JMIR Serious Games最新文献

{"title":"Development and Evaluation of a Case-Based Serious Game for Diagnosis and Treatment Planning in Orthodontic Education: Quasi-Experimental Study.","authors":"Rochaya Chintavalakorn, Chayuth Chanwanichkulchai, Napat Buranasing, Napatsaporn Parivisutt, Naruchol Patchasri, Kawin Sipiyaruk","doi":"10.2196/73956","DOIUrl":"10.2196/73956","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic education requires effective training in diagnosis and treatment planning, but traditional teaching methods may lack engagement and opportunities in offering a safe learning environment. Serious games are gaining momentum in dental education due to their positive educational impact in enhancing learner knowledge and motivation. However, their application in orthodontic diagnosis and treatment planning training remains unexplored.</p><p><strong>Objective: </strong>The aim of this study was to develop and evaluate a simulation-based serious game for training orthodontic diagnosis and treatment planning in virtual patients (OrthoVirt), examining its impact on student knowledge and satisfaction. This study also explored whether prior gaming experience influenced learning outcomes.</p><p><strong>Methods: </strong>A quasi-experimental study was conducted with 32 fourth-year dental students, who were requested to complete a preknowledge assessment, 3 simulated patients within OrthoVirt, a postknowledge assessment, and a satisfaction survey. Participants were categorized as gamers (n=16) or nongamers (n=16) based on self-reported weekly gaming time. The primary outcome was knowledge improvement, analyzed using 2-tailed paired t tests (Cohen dz). Group comparisons were conducted using 2-tailed independent t tests (Cohen d). User satisfaction was measured using a validated questionnaire based on the technology acceptance model. A stricter significance threshold (P<.01) and effect size metrics (Cohen d and Cohen dz) were used to account for the small sample size, multiple comparisons, and exploratory nature of the study.</p><p><strong>Results: </strong>Both gamer and nongamer groups showed significant knowledge improvement after using OrthoVirt (mean score increased from 10.75 (SD 2.75) to 14.75 (SD 1.81) out of 20; P<.001). The mean scores of the gamer group increased from 10.31 (SD 3.07) to 15.19 (SD 1.83) while those of the nongamer group rose from 11.19 (SD 2.40) to 14.31 (SD 1.74). No statistically significant differences were found between groups in pre- and postknowledge assessments as well as improvement scores (P>.01), suggesting that the educational benefit was consistent regardless of gaming background. Participants from both groups rated OrthoVirt positively, particularly for \"perceived ease of use.\" However, \"perceived enjoyment\" was rated slightly lower than other aspects, with nongamers scoring it 3.60 (SD 0.81) and gamers 3.45 (SD 0.73) out of 5, indicating a potential area for design enhancement. Overall satisfaction ratings were similar between the 2 groups (P>.01).</p><p><strong>Conclusions: </strong>OrthoVirt demonstrated potential as a supplementary tool for diagnosis and treatment planning in orthodontic education, with statistically significant improvements observed in learner knowledge. While feedback was generally positive, these findings should be interpreted with caution due to the quasi","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73956"},"PeriodicalIF":4.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954911","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":"Digital Catalysts for Noncommunicable Disease Prevention Serious Games and Gamified Applications: Framework Design Study.","authors":"Christoph Aigner, René Baranyi, Thomas Grechenig","doi":"10.2196/69246","DOIUrl":"10.2196/69246","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy behaviors can cause so-called noncommunicable diseases (NCDs), which are on the rise. Notable examples include chronic respiratory diseases, diabetes, cardiovascular diseases, and various types of cancer. They are responsible for approximately 41 million deaths annually, which accounts for a staggering 74% of all global deaths. Major risk factors include physical inactivity, the use of tobacco, unhealthy diets, the harmful use of alcohol, and poor mental health, which can be classified as modifiable behavioral risk factors. Other factors include metabolic and environmental risk factors, such as air pollution. Many individuals struggle to make informed decisions about their health, which contributes to the risk factors mentioned earlier and, ultimately, can lead to the development of one or more NCD.</p><p><strong>Objective: </strong>This research presents design and standardization considerations to enable the exchange of medical and game data to maximize their impact and usefulness. Serious games and gamified applications that strategically use behavior change techniques and educational content can help users change their behavior on a lasting basis, thereby reducing the aforementioned NCD risk factors. Still, each of them is currently independently designed and cannot interact with other applications.</p><p><strong>Methods: </strong>We previously developed serious games and gamified applications to prevent NCDs. These served as the foundation of an interoperable framework for NCD prevention games and applications. On the basis of a comprehensive analysis, 6 key areas were identified, ultimately leading to a framework definition that was then evaluated against the already-developed games and applications.</p><p><strong>Results: </strong>This paper presented a novel interoperable framework to support the design and development of serious games and gamified applications that enable individuals to achieve sustainable behavior change and improve their overall health and well-being by defining 6 key areas, emphasizing interoperability, and exchanging meaningful medical and game data.</p><p><strong>Conclusions: </strong>The framework presented in this study covers the major design and implementation aspects of NCD prevention games and applications in 6 key areas. Therefore, researchers should consider these guidelines when creating novel serious games and applications in those areas. The framework also intensively encourages the use of standards in the domain of medical informatics to ensure the semantic interoperability of patients' data produced. Thus, it promotes the exchange of meaningful data to improve patient care and anonymous data use for research.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69246"},"PeriodicalIF":4.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954915","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 Gamified Assessment Tool for Antisocial Personality Traits (Antisocial Personality Traits Evidence-Centered Design Gamified): Randomized Controlled Trial.","authors":"Yaobin Tang, Yongze Xu, Qunli Zhou, Ran Bian","doi":"10.2196/70453","DOIUrl":"10.2196/70453","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The traditional self-report instruments (eg, scales) used to measure antisocial personality traits are characterized by social desirability bias and fail to capture multidimensional behaviors (eg, manipulation and deception).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop and validate an evidence-based design for a gamified assessment tool (Antisocial Personality Traits Evidence-Centered Design Gamified assessment tool; ASP-ECD-G) to measure 7 antisocial personality traits (manipulative, callous, deceptive, hostile, risk taking, impulsive, and irresponsible) as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This research featured a 3-phase evidence-centered design framework. Ontology development (study 1): semistructured interviews were conducted with 9 workplace professionals to translate the DSM-5 criteria into 24 observable workplace behaviors, which were integrated into a text-based game featuring 10 subscenarios, 34 interactive questions, and logic rooted in logical jumps to simulate real-world decision-making. Model construction (study 2): 6 machine learning models were trained by reference to a set of Personality Inventory for DSM-5 Short Form scores (n=286). The gated recurrent unit model, which uses 1-hot encoding to address nominal response data, was evaluated in terms of the root mean square error (RMSE), mean absolute error, criterion correlation (r), and test-retest reliability. Retest reliability was assessed using intraclass correlation coefficients based on 10 participants (1-month interval). Empirical validation (study 3): a 2×2 mixed design (n=148) was used to compare the gamified assessment with questionnaires under conditions involving incentives (ie, situations in which \"rational results\" led to increased payments).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For model performance, the gated recurrent unit outperformed the alternatives, as indicated by the highest criterion correlation (r=0.850) and the lowest test RMSE (0.273); in particular, it excelled in moderate score ranges (1.5-3, RMSE≤0.377) and in resisting extreme value distortions (3.5-4, RMSE 0.854). Retest reliability was moderate to strong (intraclass correlation coefficients=0.776, P=.02). For validation findings, the gamified assessment was associated with higher levels of immersion (mean 7.628 vs 7.216; F147=14.259, P&lt;.001) and interest (mean 7.095 vs 6.155; F147=47.940, P&lt;.001), although it also elicited stronger negative emotions (mean 4.365 vs 2.473; F147=151.109, P&lt;.001). Incentives reduced questionnaire scores (incentivized: 2.066 vs control: 2.201; F1=5.740, P=.02) but had no effect on gamified scores (P=.71), confirming resistance to manipulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;By integrating evidence-centered design with gamified workplace simulations, ASP-ECD-G can provide more objective and ecologically valid measurements of antisoci","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e70453"},"PeriodicalIF":4.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954945","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 a Web-Based Virtual Simulation to Train Nursing Students in Suicide Risk Assessment: Randomized Controlled Investigation.","authors":"Paul Roux, Yujiro Okuya, Cristina Morel, Mariane Soulès, Hugo Bottemanne, Eric Brunet-Gouet, Solène Frileux, Christine Passerieux, Nadia Younes, Jean Claude Martin","doi":"10.2196/69347","DOIUrl":"10.2196/69347","url":null,"abstract":"<p><strong>Background: </strong>Suicide is a leading cause of preventable death worldwide. Nurses play a critical role in suicide prevention; yet, they face significant obstacles. Improving the evaluation and management of patients at risk of suicide requires innovative training techniques that safely and effectively enhance nursing students' skills, knowledge, and confidence. Virtual simulation (VS) based training can be particularly effective because it allows interaction with patients without the risk of causing harm.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the pedagogical effectiveness of a novel VS tool featuring a fully automated and emotionally reactive virtual patient by assessing its ability to assist nursing students in learning suicide risk assessment. VS also included an online group debriefing, co-run by a nurse and a medical teacher.</p><p><strong>Methods: </strong>A randomized controlled investigation was conducted with 68 first-year nursing students recruited from nursing schools offline and online. They were divided into a control group receiving teaching as usual (TAU) and an intervention group receiving TAU plus VS. The intervention was purely web-based and unblinded. Outcomes were self-assessed through questionnaires using Kirkpatrick Training Evaluation Model, which focuses on knowledge, skills, confidence, empathy, and satisfaction among students.</p><p><strong>Results: </strong>The VS group exhibited significantly higher confidence (3 points of increase after TAU vs 10.6 points of increase after VS, B=7.2; SE 2.5; t111.5=2.8; P=.006) and a marginally enhanced ability to respond appropriately to suicidal thoughts (1.6 points of improvement after TAU vs 6.4 points of improvement after VS, B=-4.5; SE 2.5; t119.5=-1.8; P=.08) compared with the control group. However, there were no significant differences in knowledge acquisition or the general level of empathy. Satisfaction with VS was high, particularly regarding the authenticity of the virtual patient. Authenticity was perceived as greater when emotional prosody was included with facial emotions.</p><p><strong>Conclusions: </strong>The use of VS demonstrated promising results in enhancing nursing students' confidence in detecting suicide risk and their skills in counseling individuals experiencing a suicide crisis, suggesting its incorporation into routine teaching methods. Further research is needed to explore its long-term benefits for students and its impact on patient outcomes.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69347"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764911","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":"Children's Improvement After Language and Rhythm Training With the Digital Medical Device Poppins for Dyslexia: Single-Arm Intervention Study.","authors":"Charline Grossard, Melanie Descamps, Hugues Pellerin, François Vonthron, David Cohen","doi":"10.2196/76435","DOIUrl":"10.2196/76435","url":null,"abstract":"<p><strong>Background: </strong>Specific learning disorder in reading (SLD reading), commonly named dyslexia, is a neurodevelopmental condition affecting reading. Current best practice recommendations for SLD reading emphasize the necessity of including graphophonological interventions. The serious game Mila-Learn, which is based on rhythm training, showed promising results in a prior randomized trial. However, it lacked a component of graphophonological training.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of Poppins, a new digital medical device that combines rhythm-based and graphophonological training for improving reading and phonological skills in children with SLD reading. We also explored its performance against Mila-Learn, the earlier version based on rhythm training only.</p><p><strong>Methods: </strong>A single-arm study without an active control group was conducted with 38 children (aged 7-11 years) diagnosed with SLD reading. The participants completed an 8-week training program with Poppins (five 20-minute sessions per week). Pre- and posttraining assessments measured reading accuracy and speed, phoneme deletion, and phonological discrimination. Statistical analysis included pre- and postcomparisons (primary analysis) and comparisons with children's improvement from a previous randomized controlled trial of Mila-Learn, an earlier version of the device (exploratory analysis).</p><p><strong>Results: </strong>The participants demonstrated significant improvements in reading accuracy (+11.46 words correctly read; P<.001), reading speed (+10.26 words read; P<.001), and phoneme deletion (+2.87 points; P<.001). No significant change was observed in reading comprehension for younger participants (grades 2-3; P=.09), although improvements were noted in older children (grades 4-5, P=.03). Exploratory analysis comparing children's improvements with Mila-Learn and Poppins revealed similar gains in reading accuracy and speed but revealed superior improvement in phonological skills for the Poppins group, with a moderate effect size according to the benchmarks by Cohen (Cohen d=0.48, P=.02).</p><p><strong>Conclusions: </strong>Poppins is an effective and safe tool for enhancing reading and phonological skills in children with SLD reading. By integrating rhythm-based and graphophonological exercises, the device aligns with best practice recommendations for curative intervention. Future research should explore its long-term effects and medicoeconomic impact and compare outcomes with those of conventional therapy, as serious games provide an engaging, scalable method for delivering such interventions.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06596980; https://clinicaltrials.gov/study/NCT06596980.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e76435"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764902","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 The Legend of Zelda: Breath of the Wild and Studio Ghibli Films on Young People's Sense of Exploration, Calm, Mastery and Skill, Purpose and Meaning, and Overall Happiness in Life: Exploratory Randomized Controlled Study.","authors":"Annisa Arigayota, Barbara Duffek, Congcong Hou, Andreas Benedikt Eisingerich","doi":"10.2196/76522","DOIUrl":"10.2196/76522","url":null,"abstract":"<p><strong>Background: </strong>Young people feel increasingly anxious and sad nowadays. Engaging with works of art and entertainment, such as playing open-world games or watching Studio Ghibli films, can be more than just a pastime. However, the extent to which, if at all, open-world games and feelings of nostalgia affect overall happiness in life remains unclear.</p><p><strong>Objective: </strong>This study aimed to examine the extent to which open-world games, such as The Legend of Zelda: Breath of the Wild, and nostalgia evoked by Studio Ghibli films, such as Hayao Miyazaki's My Neighbor Totoro or Kiki's Delivery Service, affect postgraduate students' sense of exploration, calm, mastery and skill, purpose and meaning, and, ultimately, happiness in life.</p><p><strong>Methods: </strong>A controlled laboratory experiment was conducted using a 2 (playing an open-world game vs no open-world game) × 2 (nostalgia vs no nostalgia) between-subject design. Study participants (N=518) were randomly assigned to the study's 4 conditions and answered a brief questionnaire, examining their sense of exploration, calm, mastery and skill, purpose and meaning, and, ultimately, happiness in life. As part of the study, we conducted univariate analysis and bootstrapping-based moderated mediation analysis with 5000 resamples.</p><p><strong>Results: </strong>The results showed a significant and positive impact of playing an open-world game on overall life happiness (mean [M]_playedgame 4.563, SD 0.072, vs M_{notplayedgame} 3.170, SD 0.072; F_{(1, 517)}=117.246, P<.001). Furthermore, the positive impact of open-world games on overall life happiness was significantly enhanced by nostalgia evoked by watching Studio Ghibli films (M_nostalgia 5.45, SD 0.102, vs M_nonostalgia 3.58, SD 0.102; SE 0.144, 95% CI 1.332-1.900; P<.001). Moreover, exploratory moderated mediation with bootstrapped-based analyses and 5000 resamples demonstrated that the effect of playing open-world games on happiness is mediated by a sense of exploration (effect=0.11; SE 0.05, 95% CI 0.04-0.21), sense of calm (effect=0.32; SE 0.09, 95% CI 0.15-0.51), sense of skill and mastery (effect=0.08; SE 0.05, 95% CI 0.01-0.18), and sense of purpose and meaning (effect=0.32; SE 0.14, 95% CI 0.06-0.60).</p><p><strong>Conclusions: </strong>This study shows that playing an open-world game, such as The The Legend of Zelda: Breath of the Wild, and nostalgia evoked by Studio Ghibli films significantly foster a sense of exploration and calm in life, as well as a feeling of mastery and skill, and purpose and meaning, hence ultimately contributing positively to one's overall happiness in life.</p><p><strong>Trial registration: </strong>ISRCTN ISRCTN14757739; https://www.isrctn.com/ISRCTN14757739.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e76522"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764912","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":"Mixed Reality-Based Physical Therapy in Older Adults With Sarcopenia: Preliminary Randomized Controlled Trial.","authors":"Yeongsang An, Seunghwa Min, Chanhee Park","doi":"10.2196/76357","DOIUrl":"10.2196/76357","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia in older adults is associated with reduced muscle mass and function, leading to frailty, increased fall risk, and decreased quality of life (QOL). Mixed reality (MR)-based interventions have emerged as promising tools to enhance physical therapy engagement and effectiveness through immersive, interactive environments.</p><p><strong>Objective: </strong>This study aimed to investigate the effects of a Mixed Reality-Based Physical Therapy (Mr.PT) platform on quadricep muscle thickness, balance confidence, activities of daily living, and QOL in older adults with sarcopenia.</p><p><strong>Methods: </strong>A preliminary randomized controlled trial was conducted involving 30 older women (mean age 75.3, SD 9.9 y) diagnosed with sarcopenia based on the Asian Working Group for Sarcopenia criteria. Participants were randomly assigned to either the Mr.PT group or a conventional physical activity (CPA) group. Both groups participated in 30-minute exercise sessions, 3 times per week, over 4 weeks. The Mr.PT program used head-mounted MR devices with gamified, interactive training, while the CPA group received standard therapist-led exercises using resistance bands. Outcome measures included ultrasound imaging of quadricep muscle thickness, the Korean version of the Activities of Daily Living scale (Katz Index of Independence in Activities of Daily Living), the Activities-Specific Balance Confidence (ABC) scale, and the 12-Item Short-Form Health Survey. Statistical analysis was performed using repeated-measures ANOVA and Tukey post hoc tests.</p><p><strong>Results: </strong>The Mr.PT group showed significantly greater improvement in quadricep muscle thickness than the CPA group (P=.001). Within-group improvements in balance confidence (ABC scale) and daily functioning (Katz Index of Independence in Activities of Daily Living) were observed in both groups (P<.05), though between-group differences were not statistically significant. However, the Mr.PT group demonstrated significantly greater gains in QOL as measured by 12-Item Short-Form Health Survey (P=.02). All participants completed the intervention without dropouts or adverse events.</p><p><strong>Conclusions: </strong>MR-based exercise using the Mr.PT platform appears effective in increasing muscle mass and enhancing QOL among older adults with sarcopenia. Its interactive and adaptive features may improve engagement and motivation, suggesting potential advantages over traditional programs. Further research with larger cohorts and longer follow-up is recommended to confirm these preliminary findings and explore long-term outcomes.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e76357"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764913","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":"Home-Based Virtual Reality Training for Enhanced Balance, Strength, and Mobility Among Older Adults With Frailty: Systematic Review and Meta-Analysis.","authors":"Hammad Alhasan, Elaf Alandijani, Lara Bahamdan, Ghofran Khudary, Yara Aburaya, Abdulaziz Awali, Mansour Abdullah Alshehri","doi":"10.2196/67146","DOIUrl":"10.2196/67146","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a geriatric syndrome associated with increased risk of falls, hospitalization, and reduced quality of life. Traditional exercises may be unsuitable for older adults with frailty due to mobility issues and accessibility barriers. Virtual reality (VR) offers an engaging, home-based alternative by providing interactive training with real-time feedback. VR interventions have shown potential benefits for improving balance, strength, and mobility.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the effectiveness of VR-based home training programs in improving balance, strength, and mobility among older adults with frailty and prefrailty.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, and Web of Science from inception to November 1, 2023, using terms related to older adults, frailty, virtual reality, balance, mobility, and strength. Eligible studies included randomized and nonrandomized trials involving adults with frailty or prefrailty aged ≥65 years who received home-based VR interventions aimed at improving balance, strength, or functional mobility. Comparator groups included no intervention, traditional exercise, or standard care. Studies involving participants with neurological or cognitive disorders were excluded. Study quality was assessed using the Physiotherapy Evidence Database scale. A random-effects meta-analysis was performed to calculate pooled mean differences (MD) and 95% CIs for 3 primary outcomes: Berg Balance Scale, Timed Up and Go, and Chair Stand.</p><p><strong>Results: </strong>A total of 1063 records were identified, with 1023 screened after duplicate removal. Six studies met the inclusion criteria, involving 407 participants (mean age 75.2, SD 6.4 y), of whom 198 were allocated to VR interventions and 159 to control groups. VR interventions lasted a mean of 13.3 (SD 7.7) weeks, with an average of 39.6 (SD 5.2) sessions lasting 25.3 (SD 5) minutes. Methodological quality was high in 5 studies (mean Physiotherapy Evidence Database score=5.6, SD 1.3). Four studies were included in the meta-analysis. Significant improvements were observed in balance, as measured by the Berg Balance Scale (MD=3.62; 95% CI 2.29-4.95; P<.001; I²=0%). No significant effects were found for mobility (Timed Up and Go: MD=-0.37; 95% CI -1.16 to 0.41; P=.35; I²=0%) or strength (Chair Stand: MD=-0.20; 95% CI -1.70 to 1.29; P=.79; I²=21%).</p><p><strong>Conclusions: </strong>VR-based home exercise interventions show promise in improving balance among older adults with frailty and prefrailty. However, their effects on strength and functional mobility remain unclear. Variability in study designs and outcome measures limits the generalizability of current findings. Further high-quality research is needed to determine optimal VR training protocols and assess long-term adherence and clinical effectiveness.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67146"},"PeriodicalIF":4.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

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