Xi Chen, Dian Jiang, Hongting Ning, Lina Wu, Yifei Chen, Chi Zhang, Ruotong Peng, Yishu Zhu, Hui Feng
{"title":"The Experience of and Needs for Exergames in Older Adults With Mild Cognitive Impairment: Qualitative Interview Study.","authors":"Xi Chen, Dian Jiang, Hongting Ning, Lina Wu, Yifei Chen, Chi Zhang, Ruotong Peng, Yishu Zhu, Hui Feng","doi":"10.2196/53631","DOIUrl":"https://doi.org/10.2196/53631","url":null,"abstract":"<p><strong>Background: </strong>As a novel intervention method that combines exercise and games, exergames have demonstrated a positive impact on enhancing the cognitive and physical functions of older adults with mild cognitive impairment (MCI). However, there remains a dearth of knowledge and evidence regarding the experiences and needs of the older adult population in China with MCI about exergames.</p><p><strong>Objective: </strong>This qualitative study aimed to investigate the experience of and needs for exergames among older adults with MCI.</p><p><strong>Methods: </strong>We adopted a phenomenological methodology for this study, and conducted it at a community and nursing home in Changsha, Hunan Province, from June to August 2023. We used the purpose sampling method to conduct semistructured interviews with 21 older people with MCI. Older people with MCI were allowed to experience exergames using our preselected exergame device, the Nintendo Switch, and they were interviewed to understand their experience and needs for exergames. The interviews were recorded and transcribed verbatim, and the data were uploaded to NVivo 12 software for encoding. The corresponding text was then reviewed for data analysis. Data analysis was guided by the methodology proposed by Giorgi and was carried out simultaneously with data collection. This study's trustworthiness was evaluated according to credibility, dependability, confirmability, and transferability criteria.</p><p><strong>Results: </strong>Overall, 21 participants (mean age 70.2, SD 7.6 y; n=17, 81% women; mean Montreal Cognitive Assessment score 18.8, SD 3.6) were interviewed. Moreover, 21 interviews were conducted. By the 18th interview, the data were saturated, and to make sure no new topics came up, we conducted 3 more interviews. The experience of older people with MCI with exergames includes five parts: their attitudes toward exergames vary, they are both entertaining and interesting, they promote physical activity and exercise, they pass the time and relieve loneliness, and their conditions of use are not restricted. The needs of older people with MCI for exergames include the desire to design older people-friendly exergames, ensure scientific validity and safety in the process of sports, provide a good gaming experience, exercise physical and cognitive function, and provide support and training.</p><p><strong>Conclusions: </strong>This study provides an interpretative understanding of the experiences and needs associated with exergames in older people with MCI, which could inform exergame development appropriate for this population and guide the implementation of exergame interventions in this population. Most older people with MCI expressed a positive attitude toward exergames, but not all were interested in them. Older people with MCI viewed exergames as both entertaining and fun, promoting physical activity and exercise, passing the time, relieving loneliness, and the conditions of use w","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e53631"},"PeriodicalIF":3.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316971","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 to Users of a Serious Game: Vignette Experiment.","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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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 long-term retention (H3).</p><p><strong>Methods: </strong>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, 1 week later, and 1 month later, via web-based surveys.</p><p><strong>Results: </strong>The AR serious game elicited strong interest in the topic (perceived relevance in Attention, Relevance, Confidence, and Satisfaction [ARCS], W=10,417; P<.001) and motivated students by increasing self-efficacy (confidence in ARCS, W=11,882.5; P=.02) and satisfaction (in ARCS, W=4561; P<.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 with text-only methods and had higher learning success (t=-2.518; P=.02).</p><p><strong>Conclusions: </strong>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 could not 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 i","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e64751"},"PeriodicalIF":3.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309943","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}
Elena Brambilla, Karen Stendal, Vibeke Sundling, Giovanna Calogiuri
{"title":"Nature Engagement Outcomes of Viewing Nature Through a 360° Video or a Tablet Screen: Randomized Trial.","authors":"Elena Brambilla, Karen Stendal, Vibeke Sundling, Giovanna Calogiuri","doi":"10.2196/63424","DOIUrl":"https://doi.org/10.2196/63424","url":null,"abstract":"<p><strong>Background: </strong>Nature engagement, including affective and physical interactions with nature, is linked to a multitude of health and well-being benefits. Unfortunately, opportunities for engaging with nature are decreasing worldwide. University students, especially, are a demographic group that tends to engage little with nature. Immersive virtual nature (IVN; ie, digital nature content delivered through immersive devices, such as head-mounted displays) has been proposed as a medium to facilitate nature experiences and engagement. In recent years, 360° nature videos have emerged as an accessible way to create IVN content, although it is still unclear whether they can elicit presence and increase nature engagement to a greater extent than nature videos delivered through nonimmersive media.</p><p><strong>Objective: </strong>We aimed to investigate the effectiveness of nature videos as a medium to promote nature engagement among university students, comparing devices with different levels of immersion. Specifically, 2 experimental conditions were tested: a 360° nature video delivered through a head-mounted display (IVN) and a matching video displayed on a tablet screen (nonimmersive virtual nature).</p><p><strong>Methods: </strong>In total, 38 students were recruited at the library of a university campus and invited to participate in an organized hiking tour at the location displayed during the virtual nature experience. They were then randomized, using a random number generator, to either the IVN (n=20, 53%) or the nonimmersive virtual nature condition (n=18, 47%). Pre- and postexposure assessments of nature connectedness, intention to perform green exercise, intention to visit the hiking location, and intention to participate in the organized hiking tour were collected. Presence, cybersickness, and actual attendance on the tour were also assessed.</p><p><strong>Results: </strong>A mixed ANOVA showed statistically significant pre- to postexposure assessment increases in nature connectedness (F<sub>1,36</sub>=33.49; P<.001; η<sub>p</sub><sup>2</sup>=0.48); intention to perform green exercise (F<sub>1,36</sub>=5.55; P=.02); intention to visit the hiking location (F<sub>1,36</sub>=15.34; P<.001; η<sub>p</sub><sup>2</sup>=0.26); and intention to participate in the hiking tour (F<sub>1,36</sub>=12.45; P=.001; η<sub>p</sub><sup>2</sup>=0.30). Both conditions were associated with medium to high ratings of \"being there\" and \"sense of reality\" but low ratings of \"realism.\" The cybersickness levels were generally low. Of the 38 students, 6 (16%) participated in the organized tour. The mixed ANOVA found no statistical differences between the two conditions for any of the outcomes. The participants' changes in nature connectedness (ρ=0.35; P=.03) and attendance on the hiking tour (ρ=.37; P=.02) correlated with the presence item \"being there.\"</p><p><strong>Conclusions: </strong>This study provides novel evidence on the potential of virtual natu","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e63424"},"PeriodicalIF":3.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309944","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}
Minha Kim, Meong Hi Son, Suhyeon Moon, Won Chul Cha, Ik Joon Jo, Hee Yoon
{"title":"Correction: A Mixed Reality-Based Telesupervised Ultrasound Education Platform on 5G Network Compared to Direct Supervision: Prospective Randomized Pilot Trial.","authors":"Minha Kim, Meong Hi Son, Suhyeon Moon, Won Chul Cha, Ik Joon Jo, Hee Yoon","doi":"10.2196/77586","DOIUrl":"https://doi.org/10.2196/77586","url":null,"abstract":"","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e77586"},"PeriodicalIF":3.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284428","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}
Ruben Debeuf, Reinhard Claeys, Margo Berlanger, Myrthe Bunt, Aziz Debain, Daan De Vlieger, Matthias Eggermont, Mahyar Firouzi, Stefania Guida, Katarína Kostková, Siddhartha Lieten, Lubos Omelina, Silvia Zaccardi, Bart Jansen, Eva Swinnen, David Beckwée
{"title":"Insights on the User Experience and Feasibility of an Electromyography-Driven Exergame Combined With Blood Flow Restriction for Strength Training in Hospitalized Older Adults: Mixed Methods Randomized Controlled Feasibility Study.","authors":"Ruben Debeuf, Reinhard Claeys, Margo Berlanger, Myrthe Bunt, Aziz Debain, Daan De Vlieger, Matthias Eggermont, Mahyar Firouzi, Stefania Guida, Katarína Kostková, Siddhartha Lieten, Lubos Omelina, Silvia Zaccardi, Bart Jansen, Eva Swinnen, David Beckwée","doi":"10.2196/69400","DOIUrl":"10.2196/69400","url":null,"abstract":"<p><strong>Background: </strong>Hospitalized older adults often spend prolonged periods of time bedridden, leading to decreased muscle strength and function. To tackle this, rehabilitation aims to keep patients active and train affected muscles. Exergames have proven to be effective in the rehabilitation of different patient populations and offer a motivating solution to combat inactivity associated with hospitalization. Furthermore, blood flow restriction (BFR) is effective in therapy for weakened patients, so combining BFR and exergames might be promising.</p><p><strong>Objective: </strong>As part of an iterative process of user-centered development, this mixed method study investigates the acceptability and feasibility of the Ghostly game as a stand-alone added therapy or combined with BFR in strength training of hospitalized older adults.</p><p><strong>Methods: </strong>A mixed methods study was conducted on 15 hospitalized older adults. Participants were randomized into 3 groups and received daily interventions from the moment they were included in the geriatric ward, until discharge from the hospital. The Ghostly group received daily conventional therapy with the Ghostly game as added therapy, the Ghostly + BFR group received daily conventional therapy with Ghostly in combination with BFR as added therapy and last, the control group received daily conventional therapy with dose-matched isometric exercises as added therapy. The primary outcome, user experience, was assessed before discharge from the hospital using the Usefulness, Satisfaction, and Ease of Use questionnaire and through expert observations. Clinical outcomes such as muscle strength, muscle architecture, and segmental body composition were assessed at baseline and before discharge from the hospital to test the feasibility of the research protocol in preparation for future randomized controlled trials.</p><p><strong>Results: </strong>A total of 15 hospitalized older adults (11 female participants, 73.33%) were included in this study with an average age of 84.53 (range: 78-94) years. Participants received an average of 3.47 (range: 3-5) intervention sessions after transferring to the geriatric ward of the hospital. Results on user experience revealed high scores on all subcategories of the Usefulness, Satisfaction, and Ease of Use questionnaire (usefulness: 78.93%, ease of use: 82.99%, ease of learning: 85.36%, and satisfaction: 87.55%). Furthermore, expert observations identified issues with color contrast, reaction time speed, and the need to tailor the game to accommodate the diverse requirements of different patient populations. All outcomes and procedures were found feasible for a future randomized controlled trial.</p><p><strong>Conclusions: </strong>This mixed methods study combines the innovative aspects of an electromyography-driven exergame with strength training principles of BFR and reveals the acceptability and feasibility of the Ghostly game as a stand-alone added t","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69400"},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266284","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}
Yaqin Li, Yaqian Liu, Angela Ym Leung, Jed Montayre
{"title":"Technology-Assisted Motor-Cognitive Training Among Older Adults: Rapid Systematic Review of Randomized Controlled Trials.","authors":"Yaqin Li, Yaqian Liu, Angela Ym Leung, Jed Montayre","doi":"10.2196/67250","DOIUrl":"https://doi.org/10.2196/67250","url":null,"abstract":"<p><strong>Background: </strong>Age-related physiological changes in older adults involve a rapid decline in motor exercise ability; some older adults may also experience difficulties in maintaining focus, memory loss, and a decline in reaction time, which consequently impair their ability to perform dual tasks. Motor-cognitive training (MCT) refers to a blend of motor activity and cognitive training that occurs simultaneously and can assist older adults in enhancing their physical function, cognitive abilities, and dual-task performance. In recent years, the use of technology for delivering MCT has become increasingly popular in research. This has been achieved through various technologies that simplify MCT for older adults.</p><p><strong>Objective: </strong>This study aimed to systematically examine the feasibility and effectiveness studies on technology-assisted MCT among older adults.</p><p><strong>Methods: </strong>This rapid review was conducted following the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 standards, and the Synthesis Without Meta-analysis (SWiM) in systematic reviews reporting guideline. Four databases were searched, including CINAHL, Embase, PubMed, and Scopus, from January 2013 to March 2025. Search strategies were constructed based on three main topics: (1) older adults, (2) MCT, and (3) technology. Inclusion criteria followed the population, intervention, comparator, outcome, and study design framework as follows: older adults (population); technology-assisted MCT (intervention); standard treatment control, active control, partial intervention control, placebo control, and dose-response control (comparator); various measures of physical, cognitive, and dual-task performance (outcome); and randomized controlled trials (RCTs) and pilot RCTs (study design). The Cochrane Risk of Bias Tool was applied for quality appraisal of the included studies. The feasibility of the included studies was assessed using completion rates and attrition rates. Descriptive statistics were used to describe the demographic and clinical characteristics of the groups, while narrative methods were used to categorize and synthesize their effectiveness.</p><p><strong>Results: </strong>In total, 20 studies were included, comprising 16 RCTs and 4 pilot RCTs, most of which were conducted within a 6-week period. Each session typically lasted between 10 and 30 minutes and was held 2 to 3 times per week. Feasibility analysis showed that technology-assisted MCT was generally feasible. While the workload was high, the perceived usability was also high, with a considerable amount of positive feedback and very few reported adverse events. The types of MCT varied in terms of components, duration, and frequency. The majority of studies (18/20, 90%) demonstrated statistically significant improvements in physical, cognitive, and dual-task performance because of technology-assisted MCT.</p><p><strong>Conclusions: </strong>T","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67250"},"PeriodicalIF":3.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215887","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":"The Positive Effect of Video-Game Play on College Students' Anxiety and Depression Symptoms During the COVID-19 Pandemic Shelter-in-Place Lockdowns: Mixed Methods Study.","authors":"Fengbin Hu, Zixue Tai, Jianping Liu","doi":"10.2196/58857","DOIUrl":"10.2196/58857","url":null,"abstract":"<p><strong>Background: </strong>A growing body of research has examined the connection between video game play and relief from anxiety and depressive symptoms during the COVID-19 pandemic years. However, evidence has been limited in dissecting the role of video games in moderating personal health outcomes such as anxiety and depression. This research aimed to provide insights into this area by investigating Chinese college students living under difficult conditions during the COVID-19 pandemic shelter-in-place lockdowns.</p><p><strong>Objective: </strong>This study investigated the effect of video games on mental disorders among Chinese college students during the COVID-19 pandemic shelter-in-place lockdown mandates.</p><p><strong>Methods: </strong>A mixed methods approach was adopted. The quantitative portion included a cross-sectional survey of a national sample of 2818 (n=1396, 49.54% male vs n=1422, 50.46% female) college students from 8 provinces spanning 16 geographic regions during the extended COVID-19 pandemic lockdowns in late 2021 and early 2022. The qualitative portion encompassed 17 semistructured in-depth interviews of (9/17, 53% female vs 8/17, 47% male) students on their experiences, perceptions, and evaluations of playing video games during the lockdowns. Anxiety symptoms were measured using the 7-item self-administered Generalized Anxiety Disorder scale, while depression was assessed with the 9-item Patient Health Questionnaire scale. Multiple regression analyses were used to examine whether demographic variables (ie, sex and year in college), modality and content of play, and play time accounted for the outcomes of anxiety and depression. ANOVA tests were performed on overall playtime and the prelockdown-to-lockdown period change in game time on the severity of anxiety and depression symptoms. Thematic analysis of qualitative data provided additional perspectives on gaming dynamics in relation to anxiety and depression.</p><p><strong>Results: </strong>No significant sex effect was detected in video game play outcomes for anxiety or depression. At the level of the study population, a significant difference between gamers and nongamers was observed to moderate anxiety (t<sub>2816</sub>=-0.42, P=.02) but not depression (t<sub>2816</sub>=-0.12, P=.60) symptoms, controlling for the effect of sex. Playing more online games, spending more time gaming, and an increase in play time were linked to heightened anxiety and depression symptoms. Conversely, playing with friends was connected to lowered anxiety (β=-0.05, P=.04) and depression (β=-0.08, P=.003) scores.</p><p><strong>Conclusions: </strong>The buffer effects of video games may be strongest among routine players with moderate to low anxiety and depression symptoms, while excessive gaming, as shown in the overall amount of game time as well as the prelockdown-to-lockdown period increase in game time, may have detrimental consequences among those struggling with high anxiety and dep","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e58857"},"PeriodicalIF":3.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187041","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":"The Impact of Gamified Interventions on the Management of Chronic Obstructive Pulmonary Disease: Systematic Literature Review.","authors":"Jinsong Chen, Tingzhong Yang, Qilian He, Mingli Pang, Ying Cao, Zheng Liu, Linfei Li, Hsing-I Liu, Christopher Bullen","doi":"10.2196/69510","DOIUrl":"10.2196/69510","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) requires consistent sustained management, including regular physical activity, pulmonary rehabilitation, and self-care adherence. Despite strong clinical guidelines, patient engagement remains a major challenge, leading to suboptimal disease control and increased health care use. Gamified interventions have emerged as potential tools to improve adherence, motivation, and outcomes in chronic disease management. However, their effectiveness and implementation in COPD remain underexplored.</p><p><strong>Objective: </strong>This review synthesizes current evidence on gamified interventions for COPD management to evaluate their effectiveness, focusing on patient engagement, physical outcomes, and quality of life.</p><p><strong>Methods: </strong>We conducted a systematic search in PubMed, Scopus, Web of Science, Embase, IEEE Xplore, Cochrane Library, and China National Knowledge Infrastructure for studies published from January 2014 to October 2024. Only original studies involving trials (both randomized controlled trials [RCTs] and non-RCTs), intervention studies, feasibility studies, cross-sectional surveys, or qualitative studies were included.</p><p><strong>Results: </strong>A total of 29 studies met the inclusion criteria: 11 (38%) RCTs; 7 (24%) pilot studies; 5 (17%) observational studies (including qualitative studies); and 6 (21%) other studies using gamified technologies such as virtual reality, exergames, and mobile apps. Compared to nongamified methods, gamified interventions provided an engaging, home-based alternative for COPD management, supporting long-term rehabilitation. Gamification features such as real-time feedback, adaptive challenges, and personalized goals increased patient adherence and motivation, with high engagement seen in virtual reality and exergame-based interventions, and showed notable improvements in COPD management, enhancing exercise tolerance, self-management, and symptom control. However, most of the studies (22/29, 76%) were of short duration, with small sample sizes.</p><p><strong>Conclusions: </strong>Gamified COPD management tools offer flexibility and empower patients to self-manage their condition, potentially reducing the need for clinic visits. Gamified interventions show promise in COPD management, although current studies have methodological limitations. Future research should focus on conducting larger trials to assess the sustained impact of gamified interventions on COPD outcomes; developing culturally relevant adaptations to enhance the global applicability of these interventions; and collaborating with patients, clinicians, and game developers to make the interventions more engaging and effective.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69510"},"PeriodicalIF":3.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187040","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}
Cuirong Hu, Xia Lan, Yanwen Luo, Shu Zhu, Guilan Cheng
{"title":"Efficacy of Motion-Sensing Game-Assisted Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Cuirong Hu, Xia Lan, Yanwen Luo, Shu Zhu, Guilan Cheng","doi":"10.2196/69562","DOIUrl":"10.2196/69562","url":null,"abstract":"<p><strong>Background: </strong>While motion-sensing game (MSG) platforms provide immersive, real-time feedback environments for rehabilitation, research findings on their effectiveness in chronic obstructive pulmonary disease (COPD) pulmonary rehabilitation remain heterogeneous.</p><p><strong>Objective: </strong>This study aims to systematically evaluate the efficacy of MSG-assisted pulmonary rehabilitation for patients with COPD.</p><p><strong>Methods: </strong>This meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. Eight electronic databases (PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, China National Knowledge Infrastructure, and Wanfang) were systematically searched from inception to March 2025. Randomized controlled trials (RCTs) comparing MSG-assisted versus conventional pulmonary rehabilitation in patients with COPD were included. Data analysis was performed using Review Manager 5.3 (Cochrane Collaboration) and Stata 17 (StataCorp LLC). Mean differences (MDs) and odds ratios (ORs) with 95% CIs were calculated. Risk of bias was assessed using the revised Cochrane Risk of Bias tool (Cochrane Collaboration), and evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluations (GRADE) approach.</p><p><strong>Results: </strong>Analysis of 12 RCTs (n=776) demonstrated that MSG-assisted pulmonary rehabilitation, compared with conventional pulmonary rehabilitation, significantly improved 6-Minute Walk Distance (MD 23.23, 95% CI 14.47-31.99; P<.001), upper limb strength via 30-Second Arm Curl Test (MD 1.83, 95% CI 0.63-3.03; P=.003), balance performance (Balance Evaluation Systems Test; MD 2.34, 95% CI 1.52-3.17; P<.001), and exercise adherence (OR 3.00, 95% CI 1.38-6.52; P=.005). Additionally, significant improvements were observed in dyspnea severity (MD -0.25, 95% CI -0.48 to -0.02; P=.03), health-related quality of life (MD -6.00, 95% CI -10.96 to -1.04; P=.02), and psychological outcomes including anxiety (MD -2.41, 95% CI -3.42 to -1.39; P<.001) and depression (MD -1.40, 95% CI -2.69 to -0.42; P=.03). The overall methodological quality of the included studies was suboptimal with most evidence rated as \"low\" or \"very low\" quality.</p><p><strong>Conclusions: </strong>MSG-assisted pulmonary rehabilitation demonstrates significant improvements in exercise capacity, respiratory symptoms, quality of life, and psychological well-being among patients with COPD. Despite potential benefits, the predominance of low-quality evidence highlights the necessity for risk-benefit assessment before clinical implementation. Future research priorities should include larger, methodologically rigorous RCTs, standardized intervention protocols, investigation of sustained therapeutic effects, and cost-effectiveness analyses to establish definitive","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69562"},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182465","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":"Haptic-Driven Serious Card Games for Older Adults: User Preferences Study.","authors":"Xin Huang, Nazlena Mohamad Ali, Shafrida Sahrani","doi":"10.2196/73135","DOIUrl":"10.2196/73135","url":null,"abstract":"<p><strong>Background: </strong>Haptic feedback technology is widely used, including in serious games. It is an additional sensory method that supplements audio and vision, provides a novel user experience through a physical control layer, and enhances the immersion of virtual reality, thereby improving the user's cognitive state while alleviating dependence on visual information. However, there is limited research on haptic feedback preferences for mobile serious card games designed for older adults.</p><p><strong>Objective: </strong>The study aims to investigate older adults' preferences for haptic feedback in mobile serious card games.</p><p><strong>Methods: </strong>This study recruited a total of 250 participants from Dangtu County, Anhui Province, China, with an average age of 64.78 (SD 4.23) years. A descriptive survey was conducted among older adults, structured questionnaires were distributed, and data were collected via the Wenjuanxing (Changsha Ranxing Information Technology Co Ltd) mobile app. Reliability and validity analyses were performed using SPSS (IBM Corp) software. The questionnaire investigated older adults' basic understanding of card games and serious games, the integration of card games with mobile devices, the potential impact of combining card games with haptic feedback technology, as well as suggestions and opinions.</p><p><strong>Results: </strong>The results showed that 63.2% (158/250) of the older adults liked the slight haptic feedback mode, and 78.4% (196/250) of the participants believed that combining haptic feedback technology with mobile card games would help improve cognitive abilities. The study found that 73.6% (184/250) of the older adults believed that this technology could reduce their reliance on visual information. This confirms that the combination of serious card games and haptic feedback can alleviate sensory impairments in older adults. Qualitative analysis revealed the potential of haptic feedback to reduce visual fatigue and provide an engaging cognitive training experience.</p><p><strong>Conclusions: </strong>Older adults have shown great interest in incorporating haptic feedback into mobile serious card games, believing that this could enhance their cognitive abilities while reducing their reliance on visual information. However, limitations include sample size and geographic restrictions, differences in digital literacy, self-reported data, and lack of longitudinal assessment. Longitudinal studies are recommended to evaluate the long-term effects of mobile serious card games with haptic feedback on cognitive abilities. Such investigations could provide valuable insights for game developers, rehabilitation institutions, and the development of cognitive training tools for older adults.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73135"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159150","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}