JMIR Serious Games最新文献

{"title":"Effectiveness of Augmented Reality in the Teaching of Health University Students: Quasi-Experimental Study.","authors":"Rocío Martín-Valero, Alejandro Vega-Morales, Francisco Javier Martín-Vega, Manuel Rodriguez-Huguet, Maria Carmen Rodríguez-Martínez, Maria Jesus Vinolo-Gil","doi":"10.2196/54312","DOIUrl":"10.2196/54312","url":null,"abstract":"<p><strong>Background: </strong>The exponential growth of new technologies has resulted in the need for updating the field of education. From the educational point of view, there are some studies that have promoted the implementation of new technologies. These facts have raised the need to implement augmented reality in the university environment, especially among students of health sciences. The use of augmented reality can mean a new approach to teaching by teachers and better learning by students.</p><p><strong>Objective: </strong>We aimed to analyze the degree of usability of two augmented reality applications and to compare the academic performance between the control group and the experimental group at the Universities of Cádiz and Málaga. The students at the University of Málaga used the Zapworks augmented reality software, while those at the University of Cádiz used the Aumentaty augmented reality software for their respective experimental groups. The secondary objective was to measure the relationships between all the studied variables.</p><p><strong>Methods: </strong>This was a quasi-experimental design with a posttest as the only evaluation measure. We followed the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement and the ethical and legal aspects of the Principles of the Declaration of Helsinki. An intervention was carried out using two augmented reality applications on the subject of General Procedures in Physiotherapy II at the Universities of Málaga and Cádiz.</p><p><strong>Results: </strong>A total of 199 participants took part in the study. Demographic variables, ratings, and usability were assessed, followed by statistical analysis, with the results and their interpretation being described in the study. Significant differences (P<.001) were found in the ratings at both the universities. In addition, significant differences (P<.001) were found between the experimental group and the control group. Regarding the degree of usability in the univariate analysis, no significant differences were found (P=.049). A multiple regression analysis of the rating and usability was performed. The rating showed significant differences, with a beta of 1.4 (P<.001), and usability was also significant (P=.03) in favor of the Aumentaty group.</p><p><strong>Conclusions: </strong>Significant differences were observed in those who used augmented reality compared to the control group, with higher values observed in the University of Cádiz. There are no correlations between the variables of usability and qualifications.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e54312"},"PeriodicalIF":3.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730042","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":"Feasibility and Usability of an Artificial Intelligence-Powered Gamification Intervention for Enhancing Physical Activity Among College Students: Quasi-Experimental Study.","authors":"Yanan Gao, Jinxi Zhang, Zhonghui He, Zhixiong Zhou","doi":"10.2196/65498","DOIUrl":"10.2196/65498","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) is vital for physical and mental health, but many college students fail to meet recommended levels. Artificial intelligence (AI)-powered gamification interventions through mobile app have the potential to improve PA levels among Chinese college students.</p><p><strong>Objective: </strong>This study aimed to assess the feasibility and usability of an AI-powered gamification intervention.</p><p><strong>Methods: </strong>A quasi-experimental study spanning 2 months was conducted on a sample of college students aged 18 to 25 years old from 18 universities in Beijing. PA data were recorded using the ShouTi Fitness app, and participant engagement was evaluated through surveys. User satisfaction was gauged through the System Usability Scale, while the intervention's feasibility was assessed through Spearman rank correlation analysis, Mann-Whitney tests, and additional descriptive analyses.</p><p><strong>Results: </strong>As of July 2023, we enrolled 456 college students. In total, 18,073 PA sessions were recorded, with men completing 8068 sessions and women completing 10,055 sessions. The average PA intensity was 7 metabolic equivalent of energy (MET)s per session. Most participants preferred afternoon sessions and favored short-duration sessions, with men averaging 66 seconds per session and women 42 seconds. The System Usability Scale score for the intervention based on app is 65.2. Users responded positively to the integration of AI and gamification elements, including personalized recommendations, action recognition, smart grouping, dynamic management, collaborative, and competition. Specifically, 341 users (75%) found the AI features very interesting, 365 (80%) were motivated by the gamification elements, 364 (80%) reported that the intervention supported their fitness goals, and 365 (80%) considered the intervention reliable. A significant positive correlation was observed between the duration of individual PA and intervention duration for men (ρ=0.510, P<.001), although the correlation was weaker for women (ρ=0.258, P=.046). However, the frequency of PA declined after 35 days.</p><p><strong>Conclusions: </strong>This study provides pioneering evidence of the feasibility and usability of the AI-powered gamification intervention. While adherence was successfully demonstrated, further studies or interventions are needed to directly assess the impact on PA levels and focus on optimizing long-term adherence strategies and evaluating health outcomes.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65498"},"PeriodicalIF":3.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700438","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":"Impact of a 3-Month Recall Using High-Fidelity Simulation or Screen-Based Simulation on Learning Retention During Neonatal Resuscitation Training for Residents in Anesthesia and Intensive Care: Randomized Controlled Trial.","authors":"Anne-Claire Louvel, Cécile Dopff, Gauthier Loron, Daphne Michelet","doi":"10.2196/57057","DOIUrl":"10.2196/57057","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Retention capacities are dependent on the learning context. The optimal interval between two learning sessions to maintain a learner's knowledge is often a subject of discussion, along with the methodology being used. Screen-based simulation could represent an easy alternative for retraining in neonatal resuscitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study was to evaluate the benefits of a 3-month recall session using high-fidelity simulation or screen-based simulation, assessed 6 months after an initial neonatal resuscitation training session among anesthesia and intensive care residents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All participating anesthesia and intensive care residents were volunteers, and they underwent training in the same session, which included a theoretical course and high-fidelity simulation. The attendees were then randomized into three groups: one with no 3-month recall, one with a high-fidelity simulation recall, and one with a screen-based simulation recall. To reassess the skills of each participant, a high-fidelity simulation was performed at 6 months. The primary outcomes included expert assessment of technical skills using the Neonatal Resuscitation Performance Evaluation score and nontechnical skills assessed by the Anesthesia Non-Technical Skills score. Secondary outcomes included a knowledge quiz and self-assessment of confidence. We compared the results between groups and analyzed intragroup progressions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-eight participants were included in the study. No significant differences were observed between groups at the 6-month evaluation. However, we observed a significant improvement in theoretical knowledge and self-confidence among students over time. Regarding nontechnical skills, as evaluated by the Anesthesia Non-Technical Skills score, there was significant improvement between the initial training and the 6-month session in both recall groups (16 vs 12.8, P=.01 in the high-fidelity group; 16 vs 13.9, P=.05 in the simulation group; 14.7 vs 15.1, P=.50 in the control group). For technical skills assessed by the Neonatal Resuscitation Performance Evaluation score, a nonsignificant trend toward improvement was observed in the two recall groups, while a regression was observed in the control group (all Ps&gt;.05). The increase in students' self-confidence was significant across all groups but remained higher in the two 3-month recall groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Initial neonatal resuscitation training for anesthesia and intensive care residents leads to improved knowledge and self-confidence that persist at 6 months. A 3-month recall session, whether through high-fidelity simulation or screen-based simulation, improves nontechnical skills (eg, situation management and team communication) and technical skills. Screen-based simulation, which saves time and resources, appears to be an effective educational method for recall after","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e57057"},"PeriodicalIF":3.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673909","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":"Personal Protection Equipment Training as a Virtual Reality Game in Immersive Environments: Development Study and Pilot Randomized Controlled Trial.","authors":"Liang Zhou, Haoyang Liu, Mengjie Fan, Jiahao Liu, Xingyao Yu, Xintian Zhao, Shaoxing Zhang","doi":"10.2196/69021","DOIUrl":"10.2196/69021","url":null,"abstract":"<p><strong>Background: </strong>Proper donning and doffing of personal protection equipment (PPE) and hand hygiene in the correct spatial context of a health facility is important for the prevention and control of nosocomial infections. On-site training is difficult due to the potential infectious risks and shortages of PPE, whereas video-based training lacks immersion which is vital for the familiarization of the environment. Virtual reality (VR) training can support the repeated practice of PPE donning and doffing in an immersive environment that simulates a realistic configuration of a health facility.</p><p><strong>Objective: </strong>This study aims to develop and evaluate a VR simulation focusing on the correct event order of PPE donning and doffing, that is, the item and hand hygiene order in the donning and doffing process but not the detailed steps of how to don and doff an item, in an immersive environment that replicates the spatial zoning of a hospital. The VR method should be generic and support customizable sequencing of PPE donning and doffing.</p><p><strong>Methods: </strong>An immersive VR PPE training tool was developed by computer scientists and medical experts. The effectiveness of the immersive VR method versus video-based learning was tested in a pilot study as a randomized controlled trial (N=32: VR group, n=16; video-based training, n=16) using questionnaires on spatial-aware event order memorization questions, usability, and task workload. Trajectories of participants in the immersive environment were also recorded for behavior analysis and potential improvements of the real environment of the health facility.</p><p><strong>Results: </strong>Comparable sequence memorization scores (VR mean 79.38, SD 12.90 vs video mean 74.38, SD 17.88; P=.37) as well as National Aeronautics and Space Administration Task Load Index scores (VR mean 42.9, SD 13.01 vs video mean 51.50, SD 20.44; P=.16) were observed. The VR group had an above-average usability in the System Usability Scale (mean 74.78>70.0) and was significantly better than the video group (VR mean 74.78, SD 13.58 vs video mean 57.73, SD 21.13; P=.009). The analysis and visualization of trajectories revealed a positive correlation between the length of trajectories and the completion time, but neither correlated to the accuracy of the memorization task. Further user feedback indicated a preference for the VR method over the video-based method. Limitations of and suggestions for improvements in the study were also identified.</p><p><strong>Conclusions: </strong>A new immersive VR PPE training method was developed and evaluated against the video-based training. Results of the pilot study indicate that the VR method provides training quality comparable to video-based training and is more usable. In addition, the immersive experience of realistic settings and the flexibility of training configurations make the VR method a promising alternative to video instructions.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69021"},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Video Games Versus Midazolam in Reducing Perioperative Anxiety in Pediatric Patients: Systematic Review and Meta-Analysis.","authors":"Ziyue Luo, Sisi Deng, Ruihao Zhou, Ling Ye, Tao Zhu, Guo Chen","doi":"10.2196/67007","DOIUrl":"10.2196/67007","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients undergoing surgery frequently experience significant anxiety, which can result in adverse effects such as prolonged sedation and behavioral changes associated with pharmacological interventions such as oral midazolam. Video games offer a nonpharmacological distraction method that shows promise in alleviating procedural anxiety without significant adverse effects. However, the effectiveness of video games compared to midazolam in managing perioperative anxiety remains uncertain.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of video game interventions in reducing perioperative anxiety in pediatric patients undergoing general anesthesia.</p><p><strong>Methods: </strong>We conducted a comprehensive search across PubMed, Embase, Web of Science, and the Cochrane Library, supplemented by reference screening. Primary outcomes included anxiety levels assessed during parent separation and mask induction procedures, while secondary outcomes encompassed emergence delirium, postoperative behavior, and length of stay in the postanesthesia care unit (PACU). The risk of bias was assessed using the Risk of Bias 2 scale. Data were synthesized descriptively and through meta-analysis, with the certainty of the evidence evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.</p><p><strong>Results: </strong>Six randomized controlled trials involving 612 participants were included in the analysis. Children who participated in video game interventions reported significantly lower anxiety levels during parent separation (standardized mean difference, SMD -0.31, 95% CI -0.50 to -0.12; P=.001), with high certainty, and during mask induction (SMD -0.29, 95% CI -0.52 to -0.05; P=.02), with moderate certainty, compared to those receiving oral midazolam. Additionally, significant differences in postoperative behavior changes in children were observed compared to oral midazolam (SMD -0.35, 95% CI -0.62 to -0.09; P=.008). Children in the video game intervention groups also had a shorter length of stay in the PACU (mean difference, MD -19.43 min, 95% CI -31.71 to -7.16; P=.002). However, no significant differences were found in emergence delirium (MD -2.01, 95% CI -4.62 to 0.59; P=.13).</p><p><strong>Conclusions: </strong>Video game interventions were more effective than midazolam in reducing perioperative anxiety among pediatric patients, improving postoperative behavior, and shortening the length of stay in the PACU. However, video games alone did not outperform midazolam in managing emergence delirium. Further high-quality research is needed for more conclusive results.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67007"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamified Adaptive Approach Bias Modification in Individuals With Methamphetamine Use History From Communities in Sichuan: Pilot Randomized Controlled Trial.","authors":"Danlin Shen, Jianping Jiao, Liqun Zhang, Yanru Liu, Xiang Liu, Yuanhui Li, Tianjiao Zhang, Dai Li, Wei Hao","doi":"10.2196/56978","DOIUrl":"10.2196/56978","url":null,"abstract":"<p><strong>Background: </strong>Cognitive bias modification (CBM) programs have shown promise in treating psychiatric conditions, but they can be perceived as boring and repetitive. Incorporating gamified designs and adaptive algorithms in CBM training may address this issue and enhance engagement and effectiveness.</p><p><strong>Objectives: </strong>This study aims to gather preliminary data and assess the preliminary efficacy of an adaptive approach bias modification (A-ApBM) paradigm in reducing cue-induced craving in individuals with methamphetamine use history.</p><p><strong>Methods: </strong>A randomized controlled trial with 3 arms was conducted. Individuals aged 18-60 years with methamphetamine dependence and at least 1 year of methamphetamine use were recruited from 12 community-based rehabilitation centers in Sichuan, China. Individuals with the inability to fluently operate a smartphone and the presence of mental health conditions other than methamphetamine use disorder were excluded. The A-ApBM group engaged in ApBM training using a smartphone app for 4 weeks. The A-ApBM used an adaptive algorithm to dynamically adjust the difficulty level based on individual performance. Cue-induced craving scores and relapses were assessed using a visual analogue scale at baseline, postintervention, and at week-16 follow-up.</p><p><strong>Results: </strong>A total of 136 participants were recruited and randomized: 48 were randomized to the A-ApBM group, 48 were randomized to the static approach bias modification (S-ApBM) group, and 40 were randomized to the no-intervention control group. The A-ApBM group showed a significant reduction in cue-induced craving scores at postintervention compared with baseline (Cohen d=0.34; P<.01; 95% CI 0.03-0.54). The reduction remained significant at the week-16 follow-up (Cohen d=0.40; P=.01; 95% CI 0.18-0.57). No significant changes were observed in the S-ApBM and control groups.</p><p><strong>Conclusions: </strong>The A-ApBM paradigm with gamified designs and dynamic difficulty adjustments may be an effective intervention for reducing cue-induced craving in individuals with methamphetamine use history. This approach improves engagement and personalization, potentially enhancing the effectiveness of CBM programs. Further research is needed to validate these findings and explore the application of A-ApBM in other psychiatric conditions.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e56978"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

{"title":"Effects and Acceptability of a 1-Week Home-Based Virtual Reality Training for Supporting the Management of Stress and Anxiety: Randomized Pilot Trial.","authors":"Federica Pallavicini, Eleonora Orena, Lisa Arnoldi, Federica Achille, Stefano Stefanini, Maddalena Cassa, Alessandro Pepe, Guido Veronese, Luca Bernardelli, Francesca Sforza, Sara Fascendini, Carlo Alberto Defanti, Marco Gemma, Massimo Clerici, Giuseppe Riva, Fabrizia Mantovani","doi":"10.2196/50326","DOIUrl":"10.2196/50326","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) is helpful for the management of stress and anxiety. However, current interventions have limitations related to location (ie, therapist's office or hospitals) and content (ie, virtual experiences only for relaxation).</p><p><strong>Objective: </strong>This randomized pilot trial aims to investigate the efficacy and acceptability of a brief remote VR-based training for supporting stress and anxiety management in a sample of Italian health care workers.</p><p><strong>Methods: </strong>A total of 29 doctors and nurses (n=21; 72% female; mean age 35.6, SD 10.3 years) were recruited and randomized to a VR intervention group or a control group in a passive control condition. Participants assigned to the VR intervention group received remote VR-based training consisting of 3 sessions at home delivered in 1 week using the VR psychoeducational experience \"MIND-VR\" and the 360° relaxing video \"The Secret Garden.\" The primary outcome measures were stress, anxiety, depression, and the knowledge of stress and anxiety assessed at baseline and posttreatment. We also evaluated the immediate effect of the remote VR-based training sessions on the perceived state of anxiety and negative and positive emotions. The secondary outcome measure was the usability at home of the VR system and content.</p><p><strong>Results: </strong>The VR intervention significantly reduced stress levels as assessed by the Perceived Stress Scale (6.46, 95% CI 2.77 to 10.5; P=.046) and increased the knowledge of stress and anxiety, as evaluated by the ad hoc questionnaire adopted (-2.09, 95% CI -3.86 to -0.529; P=.046). However, the home-based VR training did not yield similar reductions in stress, anxiety, and depression levels as assessed by the Depression, Anxiety, and Stress Scale-21 items or in trait anxiety as evaluated through the State-Trait Anxiety Inventory Form Y-1. After the home training sessions with VR, there was a significant decrease in anxiety, anger, and sadness and an increase in happiness levels. Analyses of the questionnaires on usability indicated that the health care workers found using the VR system at home easy and without adverse effects related to cybersickness. Of 33 participants, 29 (88%) adhered to the protocol.</p><p><strong>Conclusions: </strong>The results of this randomized pilot study suggest that a week-long home VR intervention, created with content created specifically for this purpose and available free of charge, can help individuals manage stress and anxiety, encouraging further research investigating the potential of remote VR interventions to support mental health.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04611399; https://tinyurl.com/scxunprd.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e50326"},"PeriodicalIF":3.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Session of Exergames and Traditional Games on Inhibitory Control in Children With Autism Spectrum Disorder: Randomized Controlled Crossover Trial.","authors":"Juliana Macedo Miranda, Rodrigo Alberto Vieira Browne, Weslley Quirino Alves da Silva, João Paulo Rodrigues Dos Santos, Carmen Silvia Grubert Campbell, Isabela Almeida Ramos","doi":"10.2196/65562","DOIUrl":"10.2196/65562","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is characterized by deficits in executive functions, such as inhibitory control, which affect behavior and social adaptation. Although physical activity-based interventions, such as exergames, have shown potential to improve these functions, their comparative effects with active traditional games remain underexplored, particularly regarding inhibitory control in children with ASD.</p><p><strong>Objective: </strong>We aim to analyze the effects of a session of exergames and active traditional games on inhibitory control in children with ASD.</p><p><strong>Methods: </strong>This randomized controlled crossover trial included 9 male children with ASD (mean age 8.6, SD 1.4 y). Participants completed three 20-minute experimental sessions in random order, with a minimum interval of 48 hours: (1) active traditional games, (2) exergames using Just Dance 2022, and (3) a control session with manual painting activities. Inhibitory control was assessed 5 minutes postsession using a modified flanker task in the E-Prime (version 3.0; Psychological Software Tools Inc) program, recording reaction time (RT) and accuracy in congruent and incongruent phases. Repeated measures ANOVA was used to compare RT and accuracy between experimental and control conditions. Data are presented as means and 95% CIs.</p><p><strong>Results: </strong>There was a statistically significant effect of condition on RT in the incongruent phase (P=.02). RT in the exergame session (849 ms, 95% CI 642 to 1057) was lower compared to the traditional games (938 ms, 95% CI 684 to 1191; P=.02) and control (969 ms, 95% CI 742, 1196 to P=.01) sessions. No significant differences were observed in RT during the congruent phase or in accuracy across either phase.</p><p><strong>Conclusions: </strong>A 20-minute session of exergame improved inhibitory control performance in children with ASD compared to active traditional games and painting activities.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e65562"},"PeriodicalIF":3.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kangaroo Stimulation Game in Tracheostomized Intensive Care-Related Dysphagia: Interventional Feasibility Study.","authors":"Marjolein Jansen, Ingrid D van Iperen, Anke Kroner, Raphael Hemler, Esther Dekker-Holverda, Peter E Spronk","doi":"10.2196/60685","DOIUrl":"10.2196/60685","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is common in intensive care unit (ICU) patients. Using surface electromyography (sEMG) signals as biofeedback training exercises might offer a promising path to improving swallowing function. The Rephagia biofeedback system uses sEMG to assess muscle strength, stamina, and timing of the swallowing action.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the feasibility of the Rephagia system in ICU patients with dysphagia.</p><p><strong>Methods: </strong>This feasibility study included patients admitted to a 14-bed mixed medical-surgical ICU. All patients underwent a new tracheostomy placement during ICU stay due to persistent aspiration and ICU-acquired weakness, accompanied by verified dysphagia. Following Rephagia training, patients completed a questionnaire assessing comprehension, satisfaction, and motivation. Swallowing characteristics were assessed via mean sEMG peak values during exercise.</p><p><strong>Results: </strong>Twenty patients with a mean age of 69.4 (SD 8.2) years were included. The means of sEMG values at the beginning of a measurement were not significantly different at baseline versus everyone's last measurement (52 µV [23 µV] vs 57 µV [22 µV]; P=.50). The means of sEMG values obtained at the end of a measurement were not significantly different at baseline versus everyone's last measurement (56 µV [18 µV] vs 59 µV [23 µV]; P=.62). However, dysphagia improved in all patients. Patients understood the importance of the game in relation to their swallowing problems (16/80, 89%), which kept them motivated to participate in the training sessions (9/18, 50%).</p><p><strong>Conclusions: </strong>The Rephagia biofeedback system for stimulating swallowing actions in tracheotomized ICU patients with dysphagia is feasible. No relation was found between clinical improvement in swallowing function and sEMG signals.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e60685"},"PeriodicalIF":3.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}