JMIR Serious Games最新文献

{"title":"Design and Iterative Development of Serious Exergames for Children With Autism Spectrum Disorder: Formative Multiple-Case Pilot Study.","authors":"Won Kim, Minwoo Seong, SeungJun Kim","doi":"10.2196/77727","DOIUrl":"10.2196/77727","url":null,"abstract":"<p><strong>Background: </strong>Children with autism spectrum disorder (ASD) exhibit cognitive, motor, and social difficulties that affect engagement, causing developmental delays, behavioral challenges, and obesity-interrelated concerns in daily functioning and well-being. Although interactive interventions have incorporated physical activity, they often rely on limited physical involvement and lack iterative, expert-informed design, as built on pre-existing game frameworks. Physical activity is often operationalized as constrained input (eg, gestures or in-place actions) rather than exertion-intensive, whole-body exercise, and design guidance for adapting exercise content under ASD-oriented safety and cognitive-sensory constraints remains limited. These limitations highlight the need for exergames that promote sustained, full-body participation aligned with developmental goals, motivating formative, co-design with expertise and initial field testing in this population.</p><p><strong>Objective: </strong>We aim to iteratively design exercise-based serious games (SGs) for children with ASD through a structured, expert-informed co-design process involving 21 professionals across special education, adapted physical education, and human-computer interaction, and to examine feasibility and use contexts through an exploratory multiple-case pilot study.</p><p><strong>Methods: </strong>We derived serious exergames using 4 design methods-stakeholder interview, concept mapping, creative matrix, and visualize the vote. Two exergames-\"Fruit Sorting Run\" and \"Hazard Avoiding Ride\"-were developed, integrating full-body running and cycling movements into goal-directed tasks under ASD-oriented constraints. We conducted a multiple-case pilot with 3 children with ASD. During gameplay, caregivers labeled engagement using a binary input interface, and we conducted postsession caregiver interviews to capture complementary observations.</p><p><strong>Results: </strong>Engagement in both exergames tended to increase over normalized time. Generalized estimating equations with a logit link and an autoregressive working correlation of order 1 (AR1), including participant indicators, showed a statistically significant association between normalized time and engagement in Fruit Sorting Run (per 0.1 increase: β=0.48; odds ratio 1.62, 95% CI 1.09-2.38; P=.02) and Hazard Avoiding Ride (per 0.1 increase: β=0.66; odds ratio 1.93, 95% CI 1.04-3.60, P=.04). Caregiver interviews reinforced these findings, reporting increased attention, motivation, and enjoyment across both activities.</p><p><strong>Conclusions: </strong>The findings support the applicability of an expert-informed design approach and the viability of the resulting exergames, integrating goal-directed physical activity, virtual agent-based prompting, and stakeholder-informed considerations such as motor-cognitive alignment, interactive scaffolding, and support for daily living skills. Distinct from prior SG approache","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e77727"},"PeriodicalIF":4.7,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325910","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":"Design Requirements for Gamified Exercise Apps for Adults With Prehypertension Based on the Octalysis Framework and Self-Determination Theory: Qualitative Interview Study.","authors":"Sijia Li, Genying Liu, Li Qiao, Hong-Yu Yu, Yu-Yang Zhang, Runyuan Pei, Yue-Tao Lin, Hao-Ming Ma, Mei-Hua Piao","doi":"10.2196/86793","DOIUrl":"10.2196/86793","url":null,"abstract":"<p><strong>Background: </strong>Managing blood pressure (BP) in prehypertensive individuals is crucial to prevent the incidence of hypertension. While physical activity has proven effective in BP management, physical inactivity remains prevalent. Gamification has shown promise in addressing physical inactivity; however, its effectiveness is limited due to the suboptimal intervention design.</p><p><strong>Objective: </strong>This study aimed to develop a comprehensive understanding of prehypertensive individuals' needs, design preferences, and motivational drives for gamified exercise apps by integrating the Octalysis Gamification Framework with Self-Determination Theory (SDT) through a participatory qualitative methodology.</p><p><strong>Methods: </strong>The study adopted a cross-sectional qualitative interview study design and used semistructured interviews conducted from June to July 2025 across mainland China. Participants were recruited through online platforms using purposive sampling to select adults with prehypertension (systolic BP 120-139 mm Hg and/or diastolic BP 80-89 mm Hg). Interview guides were systematically structured around SDT constructs and the Octalysis Framework's 8 core gamification drives to explore participants' needs, design preferences, and motivational drives for gamified exercise apps. An inductive or deductive hybrid thematic analysis was used to identify key themes.</p><p><strong>Results: </strong>A total of 14 eligible prehypertensive individuals participated in the study. Their needs and preferences for exercise apps, including exercise guidance, data monitoring and feedback, and wearable device portability, were summarized. Eight core gamification motivational drives, such as epic meaning and social influence, according to the Octalysis Framework, were explored with interviewees, including their attitudes and creative design considerations. Moreover, the study examined how the satisfaction of basic psychological needs (eg, sense of volition, technical challenges, and social connections) influences the transformation of motivation.</p><p><strong>Conclusions: </strong>This theory-informed qualitative study is among the first to explore the needs and preferences of individuals with prehypertension for gamified exercise apps by integrating the Octalysis Gamification Framework with SDT. The findings suggest that successful gamified exercise apps for prehypertensive individuals may benefit from going beyond traditional game mechanics to address deeper psychological needs. Participants emphasized the importance of personalized exercise programming, robust health monitoring capabilities, and human-centered gamification designs that support autonomy, competence, and relatedness. Satisfaction of these basic psychological needs is critical for transforming extrinsic motivations, such as weight management and health values, into intrinsic enjoyment of exercise. By integrating a theoretical basis with user-centered perspectiv","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e86793"},"PeriodicalIF":4.7,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290036","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":"Quantifying Slowness in Parkinson Disease Using a Serious Game: Cross-Sectional Study.","authors":"Luanne Cardoso Mendes, Ariana Moura Cabral, Camille Marques Alves, Isabela Alves Marques, Alberto López Delis, Yann Morère, Adriano de Oliveira Andrade","doi":"10.2196/79463","DOIUrl":"10.2196/79463","url":null,"abstract":"<p><strong>Background: </strong>Slowness in voluntary movements is a hallmark of Parkinson disease (PD); yet, objective measurement outside clinical settings is limited. Serious games represent a promising alternative to extract motor performance metrics during interactions. However, evidence on the effectiveness of these games in discriminating motor performance between individuals with and those without PD is still scarce.</p><p><strong>Objective: </strong>This study aimed to objectively assess slowness using the RehaBEElitation serious game, based on in-game estimated measurements.</p><p><strong>Methods: </strong>The study included 15 individuals with mild to moderate PD (Hoehn and Yahr I-III), assessed in both ON and OFF medication states, and 15 age- and gender-matched healthy controls (10 men and 5 women; mean 66.27, SD 9.13 years; range 45-82 years). All participants played each phase of the game on the easiest level. Slowness was evaluated by detecting the voluntary movement of the gyroscope signals using the singular spectrum analysis method. The response time (RT) and angular velocity (AV) of the participants while playing RehaBEElitation were estimated. Group-level comparisons were performed to investigate the presence of slowness patterns across conditions. The Kruskal-Wallis test and Wilcoxon signed rank test with Bonferroni correction were used to confirm the differences between groups, and the effect size was estimated using eta square (η2). Spearman correlation analyses were conducted to examine associations between the RT and AV and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor items.</p><p><strong>Results: </strong>Groups were age-homogeneous (P>.05). Participants with PD had significantly higher scores on MDS-UPDRS Part III in the OFF state compared to the ON state of medication (mean difference 2.86, 95% CI 2-12; P<.05). RT was generally shorter and AV higher in controls than in participants with PD. In the PD group, RT decreased and AV increased from OFF to ON states, reflecting an improvement in motor performance. Significant differences in RT were observed between groups in all phases of the game, with effect sizes ranging from small to moderate (η2=0.0239-0.0650). AV differed markedly between groups in phase 4, with a large effect size (η2=0.404). Correlation analyses revealed weak positive associations between RT and MDS-UPDRS items, while AV showed strong negative correlations with each motor item and the summary score for bradykinesia.</p><p><strong>Conclusions: </strong>This study proposes a new method to assess slowness in PD by using inertial sensor data to extract objective motor measures (RT and AV) during a serious game, allowing continuous and quantitative evaluation beyond traditional clinical scales and tests. The findings demonstrate that RT and AV extracted from gameplay can detect slowness-related motor differences, supporting the RehaBEElitation serious game as an ","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e79463"},"PeriodicalIF":4.7,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290015","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 Versus Nongamified Metaverse Learning for Breast Health Knowledge in Women: Randomized Controlled Trial.","authors":"Rui Li, Sabzali Musa Kahn, Bingyu Duan, Seng Yue Wong","doi":"10.2196/75318","DOIUrl":"10.2196/75318","url":null,"abstract":"<p><strong>Background: </strong>The metaverse provides an immersive, interactive medium for health education, but most studies evaluate immersion and gamification together. Randomized evidence disentangling their separate effects on immediate learning and short-term retention in breast health education is lacking.</p><p><strong>Objective: </strong>This study aimed to isolate the effects of gamification, over and above an identical immersive metaverse environment, on immediate gains and 4-week retention of women's breast health knowledge.</p><p><strong>Methods: </strong>This 2-arm, parallel, individually randomized controlled trial was conducted in Hangzhou, China. Eligible participants were women aged ≥18 years who were interested in breast health and able to use a personal computer with internet access. A total of 80 women were recruited via the Xiaohongshu social media platform; 8 withdrew before randomization or did not complete the baseline assessment, and the remaining 72 women were randomized to a gamified metaverse (GM) group or a nongamified metaverse (NGM) group using a computer-generated 1:1 sequence. Both groups used the Mammoverse platform with identical educational content and exposure time. Breast health knowledge was assessed at baseline (T1), immediately postintervention (T2), and 4-week follow-up (T3) using the same questionnaire. The primary outcome was a change in knowledge score. Linear mixed-effects models were used, with age, education, family history of breast cancer, prior training, and baseline knowledge as covariates. Participants and investigators were not blinded.</p><p><strong>Results: </strong>All randomized participants completed follow-up and were included in the analysis (GM group: n=36; NGM group: n=36), with no loss to follow-up. Knowledge scores improved in both groups, but gains from T1 to T2 were larger in the GM group than in the NGM group (Hedges g=0.65, 95% CI 0.18-1.12; P=.007). From T2 to T3, there was no between-group difference in change scores (P=.91). However, at 4 weeks, the GM group retained higher absolute knowledge than the NGM group (estimated marginal means 15.7 vs 13.0). No intervention-related adverse events were reported.</p><p><strong>Conclusions: </strong>This study marks the first application of gamification in breast self-examination education for ordinary Chinese women within a 3D desktop metaverse. By comparing gamified and nongamified versions under identical metaverse platform conditions, it expands the application boundaries of the GM group in breast health education. Gamification significantly enhanced immediate acquisition of breast health knowledge but did not provide additional advantages for short-term retention. However, the gamified group maintained higher absolute knowledge levels at the 4-week follow-up. Overall, in the 3D desktop metaverse, immersive experiences provide foundational effects, while gamification delivers immediate gains. To further optimize long-term retenti","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e75318"},"PeriodicalIF":4.7,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194696","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 Exergaming Tennis on Players' Tennis Skills and Mental State Compared to Regular Tennis in Adult Players: Quasi-Experimental Study.","authors":"Jia Sheng Ngo, See Ziau Hoe, Maziah Mat Rosly","doi":"10.2196/73732","DOIUrl":"10.2196/73732","url":null,"abstract":"<p><strong>Background: </strong>Exergaming, which combines physical activity with interactive gaming, has been shown to improve motor skills and fitness. However, exergaming's potential in complex, open-skill sports such as tennis, which require real-time coordination, decision-making, and technical precision, remains underexplored. Furthermore, only a few studies have evaluated the impact of exergaming on both technical skill development and psychological outcomes such as motivation and confidence, especially among novice players. This study addresses these gaps by comparing the combination of exergame-based tennis training and on-court tennis training (EBTT+OCTT) with on-court tennis training alone (OCTT×2) in improving technical skills, grip strength, confidence, and motivation.</p><p><strong>Objective: </strong>This study aims to assess the effect of exergaming tennis in developing tennis technical skills, grip strength, confidence level, and motivation level.</p><p><strong>Methods: </strong>In a 12-week quasi-experimental trial, 66 novices were randomized to either the EBTT+OCTT or the OCTT×2 group. Participants consisted of 22 males and 44 females, with the mean BMI and age of approximately 22 (SD 2.9) kg/m<sup>2</sup> and 26 (SD 7) years, respectively. The EBTT+OCTT group had 1 weekly session of OCTT and 1 session of exergaming training using Virtual Tennis (PlayStation 3 Move), while the OCTT×2 group completed 2 weekly on-court sessions. Outcomes included tennis technical skills such as groundstroke technique, service speed, and service accuracy (assessed using the Hewitt tennis test), grip strength (using a handheld dynamometer), confidence (using the Sports Confidence Inventory), and motivation (using the Sport Motivation Scale). Mean differences (MDs) between pre- and postintervention were collected and analyzed using repeated-measures ANOVA (α=.05) and Pearson correlation analysis. Effect sizes were calculated using partial eta squared (ηp²), where values ≥0.14 indicated large effects.</p><p><strong>Results: </strong>After 12 weeks of training, both EBTT+OCTT and OCTT×2 groups showed significant improvements (P<.001) in tennis technical skills (MD=17.06-22.62), grip strength (MD=9.59-11.04 kg), and confidence levels (MD=23.29-26.28). These outcome measures have large effect sizes (ηp²=0.84-0.92); however, they did not significantly differ (P>.05) across the groups when compared, with P<sub>grip strength</sub>=.24, P<sub>hit</sub>=.97, P<sub>accuracy</sub>=.86, P<sub>speed=</sub>.72, and P<sub>confidence</sub>=.31. In terms of motivation, EBTT+OCTT retained intrinsic motivation (IM) better than OCTT×2, with significant reductions in IM, mainly IM-to-know (MD=7, SD 2.95) and IM-to-accomplish (MD=5, SD 3.77) observed in the OCTT×2 group (P<.001). Grip strength, confidence, and motivation levels (except amotivation) showed positive correlations with tennis technical skills (r=0.39-0.80).</p><p><strong>Conclusions: </strong>EBTT+OCTT and O","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e73732"},"PeriodicalIF":4.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105530","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 Physical Education and Cognitive Performance Among Chinese Secondary School Students: Cross-Sectional Moderation Mediation Study.","authors":"Jingtong Zhang, Sae-Sook Oh, Yaru Xu","doi":"10.2196/81086","DOIUrl":"10.2196/81086","url":null,"abstract":"<p><strong>Background: </strong>Educators are exploring new methods to educate beyond the classroom as global concerns about students' cognitive, emotional, and social well-being grow. Physical education (PE) has been demonstrated to boost cognitive and psychological outcomes in several studies. Most research has neglected the benefits of gamification and artificial intelligence (AI)-based feedback in PE, focusing instead on conventional PE formats. The impacts of technologically enhanced PE settings on students' cognitive performance through feedback and reward mechanisms remain understudied.</p><p><strong>Objective: </strong>This study aimed to investigate how intrinsic motivation and AI-based feedback moderated the effects of gamified PE on students' cognitive performance.</p><p><strong>Methods: </strong>The study used a cross-sectional design. In Beijing, Shanghai, Chengdu, and Guangzhou, a total of 1029 public high school students completed a standardized questionnaire. Students in secondary school (male: n=490, 47.6% and female: n=539, 52.4%) aged 10-18 years, were recruited from urban, suburban, and rural locales. Participants were sourced from public, private, and semigovernment schools, reflecting a range of academic achievement levels and access to technology. Students participating in standard PE sessions were included, whereas those with medical conditions that restricted physical exercise were excluded. Data were gathered via standardized questionnaires during designated PE sessions. Gamified PE, cognitive performance, intrinsic motivation, teacher support, collaboration, and AI feedback were examined using standardized instruments. Trained facilitators helped younger participants understand and follow ethical norms. The study used maximum likelihood estimation for structural equation modeling. Bootstrapping was used to analyze mediation and moderation effects at a 5% significance level (α=.05).</p><p><strong>Results: </strong>According to structural equation modeling, gamified PE highly predicts cognitive performance (β=.34; P<.001). Other significant factors were teacher support (β=.31; P<.001), physical exercise enjoyment (β=.28; P<.001), and teamwork (β=.26; P<.001). AI-based feedback strengthened the link between gamified PE and cognitive performance under moderation analysis (β=.18; P<.001). Mediation analysis indicated that intrinsic motivation partially mediated the relationship, resulting in a significant indirect effect (β=.21, 95% CI 0.12-0.31; SE=0.05).</p><p><strong>Conclusions: </strong>This research integrates gamified PE with AI-based feedback mechanisms to evaluate students' cognitive outcomes, a domain that has been rarely investigated experimentally. This study highlights the combined effect of intrinsic motivation and AI-generated feedback in a technology-enhanced PE context, in contrast to previous research that primarily focuses on traditional PE methods or isolated gamification elements. The findings enhance th","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e81086"},"PeriodicalIF":4.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105486","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 Haptic-Driven Serious Game for Cognitive Stimulation and Visual Impairment Mitigation in Older Adults Based on the Design-Play-Experience Framework: Cross-Sectional Mixed Methods Pilot Study.","authors":"Xin Huang, Nazlena Mohamad Ali, Shafrida Sahrani, Yue Zhang","doi":"10.2196/86290","DOIUrl":"10.2196/86290","url":null,"abstract":"<p><strong>Background: </strong>In the context of global aging, cognitive decline among older adults has become a prevalent issue, significantly impacting their daily lives. Serious games have demonstrated potential in enhancing cognitive abilities in this population. However, most existing serious games designed for older adults rely heavily on visual interfaces, which are often potentially detrimental for those with pre-existing visual impairments.</p><p><strong>Objective: </strong>This study had two primary objectives: (1) to design a theoretical prototype for a haptic-driven serious game for older adults based on the Design-Play-Experience (DPE) framework, aiming to enhance cognitive abilities, including attention, logical reasoning, and decision-making while simultaneously mitigating challenges associated with visual impairment, and (2) to conduct a pilot study evaluating the prototype's usability, accessibility, and user experience within the target population.</p><p><strong>Methods: </strong>We used a cross-sectional, mixed methods pilot study with a single-group observational design, comprising a theoretical design and a pilot user study. First, the DPE framework was systematically applied to develop a game prototype by integrating haptic feedback technology (using built-in smartphone vibration motors) across its 3 core dimensions: design (haptic symbol system, accessible interface), play (dynamic difficulty adjustment), and experience (emotional engagement). Subsequently, a pilot study was conducted with 10 older adults recruited via convenience sampling (mean age 62.9, SD 3.35 years; 5 male, 5 female; all with self-reported mild visual impairments, such as presbyopia). Following interaction with the prototype, data were collected remotely using the System Usability Scale (SUS) and semistructured interviews administered via videoconferencing. Quantitative data from the SUS were analyzed using descriptive statistics, while qualitative data from the interviews were processed using thematic analysis.</p><p><strong>Results: </strong>Pilot user studies showed that the game prototype had good usability, with an average SUS score of 89.5 (SD 2.72; 95% CI 87.6-91.4), which is considered \"excellent.\" Thematic analysis of the interviews revealed three significant themes. The first theme was intuitive haptic feedback, which reflected that participants were able to quickly grasp and value the vibrational cues used to identify cards. The second theme was based on reduced eye strain, in which the combination of large fonts, high-contrast interfaces, and haptic feedback was praised for its effectiveness in relieving eye strain. The third theme was simplicity, where the simplified card game mechanics were considered both fun and challenging.</p><p><strong>Conclusions: </strong>This study developed and validated a haptic, serious game for older adults. Its innovation lies in the systematic application of the DPE framework to achieve \"haptic substitution ","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e86290"},"PeriodicalIF":4.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093317","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":"Co-Designing Mobile Serious Games to Support Patients With Psoriatic Arthritis and Chronic Pain: Mixed Methods Study.","authors":"Bárbara Ramalho, Samuel Gomes, Marta Silva Vicente, Filipa Magalhães, Rodolfo Gonçalves Costa, Sandra Gama, Vasileios Charisis, Leontios Hadjileontiadis, Sofia B Dias","doi":"10.2196/75072","DOIUrl":"10.2196/75072","url":null,"abstract":"<p><strong>Background: </strong>Serious games offer promising avenues for clinical care by enhancing patient engagement and delivering therapeutic benefits. In psoriatic arthritis (PsA), chronic pain contributes to emotional distress, functional limitations, and reduced well-being. While symptom-tracking apps exist, few digital interventions directly address chronic pain through engaging, therapeutic experiences tailored to patients' cognitive and physical needs.</p><p><strong>Objective: </strong>This study aimed to co-design mobile serious games-NoPain Games-to support patients with PsA in managing chronic pain. Conducted within the iPROLEPSIS Horizon Europe project, the study involved a multidisciplinary cocreation session with rheumatologists, researchers, and technical experts, followed by a usability feedback session with patients with PsA. The goal was to identify therapeutic priorities, refine game mechanics, and assess usability to inform the development of personalized, accessible digital interventions.</p><p><strong>Methods: </strong>A sequential mixed methods design was used. First, a 90-minute remote cocreation session was held with 14 experts (6 rheumatologists, 4 technical experts, and 4 researchers) from 3 European countries. Participants reviewed game storyboards and discussed therapeutic and design priorities. Thematic analysis of transcribed discussions identified key insights. Next, a 60-minute remote usability feedback session was conducted with 5 patients with PsA (aged 25-64 y), who interacted with 2 high-fidelity game prototypes (Space Oddity and Four Seasons). Usability was assessed using the System Usability Scale (SUS), and qualitative feedback was collected through moderated discussion. Item-level analysis using item characteristic curves provided deeper insight into usability perceptions and item sensitivity. All ethics requirements were met for both study phases.</p><p><strong>Results: </strong>Thematic analysis of the transcribed dialogs of the cocreation session revealed three core themes: (1) therapeutic benefits (pain distraction, memory enhancement, cognitive stimulation, stress reduction, and creative engagement); (2) game difficulty (balancing duration and complexity to sustain engagement without fatigue); and (3) accessibility and interaction (addressing physical limitations, optimizing touchscreen usability, and ensuring inclusive design). These insights informed the development of 2 NoPain Game prototypes, which received a SUS score of 79 (SD 10.4; 95% CI 69.89-88.11), indicating good usability. Item characteristic curve analysis showed strong discrimination for learnability, while ease of use and confidence exhibited ceiling effects. Items like support needs and inconsistency showed minimal variability, and the learning curve demonstrated delayed but meaningful responsiveness at higher usability levels. Qualitative feedback reinforced the relevance of difficulty adjustment, technical refinements, and game m","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e75072"},"PeriodicalIF":4.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093258","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":"Immersive Tai Chi for Home-Based Exercise in Older Adults: Usability and Feasibility Study.","authors":"XiaCheng Song, Nazlena Mohamad Ali, Mohamad Hidir Mhd Salim, Muhammad Yudhi Rezaldi","doi":"10.2196/79453","DOIUrl":"https://doi.org/10.2196/79453","url":null,"abstract":"<p><strong>Background: </strong>Longer life expectancy makes physical exercise crucial for active aging. However, adherence to traditional exercise among community-dwelling older adults is generally low. Virtual reality (VR) and mixed reality (MR) Tai Chi exergames, as novel health promotion tools, show significant potential, particularly for older adults exercising in a home setting.</p><p><strong>Objective: </strong>This study aimed to evaluate the usability and feasibility of a VR and MR Tai Chi exergame for community-dwelling older adults, focusing on subjective experience, physiological comfort, and objective interaction performance. The study also explored the relationships between key usability factors and sought to quantify links between objective accuracy and subjective experience (the Game Experience Questionnaire or Virtual Reality Sickness Questionnaire [VRSQ]) to inform choices of display mode, feedback strength, and session length.</p><p><strong>Methods: </strong>Of the 86 community-dwelling older adults recruited for this study, data from 70 participants were considered valid after an initial screening, during which 16 (18.6%) were excluded due to issues with VR adaptation. Participants were sequentially assigned in a rotating order to 1 of 4 variants (VR/MR×soothing/intense) to balance exposure; however, primary analyses were preplanned to be collapsed across variants, focusing on whole-sample usability and feasibility rather than confirmatory between-group hypotheses. The primary outcome measures included the Game Experience Questionnaire, VRSQ, and objective gameplay logs.</p><p><strong>Results: </strong>The VR/MR Tai Chi game demonstrated good overall usability and acceptability among the screened participants. Subjective experience was highly positive, with median scores for \"positive affect\" (median 4.0) and \"competence\" (median 3.8) being significantly high, whereas the median for \"Challenge\" (median 1.4) was significantly low (P<.001 for all). Physiological comfort in the postscreening sample was acceptable, with the most common mild symptoms being dizziness with eyes closed (20.0%) and vertigo (18.6%), both of low severity; however, the initial exclusion of 18.6% of participants due to VR discomfort is noteworthy. Therefore, generalizability is limited because the analyzed sample overrepresents older adults who tolerate immersive displays. Accuracy showed significant positive correlations with flow (ρ=0.342) and competence (ρ=0.322), whereas the VRSQ total score was significantly negatively correlated with positive affect (ρ=-0.334, P=.005).</p><p><strong>Conclusions: </strong>Tai Chi exergames based on immersive technologies offer a feasible and attractive pathway for promoting physical exercise among community-dwelling older adults, particularly within the home environment, supporting the goal of aging in place. As a single, laboratory-based session, the reported satisfaction may partly reflect a novelty effect; therefor","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e79453"},"PeriodicalIF":4.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093268","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 Game-Based Learning on Piano Music Knowledge Among Elementary School Pupils: Pretest-Posttest Quasi-Experimental Study.","authors":"Yun Wang, Wee Hoe Tan, Qiaoling Ye, Tingting Gu","doi":"10.2196/80766","DOIUrl":"10.2196/80766","url":null,"abstract":"<p><strong>Background: </strong>Music education is central to holistic child development; yet, traditional piano instruction in China often emphasizes rote memorization at the expense of meaningful understanding. Elementary school pupils, particularly novices, frequently struggle with rhythm, melody, and music theory. Game-based learning (GBL), which applies game elements to teaching, may address these challenges by enhancing engagement, providing immediate feedback, and fostering long-term learning.</p><p><strong>Objective: </strong>This study aimed to examine the effects of a GBL module for piano education on elementary school pupils' music knowledge in Anhui Province, China, compared to traditional instruction.</p><p><strong>Methods: </strong>A quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants were allocated nonrandomly to experimental and control groups based on scheduling feasibility and teacher availability. A total of 60 novice piano learners (mean age 8.8 years, SD 1.16 years; 16 boys and 44 girls) from 3 elementary schools were assigned to either the GBL group (n=30) or the control group (n=30). Music knowledge was measured using the standardized Level 1 Basic Music Written Test before and after an 8-week intervention. Nonparametric analyses were applied, including Mann-Whitney U, Wilcoxon signed-rank, and McNemar item-level analyses. Rank-based effect sizes (r) and 95% CIs were reported where applicable.</p><p><strong>Results: </strong>Baseline differences were present, with the control group scoring higher at pretest (median 52, IQR 24-76) than the GBL group (median 28, IQR 16-64; Mann-Whitney U=265.50; r=-0.35; 95% CI -0.39 to -0.32; P=.006). After the intervention, the GBL group significantly outperformed controls (median 100, IQR 88-100 vs median 60, IQR 40-92; Mann-Whitney U=4.0; r=-0.87; 95% CI -0.90 to -0.83; P<.001). Within-group analyses confirmed significant pre-post improvements for both groups (control Z=-3.24; r=-0.59; P=.001; and GBL Z=-4.81; r=-0.88; P<.001). Item-level McNemar tests showed significant improvements (P<.05) in 5 of 25 items for the GBL group. Missing data were negligible (<2%) and handled via listwise deletion after Little's missing completely at random (MCAR) confirmation (P=.08).</p><p><strong>Conclusions: </strong>The GBL module significantly improved pupils' music knowledge, overcoming baseline disparities and producing posttest score gains with consistent mastery. The innovation of the study lies in the systematic integration of gamification with Orff and Dalcroze pedagogy through the Sidek Module Development Model, which distinguishes it from previous music education studies that examine gamification in isolation. By providing a validated, cost-effective, and scalable instructional module, the study contributes empirical evidence to the field of game-based music education and other practical implications for improving piano instruction in resource-constrai","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"14 ","pages":"e80766"},"PeriodicalIF":4.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998028","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}