JMIR Serious Games最新文献

{"title":"Measuring Stress and Perceptions for a Virtual Reality-Based Pericardiocentesis Procedure Simulation for Medical Training: Usability Study.","authors":"Alberto Rubio-López, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio Navas, Angel González-Pinto, Pablo Cardinal-Fernández","doi":"10.2196/68515","DOIUrl":"https://doi.org/10.2196/68515","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is increasingly used in medical education, providing immersive environments for training in high-risk procedures such as pericardiocentesis. This lifesaving procedure requires technical precision and induces cognitive and physiological stress. Evaluating both usability and stress responses in a VR-based pericardiocentesis simulation is essential. Heart rate variability (HRV) serves as an objective stress marker, while prior VR experience may influence usability and stress perception.</p><p><strong>Objectives: </strong>This study aimed to assess the usability of a VR-based pericardiocentesis simulation, examine the relationship between usability perceptions and physiological stress (HRV), and determine the impact of prior VR experience on usability scores and stress responses.</p><p><strong>Methods: </strong>A total of 119 final-year medical students participated in a VR pericardiocentesis simulation. Usability was evaluated using the System Usability Scale (SUS), the Post-Study System Usability Questionnaire, the Presence Questionnaire, and the Simulator Sickness Questionnaire. Physiological stress was assessed through HRV parameters, including the root-mean-square of successive differences (rMSSDs), percentage of differences greater than 50 ms (PNN50), low-frequency to high-frequency ratio, and nonlinear HRV indices (SD1/SD2 ratio, Poincaré area). Statistical analyses included descriptive statistics, Spearman correlations, and Mann-Whitney U tests to explore relationships between usability, stress, and prior VR experience.</p><p><strong>Results: </strong>The VR simulation received a mean SUS score of 75.00 (SD 6.41; 95% CI 73.42-76.58), exceeding the general usability threshold of 68 (P=.002). The mean Post-Study System Usability Questionnaire score of 2.92 (SD 1.83; 95% CI 2.55-3.29) indicated moderate satisfaction, while the mean Presence Questionnaire score of 109.46 (SD 9.12; 95% CI 107.88-111.04) reflected strong immersion. Simulator sickness symptoms were mild (mean Simulator Sickness Questionnaire score 12.43, SD 15.41; 95% CI 9.28-15.58), although novice users reported significantly higher nausea levels (P=.02). Physiological stress analysis revealed a mean rMSSD of 281.27 (SD 98.99; 95% CI 259.45-303.09) ms and PNN50 of 56.85% (SD 19.70%; 95% CI 52.23%-61.47%), indicating moderate autonomic balance. A significant negative correlation was observed between HRV parameters (rMSSD and PNN50) and simulator sickness (P=.04; Spearman ρ=-0.23), suggesting that higher physiological stress was associated with increased simulator sickness symptoms. Prior VR experience was linked to higher usability scores (SUS +5.2; 95% CI 3.12-7.28; P=.03) and lower simulator sickness symptoms (P=.02) but did not significantly affect HRV markers.</p><p><strong>Conclusions: </strong>VR-based simulations for high-risk medical procedures are effective training tools with high usability (SUS=75) and strong immersion","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e68515"},"PeriodicalIF":3.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012453","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":"An Integrated Model for Circular Waste Management Using the Internet of Things, Semantic Web, and Gamification (Circonomy): Case Study in Indonesia.","authors":"Vitri Tundjungsari, Bambang Purnomosidi Dwi Putranto, Muhamad Bahrul Ulum, Nizirwan Anwar","doi":"10.2196/66781","DOIUrl":"10.2196/66781","url":null,"abstract":"<p><strong>Background: </strong>The problem of how to deal with waste is a global issue all countries face. Like many developing countries, Indonesia has inadequate infrastructure to process the extremely high volume of waste produced throughout the country and minimal public participation in proper waste management. Although the Indonesian government regulates waste banks as a community-based waste management solution, there is a lack of integrated technological innovations to support waste banks. This study fills the gap by developing Circonomy, a model combining Internet of Things, gamification, and semantic web technologies to advance community-based circular waste management.</p><p><strong>Objective: </strong>The aim of this study is to develop Circonomy as a circular waste model that integrates an Internet of Things-based smart bin, semantic web, and gamification as an innovative technological solution.</p><p><strong>Methods: </strong>We identified the problem by observing Indonesian waste banks at 3 locations in Jakarta and Yogyakarta to define and design Circonomy. The Circonomy prototype was developed using the Design Science Research Methodology and evaluated based on technical performance and user experience. The technical performance has three indicators: bin capacity accuracy with a minimum of 80% precision, bin lid response time <5 seconds for a minimum of 80% of trials, and data transmission success rate of at least 80%. The user experience metric has two indicators: a minimum of 80% reporting high usability and ease of use, and at least 80% of users reporting that they feel more motivated using the prototype than the traditional waste bank. We selected 10 random participants aged 18-60 years to perform a user experience evaluation of our prototype.</p><p><strong>Results: </strong>The Circonomy prototype demonstrated sound and stable performances related to technical performance and user experience. Circonomy achieved at least 80% technical performance accuracy, comparable to industry standards. The accuracy problem lies in the placement of the ultrasonic sensor. The waste should be placed directly under the ultrasonic sensor to ensure the bin's capacity measurement accuracy. The user experience testing results from 10 participants indicated that Circonomy has excellent user engagement, and 100% felt motivated by gamification and 80% found the mobile app easy to use.</p><p><strong>Conclusions: </strong>The testing results showed that Circonomy has acceptable performances for early-stage prototyping, with at least an 80% accuracy rate in technical performance and user experience. This ensures that Circonomy operates effectively in real-world conditions while remaining cost-efficient and scalable. For future development, Circonomy will prioritize enhancing the accuracy and reliability of sensor-based occupancy detection through improved sensor placement, the integration of multiple sensors, and an exploration of alternative technolog","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66781"},"PeriodicalIF":3.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967755","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":"Effectiveness of Serious Games as Digital Therapeutics for Enhancing the Abilities of Children With Attention-Deficit/Hyperactivity Disorder (ADHD): Systematic Literature Review.","authors":"Jing Lin, Woo-Rin Chang","doi":"10.2196/60937","DOIUrl":"10.2196/60937","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often begins in childhood and requires long-term treatment and management. Given the potential adverse effects of pharmacological interventions in children, interest in alternative treatments has increased. Among alternative therapies, serious games have emerged as a promising digital therapeutic approach and are increasingly recognized as an important intervention for children with ADHD.</p><p><strong>Objective: </strong>This systematic review aims to evaluate the effectiveness of serious games as digital therapeutics for children with ADHD. It focuses on assessing therapeutic outcomes, including improvements in attention, hyperactivity-impulsivity, social skills, motor skills, executive functions, and enjoyment.</p><p><strong>Methods: </strong>The review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive literature search was performed across 5 databases: PubMed, Web of Science, Scopus, IEEE Xplore, and ACM Digital Library, covering English studies published from January 2010 to January 2024. Eligibility criteria were established based on the PICOS (Participants, Intervention, Comparison, Outcomes, Study design) framework, with digital therapeutics guidelines pragmatically applied to inform inclusion criteria, exclusion criteria, and quality assessment. Standardized tools including the Cochrane Risk of Bias Tool for randomized controlled trials, the Cochrane Risk of Bias Tool for Non-Randomized Studies of Interventions (ROBINS-I) for nonrandomized controlled trial studies, and the Critical Appraisal Skills Program checklists were used to evaluate risk of bias. Data on study design, targeted abilities, game software and hardware, and intervention parameters (duration, frequency, and length) were extracted and synthesized descriptively.</p><p><strong>Results: </strong>Of the 35 studies identified (1408 participants), gender data were available for 22 studies (888 participants), comprising 660 male and 228 female participants. Analysis revealed multiple abilities focused across many studies: 80% (28/35) assessed attention, 29% (10/35) addressed hyperactivity-impulsivity, 17% (6/35) explored improvements in social skills, 20% (7/35) evaluated motor skills, and 43% (15/35) investigated executive functions. Furthermore, in 89% (31/35) of the trials, children exhibited a positive attitude toward game interventions. Evidence suggests that serious games may contribute to improvements in attention, hyperactivity-impulsivity, social skills, and executive functions in children with ADHD. Although findings on motor skills were inconclusive, interventions incorporating somatosensory inputs demonstrated benefits for hand-eye coordination.</p><p><strong>Conclusions: </strong>The findings support the potential of serious games as a digital therapeutic modality for child","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e60937"},"PeriodicalIF":3.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969422","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":"Testing the Effectiveness of a Gamified Emotional Cognitive Bias Modification Task as an Intervention for Low Mood: Randomized Controlled Trial.","authors":"Rumeysa Kuruoğlu, Angela Attwood, Ian Penton-Voak","doi":"10.2196/65103","DOIUrl":"https://doi.org/10.2196/65103","url":null,"abstract":"<p><strong>Background: </strong>Emotion recognition bias in depression is well-documented and is proposed to play a causal role in depression. A cognitive bias modification (CBM) intervention targeting the bias in emotional expression perception was developed, but despite robust training effects on emotion perception, the effect on mood was unreliable and weak. We propose a new gamified cognitive bias modification (GCBM) to address potential limitations that may attenuate therapeutic effects.</p><p><strong>Objective: </strong>This study aimed to investigate the effectiveness of a single session of GCBM on emotion perception and to assess whether the gamified version of the task would produce the same robust training effects on the interpretation of emotional expressions as the original CBM. The second aim was to compare the effectiveness of a single session of CBM training, CBM control (no training), and GCBM training on immediate mood.</p><p><strong>Methods: </strong>We report a between-subjects fully automated and web-based experimental study that recruited participants via the web from the general population (N=916). We tested the effectiveness of GCBM in changing participants' responses to ambiguous facial expressions. The primary outcome was emotion recognition bias, measured as the increased identification of happy faces. We also compared the effects of a single session of GCBM training (n=397), CBM training (n=400), and CBM control (n=119) conditions on immediate mood, measured using the Immediate Mood Scaler.</p><p><strong>Results: </strong>Results showed that participants in the GCBM intervention condition classified more ambiguous faces as \"happy\" after the training compared with controls, indicating an increased perception of happiness in ambiguous faces (B=1.57, P<.001). There was also evidence that GCBM training produced more positive changes in immediate mood compared with the CBM control condition (B=-3.64, P=.003) and compared with the CBM training condition (B=1.69, P=.048).</p><p><strong>Conclusions: </strong>GCBM demonstrated promising results in changing participants' emotion recognition bias to ambiguous facial expressions and enhance the immediate mood compared with both CBM and control conditions. These results suggest that GCBM holds promise to be a better alternative to CBM for addressing mood-related cognitive biases. Further exploration of GCBM's long-term effects on mood and its clinical application is needed.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65103"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996471","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":"Acceptability of and Willingness to Use Virtual Reality Exergames for Weight Loss Among Young Adults With Overweight or Obesity in China: Qualitative Study.","authors":"Yanya Chen, Bingsheng Guan, Yaqi Zhang, Suen Chow Lee, Jia-Yu Liu, Sicun Li, Ming Liu, Xiaoshen Zhang, Wai-Kit Ming","doi":"10.2196/66998","DOIUrl":"https://doi.org/10.2196/66998","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity seriously affect physical and psychological health worldwide. They are common public health issues in young adults who are considered a \"vulnerable group\" prone to adopt unhealthy lifestyles that can lead to overweight and obesity. Virtual reality exergames could help increase balance performance among patients with Parkinson disease and improve depression and pain interference among individuals with chronic neck pain. Still, limited research has been conducted on the use of virtual reality exergames among young adults with overweight and obesity, and their willingness and acceptability remain unclear.</p><p><strong>Objectives: </strong>This study aimed to assess the acceptability of and willingness to use virtual reality exergames for weight loss among young adults with overweight or obesity.</p><p><strong>Methods: </strong>This was a qualitative study. Sixteen young adults with overweight or obesity were recruited in Guangzhou, China, and divided into 4 focus groups. They were interviewed between September and October 2023 through semistructured interviews. NVivo (version 14; Lumivero) was used to transcribe, code, and thematically analyze interviews.</p><p><strong>Results: </strong>Four main themes and 8 subthemes emerged from the data. The main themes included perception of previous weight loss measures (regarded exercise and diet as the main measures for weight loss and difficulties in holding on to the weight loss methods), acceptability of virtual reality exergames (increasing opportunities for exercise, a powerful means for propelling doing exercise, positive impact on psychological well-being, and more appealing to office workers than students), willingness to use virtual reality exergames, and concerns (weight loss effect and other concerns).</p><p><strong>Conclusions: </strong>Virtual reality exergames were seen as beneficial for maintaining exercise and promoting psychological well-being among young adults with overweight or obesity, despite concerns about effectiveness, cost, and privacy. Almost all young adults indicated their willingness to try these kinds of games if given the opportunity. These findings suggested that virtual reality exergames could be a promising tool for weight management in this population.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66998"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990490","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 Virtual Reality and AI (Generative Pretrained Transformer) to Enhance Student Preparedness for Objective Structured Clinical Examinations: Mixed Methods Study.","authors":"Shaniff Esmail, Brendan Concannon","doi":"10.2196/69428","DOIUrl":"10.2196/69428","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Immersive virtual reality (VR) and artificial intelligence have been used to determine whether a simulated clinical exam setting can reduce anxiety in first-year occupational therapy students preparing for objective structured clinical examinations (OSCEs). Test anxiety is common among postsecondary students, leading to negative outcomes such as increased dropout risk, lower grades, and limited employment opportunities. Students unfamiliar with specific testing environments are particularly prone to anxiety. VR simulations of OSCEs may allow students to become familiar with the exam setting and reduce anxiety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the efficacy of a VR simulation depicting clinical settings to reduce student anxiety about a clinical exam while gathering perspectives on their first-year coursework experiences to better understand their learning environment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An experimental, nonrandomized controlled trial compared state anxiety, trait test anxiety, and OSCE grades in 2 groups of first-year occupational therapy students analyzed using independent t tests (2-tailed). Group 1 (NoVR) was not exposed to the VR simulation and acted as a control group for group 2 (YesVR), who were exposed to the VR simulation. The VR used artificial intelligence in the form of a generative pretrained transformer to generate responses from virtual patients as students interacted with them in natural language. Self-reported psychometric scales measured anxiety levels 3 days before the OSCE. YesVR students completed perceived preparation surveys at 2 time points-3 weeks and 3 days before the OSCE-analyzed using dependent t tests. Semistructured interviews and focus groups were conducted within 1 week after the OSCE. Student perspectives on their classes and VR experiences were summarized using interpretative thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 60 students-32 (53%) in the NoVR group and 28 (47%) in the YesVR group-participated in the study, and the YesVR group showed a significant reduction in state anxiety (t&lt;sub&gt;58&lt;/sub&gt;=3.96; P&lt;.001; Cohen d=1.02). The mean difference was 11.96 units (95% CI 5.92-18.01). Trait test anxiety and OSCE scores remained static between groups. There was an increase in all perceived preparedness variables in the YesVR group. In total, 42% (25/60) of the participants took part in interviews and focus groups, providing major themes regarding factors that affect OSCE performance, including student experience and background, feedback and support, fear of unknown, self-consciousness, and knowledge of the exam environment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Intolerance of uncertainty may lead students to interpret ambiguous exam situations as overly precarious. Findings suggest that VR simulation was associated with reduced state anxiety, although results from this small, nonrandomized sample should be interpreted cautiously. ","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69428"},"PeriodicalIF":3.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010156","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":"Playful Antisedentary Interactions for Online Meeting Scenarios: A Research Through Design Approach.","authors":"Jiaqi Jiang, Shanghao Li, Xian Li, Yingxin Xu, Jian Zhao, Pengcheng An","doi":"10.2196/62778","DOIUrl":"https://doi.org/10.2196/62778","url":null,"abstract":"<p><strong>Background: </strong>Online meetings have become an integral part of daily life for many people. However, prolonged periods of sitting still in front of screens can lead to significant, long-term health risks. While previous studies have explored various interventions to address sedentary lifestyles, few have specifically focused on mitigating sedentary behavior during online meetings. Furthermore, design opportunities to address this issue in the context of online meetings remain underexplored.</p><p><strong>Objective: </strong>This study aims to investigate the design of effective antisedentary interactions for online meeting scenarios and understand user experiences with gamified bodily interactions as an antisedentary measure during online meetings.</p><p><strong>Methods: </strong>This study adopts a \"research through design\" approach to develop and explore user experiences of gamified bodily interactions as interventions to mitigate sedentary behavior during online meetings. In collaboration with 11 users, we co-designed and iterated 3 prototypes, which led to the development of the Bodily Interaction Gamification towards Anti-sedentary Online Meeting Environments (BIG-AOME) framework. Using these prototypes, we conducted user studies with 3 groups totaling 15 participants. During co-design and evaluation, all group semistructured interviews were transcribed into written format and analyzed using a conventional qualitative content analysis method.</p><p><strong>Results: </strong>The findings demonstrate that gamified bodily interactions encourage users to engage in physical movement while reducing the awkwardness of doing so during online meetings. Seamless integration with meeting software and the inclusion of long-term reward mechanisms can further contribute to sustained use. In addition, such games can serve as online icebreakers or playful tools for decision-making. Drawing from 3 design prototypes, this study offers a comprehensive analysis of each design dimension within the BIG-AOME framework: bodily engagement, attention, bodily interplay, timeliness, and virtual and physical environments.</p><p><strong>Conclusions: </strong>Our research findings indicate that antisedentary bodily interactions designed for online meetings have the potential to mitigate sedentary behaviors while enhancing social connections. Furthermore, the BIG-AOME framework that we propose explores the design space for antisedentary physical interactions in the context of online meetings, detailing pertinent design choices and considerations.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e62778"},"PeriodicalIF":3.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004513","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":"Smartwatch-Based Tailored Gamification and User Modeling for Motivating Physical Exercise: Experimental Study With the Maximum Difference Scaling Segmentation Method.","authors":"Jie Yao, Di Song, Tao Xiao, Jiali Zhao","doi":"10.2196/66793","DOIUrl":"10.2196/66793","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Smartwatch-based gamification holds great promise for enhancing fitness apps and promoting physical exercise; however, empirical evidence on its effectiveness remains inconclusive, partly due to \"one-size-fits-all\" design approaches that overlook individual differences. While the emerging research area of tailored gamification calls for more accurate user modeling and better customization of game elements, existing studies have 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 through an innovative user modeling approach 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 used the maximum difference scaling (MaxDiff) technique, which can overcome the limitations of traditional methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;With data collected from 2 MaxDiff experiments involving 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 identified. Prediction models were also proposed for quickly classifying future users into the right segments to provide them with tailored gamification solutions on smartwatch fitness apps.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 3 segments of smartwatch users based on their preferences for gamification. More importantly, we uncovered 4 segments motivated by goals, immersive experiences, rewards, or social comparison. 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 2 sets of user segments (ie, those based on preferences for game elements vs those based on the motivational effects of the 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;To our knowledge, this study is the first to investigate MaxDiff-based user segmentation for tailored gamification on smartwatches promoting physical exercise and contributes to a detailed understanding of preferences for, and the effectiveness of, different game elements among different groups of smartwatch users. As existing tailored gamification studies continue to explore ways of user modeling with mostly surveys and questionnaires, this study supported the adoption of MaxDiff experiments as an alternative method to better capture user heterogeneity in the health domain and inform the desi","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":" ","pages":"e66793"},"PeriodicalIF":3.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048785/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Hotspots and Trends of Virtual Reality Intervention for Stroke: Bibliometric Analysis.","authors":"Yixin Wei, Yuan Chen, Runting Ma, Yitong Qiu, Wei Su, Li Zhang, Qiang Gao","doi":"10.2196/65993","DOIUrl":"https://doi.org/10.2196/65993","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is a rapidly developing technology that has gained significant traction in the treatment and rehabilitation of individuals with stroke. Research on VR-based stroke treatment has garnered increasing attention.</p><p><strong>Objective: </strong>The aim of this study is to present a bibliometric analysis of VR for stroke studies to identify the application status, research hotspots, and emerging trends and guide future scientific research.</p><p><strong>Methods: </strong>We included studies and reviews on the topic of VR-based stroke treatment and rehabilitation from 1999 to 2023 were retrieved from Web of Science Core Collection database. Citespace 6.3.1 and VOSviewer 1.6.20 software was used for the visual analysis of publications, institutions, authors, journals, citations, and Scimago Graphica software was used for the geographic visualization of published countries or regions.</p><p><strong>Results: </strong>Our study analyzed 1171 papers on VR-based stroke rehabilitation published between 1999 and 2023, revealing a gradual increase in annual publications over the past 2 decades, peaking at 154 in 2022. North America and Western Europe were identified as major contributors, with significant input from their institutions, researchers, and publications. The Journal of NeuroEngineering and Rehabilitation emerged as the leading journal in this field, while Calabrò Rocco Salvatore was recognized as the most prolific author, focusing on the neurophysiological impacts of VR on patients with stroke. Keywords with notable citation bursts, such as \"environment,\" \"trial,\" \"arm,\" and \"motor learning,\" highlighted the core research themes in this domain.</p><p><strong>Conclusions: </strong>Our study provides valuable insights into the current research hotspots and emerging trends in VR-based stroke treatment and rehabilitation. Current research primarily focuses on evaluating the effectiveness of VR in improving upper limb function and balance in patients with stroke. Future directions are shifting towards integrating VR with rehabilitation techniques, such as physiotherapy and occupational therapy, while advancements in VR technology continue to garner increasing attention.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65993"},"PeriodicalIF":3.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984844","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":"Electrophysiological Insights in Exergaming-Electroencephalography Data Recording and Movement Artifact Detection: Systematic Review.","authors":"Carolina Rico-Olarte, Diego M Lopez, Bjoern M Eskofier, Linda Becker","doi":"10.2196/50992","DOIUrl":"10.2196/50992","url":null,"abstract":"<p><strong>Background: </strong>Exergames are interactive solutions that require physical activity and are commonly used in learning or rehabilitation settings. For cognitive rehabilitation with exergames, the assessment of the intervention progress can be conducted by verifying the changes in brain activity. Electroencephalography (EEG) is a well-known method for this evaluation. However, motion artifacts due to large body movements can impede signal quality. No comprehensive guide on the artifact removal methods in the context of exergaming has been found.</p><p><strong>Objective: </strong>This paper aimed to identify studies that have assessed EEG signals while a user interacts with an exergame and the applied methods for data handling and analysis with a focus on dealing with movement artifacts.</p><p><strong>Methods: </strong>This review included studies on human participants while engaging in exergames, where the primary outcome was brain activity measured by EEG. A total of 5 databases were searched at 3 time points: March 2021, October 2022, and February 2024. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies assessed methodological quality, rating studies as \"good,\" \"fair,\" or \"poor.\" Data were synthesized quantitatively to identify characteristics across studies, including sample demographics and intervention details, and basic statistics (mean [SD]) were calculated.</p><p><strong>Results: </strong>A total of 494 papers were screened, resulting in 17 studies having been included. All studies carried out EEG recordings during exergame interactions, primarily assessing attention and concentration, with the alpha wave being the most analyzed EEG band. Common motion artifact removal methods included visual inspection and independent component analysis. The review identified significant risks of bias, with 2 studies rated as \"good,\" 7 as \"fair,\" and 8 as \"poor.\" Due to the small number of studies and their heterogeneity, a meta-analysis was not feasible.</p><p><strong>Conclusions: </strong>The study successfully identifies the feasibility of recording electrophysiological brain activity during exergaming and provides insights into EEG devices, analysis methods, and exergaming systems used in previous studies. However, limitations, such as the lack of sufficient detail on motion artifact removal and a focus on short-term effects, underscore the need for improved methodologies and reporting standards, with recommendations for enhancing reliability in cognitive rehabilitation with exergames.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e50992"},"PeriodicalIF":3.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803375","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}