family-Based Exercise Intervention on Adherence to 24-Hour Movement Behavior Recommendations in Preschool Children: Single-Center Pragmatic Trial.","authors":"Gaizka Legarra-Gorgoñon, Yesenia García-Alonso, Robinson Ramírez-Vélez, Loreto Alonso-Martínez, Mikel Izquierdo, Alicia M Alonso-Martínez","doi":"10.2196/60185","DOIUrl":"10.2196/60185","url":null,"abstract":"<p><strong>Background: </strong>Adherence to 24-hour movement behavior recommendations, including physical activity (PA), sedentary time, and sleep, is essential for the healthy development of preschool children. Gamified family-based interventions have shown the potential to improve adherence to these guidelines, but evidence of their effectiveness among children is limited.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a gamified family-based exercise intervention in promoting adherence to 24-hour movement behavior recommendations among preschool-aged children.</p><p><strong>Methods: </strong>This 12-week study is a single-center, pragmatic randomized controlled trial that included 80 preschool children (56% boys) and their families, who were randomly assigned to either the gamification group (n=40) or the control group (n=40). The \"3, 2, 1 Move on Study\" incorporates family-oriented physical activities and gamification techniques to increase PA domains, reduce sedentary behavior, and improve sleep patterns. The primary outcome was to increase moderate to vigorous PA (MVPA) by 5 minutes/day, as measured by accelerometer at follow-up. Accelerometer-determined daily time spent (PA domains, sedentary behavior, and sleep), physical fitness (cardiorespiratory, speed-agility, muscular, physical fitness z-score), basic motor competencies (self-movement and object movement), and executive function (memory, cognitive flexibility, and inhibitory control) were also included as secondary outcomes.</p><p><strong>Results: </strong>The 71 participants included in the per-protocol analyses (32 girls, 45%; 39 boys, 55%) had a mean (SD) age of 5.0 (0.5) years. Change in MVPA per day after the intervention (12 weeks) increased in both groups by +25.3 (SD 24.6) minutes/day in the gamification group and +10.0 (SD 31.4) minutes/day in the routine care group, but no significant between-group differences were observed (8.62, 95% CI -5.72 to 22.95 minutes/day, ηp2=.025; P=.23). The analysis of secondary outcomes showed significant between-group mean differences in the change in physical behaviors derived from the accelerometers from baseline to follow-up of 26.44 (95% CI 8.93 to 43.94) minutes/day in favor of light PA (ηp2=.138; P=.01) and 30.88 (95% CI 4.36 to 57.41) minutes/day in favor of total PA, which corresponds to a large effect size (ηp2=.087; P=.02). Likewise, the gamification group substantially increased their score in standing long jump and physical fitness z-score from baseline (P<.05).</p><p><strong>Conclusions: </strong>In the \"3, 2, 1 Move on Study,\" a gamified intervention showed a modest but relevant increase in MVPA and other domains of 24-hour movement behavior among preschool-aged children. Therefore, gamified family-based interventions may provide a viable alternative to improve adherence to 24-hour movement behavior recommendations.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e60185"},"PeriodicalIF":3.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556929","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}