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Defining exergames & exergaming

Authors:
1
Defining Exergames & Exergaming
Yoonsin Oh
Department of Curriculum and Instruction
University of Wisconsin-Madison
Stephen Yang
Department of Physical Education
SUNY Cortland
Abstract
With growing interest in exergames research, various terms and definition have intro-
duced to describe exergames. The authors reviewed current literature to understand the inconsis-
tencies and gaps between fields. We found patterns between health-related researchers and non-
health related researcher’s terms and definitions. Exergame was the most frequently used term,
but the combination of exercise and videogames could cause confusion since the term exercise is
limited to a particular condition. The authors propose to redefine exergames as a combination of
exertion and video games including strength training, balance, and flexibility activities. Exer-
gaming is playing exergames or any other video games to promote physical activity.
Introduction
Many researchers have recommended reducing sedentary activities, such as watching television
and playing videogames, to prevent obesity among children and adolescents (Epstein et al., 1995;
Robinson, 1999; Rosenberg, Bull, Marshall, Sallis, & Bauman, 2008). For example, Robinson’s
(1999) physical activity intervention research showed that children who were asked to reduce
sedentary behaviors lowered the percent of members overweight and their percent body fat more
than another group with children who were asked to do more exercise and a final group who
were asked to both reduce sedentary behaviors and increase exercise. Although the authors did
not include behaviors like doing homework, reading for school or pleasure, and listening to mu-
sic for target sedentary activities in their analysis, they considered playing video games a seden-
tary activity. This ignores the many video games that require players to be physically active,
such as the 1988 title World Class Track Meet (WCTM) for the Nintendo Entertainment System
(Bogost, 2007). Playing WCTM requires players to move their feet similar to walking, running,
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or jumping on a power pad, a foot pad that has circles each with a sensor that recognizes the
player’s movement, in order to play it (Bogost, 2007). Even though WCTM was released in 1988
(Bogost, 2007) and numerous similar games have been released since then, some recent re-
searchers still consider playing video games a sedentary behavior (e.g. Rosenberg et al., 2008).
The inconsistent use of terminology and definitions
There are some researchers in the health-related fields that acknowledge that playing video
games is not always sedentary and may indeed be a way to accumulate more physical activity.
In simple terms, exergames are any number of types of video games / multimedia interactions
that require the game player to physically move in order to play.
Exergaming or exer
-
gaming (a portmanteau of "exercise" and "gaming") is a term used
for video games that are also a form of exercise. (Wikipedia, 2010)
Because this area of study is still in “its infancy” (Yang, Smith, & Graham, 2008), researchers
have used various terms to describe these kinds of video game play (see Table 1) and as compo-
nents of these descriptions (see Table 2). Out of 23 articles, 10 first authors chose “exergame”,
which is the most frequent term in the literature (see Table 1). The other authors used the terms
exertainment, dance simulation video game, interactive video game, activity promoting video
game, active video game, physical gaming, (kin)aesthetic video game, and physical activity-
change game. There is a pattern apparent after dividing the first authors by whether they are in
health-related areas like kinesiology, nutrition science and medical science or not. We reviewed
the articles based on where they were published and the authors’ affiliation to decide whether
authors were health-related researchers or not.
As you can see from Table 1, health-related researchers showed an inconsistent use in
terminology compared to those who are not in health-related fields. Only two health-related re-
searchers used the term exergame (Maddison, 2007; Yang, 2008). First-authors who are not in
health-related areas all used the term exergame (Adams et al., 2009; Behrenshausen, 2007; Bo-
gost, 2005; Bogost, 2007; Klein & Simmers, 2009; Sall & Grinter, 2007; Sinclair, Hingston, &
Masek, 2007 ; Sinclair, Hingston, Masek, & Nosaka, 2009; Suhonen, Väätäjä, Virtanen, &
Raisamo, 2008; Wylie & Coulton, 2008).
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After we looked at the elements of these various terms used (see Table 2), eleven out of
fifteen health-related researchers described the elements as combining videogames and physical
activity (Adams et al., 2009; Maddison et al., 2007; Suhonen et al., 2008; Yang et al., 2008). Six
out of eight non-health related researchers used Bogost’s (2007) definition combining exercise
and videogames (Klein & Simmers, 2009; Sall & Grinter, 2007; Sinclair et al., 2007; Suhonen et
al., 2008; Wylie & Coulton, 2008).
This reflects a possible disagreement over the term among researchers. While the term
exergame is frequently used the most, why do health-related researchers disagree about using the
term exergames? This inconsistency in terminology causes confusion and makes communication
among researchers more difficult.
In this paper, we will introduce the different terms that have been used in the literature
and how researchers define them. We will combine these views and propose a new definition for
this new way to play these kinds of video games.
Terms used by health-related researchers
Researchers, especially those who study health-related areas, showed inconsistent term
use to describe these video games, and many of them were reluctant to use the term “exergam-
ing” (see Table 1). Although health-related researcher terms varied, their definitions shared a
common purpose in increasing the level of physical activity (see Table 2). Researchers who used
the term activity promoting and active video game defined them by using same word. For exam-
ple, activity promoting video games were defined as video games that “have the potential to
promote physical activity during screen time” (Lanningham-Foster et al., 2006, p. e1832), and
active video games “might provide a novel opportunity to turn a traditionally sedentary behavior
into a physically active one” (Maddison, 2007, p. 335). The main idea of using these terms is to
distinguish playing video games that promote active behavior from those that result in a seden-
tary one.
Four studies used the term interactive video game (DiRico et al., 2009; Epstein, Beecher,
Graf, & Roemmich, 2007; Schuler et al., 2009; Warburton et al., 2007). Epstein et al. (2007) is
the only one who defined this term, saying that interactive video games “use physical activity as
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the game playing controller, combining exercise and video game entertainment” (p. 124). How-
ever, all video games are interactive because one distinguishing element for video games is
“immediate and interactive feedback” (Salen & Zimmerman, 2004, p.87). Since this term poten-
tially includes most of video games whether they are sedentary or not, the term “interactive video
game” may fail to specify this particular kind of video game.
Tan, Aziz, Chua, & The (2002) and Unnithan, Houser, & Fernhall (2006) used the term
dance simulation for describing Dance Dance Revolution (DDR). Although Chin, Jacobs, Vaes-
sen, Titze, & van Mechelen (2008) also used the same term, it is hard to guess what dance simu-
lation meant for them since they did not state which video games they used in the study. Without
knowing the definition for the term and inferring it from the one example of DDR, it is difficult
to apply the term to other games. Dance simulation might include games like Britney’s Dance
Beat. Britney’s Dance Beat is similar to DDR except it does not use a dance pad and instead only
uses a hand-held game controller, which makes the game play sedentary. The term “dance simu-
lation” may therefore not be able to distinguish between playing videogames that are sedentary
from more active play.
Exergame
Exergame was the most commonly used term primarily by researchers who do not have a
heath-related background. Since the term “exergame” is the most frequently used in the litera-
ture, media, and is a catchy word, we propose to continue using this term; however, we will take
a deeper look at its definition. In fact there are several commercial companies that use the term
exergame or a derivative in their company name and there is even a non-profit advocacy group
called the Exergame Network who’s mission it is to “promoting an active and healthy lifestyle
by combining video games technologies and exercise, known as exergaming” (2010). Bogost
(2007) stated that “exergaming is the combination of exercise and video games” (p. 294) and the
term was referenced in a WebMD article by a medical journalist (see Lawrence, 2005). As such,
it may help us to understand the term better after knowing what each of these words mean.
There are competing complex definitions of what games are (see Salen & Zimmerman,
2004). For the purpose of defining exergames, a simpler definition will work. A video game is
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“any game played on a digital device and encompasses a wide range of games played at arcades,
…on personal computers, or on dedicated game consoles (e.g., Nintendo GameCube, Sony
PlayStation, or Microsoft Xbox) or handheld units (e.g., Nintendo Game Boy, Sony PSP)” (Ba-
ranowski, Buday, Thompson, & Baranowski, 2007, p. 74). For example, Go played on a physical
Go board is not a videogame, but Go played on a digital device like a computer or any other
gaming console is considered a videogame.
Lawrence’s (2005) article title is “Exercise, lose weight with ‘exergaming’ – new ‘active’
video games combine body movement with gaming skill.” She lists both exercise and body
movement which can interpreted as physical activity to describe exergming. Since people often
conflate the term exercise with physical activity (Caspersen, Powell, & Christenson, 1985), it is
unclear weather she considered them different or not. In health studies, physical activity and ex-
ercise have different meanings. Physical activity is “any bodily movement produced by skeletal
muscles that results in energy expenditure” (Caspersen et al., 1985, p. 126). For example, physi-
cal activities include doing dishes, driving a car, sitting down and drawing pictures. Even sleep-
ing is a physical activity, albeit one that is very sedentary. Because physical activity includes
wide range of body movements, exergame should be combination of videogames and physical
activity that is more than sedentary one.
If we go back to Bogost’s (2007) definition of exergames, a “combination of exercise and
video games”, exergaming may refer to playing a video game for exercise.
The problem of using the “exer-” part of “exergaming” from exercise is that researchers who
have used it did not use “exercise” with a precise definition. Researchers instead used exercise in
terms of being active.
Of 23 first-authors, 14 indicated that exergames are video games that can increase physi-
cal activity level. Only 8 out of 23 first authors indicated it is combination of video game and
exercise; however, none of them stated what exercise meant or incorporated a definition of exer-
cise. They considered an exergame to be a video game that requires more than sedentary levels
of physical activity.
Wylie & Coulton (2008) defined exergaming as “video games that also provide exercise”
(p. 338) and this is similar to Bogost’s (2007) perspective. Klein & Simmers (2009, p. 35) de-
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fined exergaming as “the ability to tie video games and exercise into a single medium for the
benefit of making exercise fun” by referencing Sall & Grinter’s (2007) study, although Sall &
Grinter (2007) defined exergaming more simply as “tying play to physical activity” (p. 200).
Problems for the definition of exergame
Using the term “exergame” to define video games that promote physical activity has
some problems because of the “exercise” part. Exercise is a subset of physical activity, but spe-
cific conditions distinguish it. Exercise is doing physical activity “intentionally to improve or
maintain physical fitness with a planned, repetitive, and structured format” (Caspersen et al.,
1985, p. 126); thus, applying the definition of exercise to exergames has some potential prob-
lems. To be an exercise, the activity needs intentionally to maintain and improve physical fitness
and the actions are done repetitively in a structured and predetermined format. In this case, inten-
tion matters as when two people play DDR at a similar level. One wants to use this play to lose
weight and the other one has no such similar intention. Although they are physically active and
spending more energy than if they were sitting and talking, only the one who thought of the play
in terms of fitness can call it exergaming.
From this viewpoint, using the definition of “exercise” for exergames may be problem-
atic for promoting physical activity because it will not include some healthy behaviors without
the intention to maintain or improve fitness. From a health benefit standpoint, some physical ac-
tivity is better than nothing (U.S. Department of Health & Human Services, 2008). For an adult,
participating in a minimum of 30 minutes of moderate intensity physical activity (e.g., walking)
is recommended to achieve minimum health benefits.
Keeping in mind both the definitions of video game and exercise, exergaming may look
like this. Someone can call playing the video game Wii Fit yoga as an exergame only if he/she
plays it with the intention to maintain fitness (including balance and flexibility activities) and
does so regularly in a structured format with planning. This means that playing Wii Fit yoga
without having any intention to improve or maintain physical fitness (e.g., because it’s fun) may
not be an instance of exergaming, even though the activity itself may look same. Because the na-
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ture of exercise definition relies heavily on the player’s intentions and behaviors, it is extremely
difficult to call a video game an exergame.
Another problem of using this definition of “exercise” for exergames is that may include
sedentary activity as well. Physical fitness comprised of two groups: One is health-related, and
the other one is skill-related. The health-related physical fitness components are cardiorespira-
tory endurance, muscular endurance, strength, body composition, and flexibility (Caspersen et
al., 1985). The skill-related physical fitness components are agility, balance, coordination,
speed, power, and reaction time (Caspersen et al., 1985). Since physical fitness components also
include flexibility, balance, coordination, and reaction time, physical activity working on these
components may include playing video game that result in sedentary activity.
The coordination and reaction time components are prevalent in many video games but
the activity may not contribute to one’s health. If we continue to use the definition of exercise in
exergaming, someone can also claim playing a first person shooter game, such as Team Fortress
2 (TF2), by sitting on a chair and using a mouse is exergaming. He/she may want to improve
hand-eye coordination and reaction time and does so repetitively in a planned and structured
format. Although coordination and reaction time are included as components of physical fitness,
playing TF2 this way is a sedentary physical activity. This definition may thus be unhelpful in
distinguishing sedentary and non-sedentary video games.
This suggests that the media (e.g., Lawrence, 2005) may have started using exercise to
create exergame without considering its traditional definition (Casperson et al., 1985), instead
using it rather loosely to mean being physically active. Doing so implies some video games al-
low players to be active. Researchers from non-health backgrounds may have adopted this use
since none appear to examine the definition of exercise critically when referring to exergaming.
When we looked at the definition of exercise, it is problematic to call video games as exegames
unless knowing players’ intention and playing behaviors.
Other definitions of exergames
Some researchers added promoting “physical activity” or “exercise equipment” in addi-
tion to “exercise” in their definitions. Yang, Treece, Miklas, & Graham (2009) stated exergam-
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ing is “a new form of video game interaction that requires the game player to physically move in
order to play.” Similar to Yang et al. (2009), Adams et al. (2009) defined it more specifically as
“videogames that use exertion-based interfaces to promote physical activity, fitness, and gross
motor skill development.”
Some researchers mentioned exergaming but did not prefer to use that term. Maddison et
al. (2007) referenced the term exergame in their study, but they used the term only once, instead
preferring the term active video game. Similar to Maddison et al. (2007), Sall & Grinter (2007)
used the term exergame, but used the term “physical gaming” more than exergaming, and de-
fined it as “a genre of games that uses individual player’s physical movement as input for game-
play” (p. 200). These researchers defined exergaming as video games that promote active physi-
cal activity.
Sinclair et al. (2007) defined exergaming as “the use of video games in exercise activity”
(p. 289). This definition seems to be similar to Bogost’s (2007) definition, but Sinclaire et al.
(2007) also defined this by additionally defining exergaming as “the merger of video game and
exercise equipment” (p. 289). The authors explained their examples of exergaming systems as an
exercise bike connected to computer games, foot operated pads for the video games like WCTM
and DDR, and motion sensors for the Sony EyeToy and Nintendo Wii.
For example, Warburton et al. (2007) used a racing video game that does not require
players to be active, but by adding a stationary bike as the primary controller the game becomes
more active rather than just sitting. If a player chooses to play the same racing video game with-
out having a stationary bike, he/she will be participating in sedentary activity. It is also difficult
to call the racing video game that was not built for stationary biking as an exergame, but the ac-
tivity itself can be exergaming when playing video games on an exercise machines.
Exergaming for healthy life styles
We mentioned earlier in this paper that we consider exergaming as providing more than
sedentary physical activity during play. How do people know which video games provide mod-
erate physical activity during play? There are two ways to assess aerobic intensity: absolute in-
tensity and relative intensity. In absolute terms, moderate to vigorous intensity is at least 3.0
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metabolic equivalents (MET), where “a MET is the ratio of the rate of energy expended during
an activity to the rate of energy expended at rest.” (U.S. Department of Health & Human Serv-
ices, 2008, p. 54). An example of an absolute moderate intensity activity is walking at 3.0 miles
per hour, which is 3.3 METs (U.S. Department of Health & Human Services, 2008, p. 55).
Walking at 3.0 miles per hour may feel differently based on one’s figure and fitness level.
For example, an overweight person may feel tired and exhausted at this level while normal
weight person may not. Since everyone has a different figure and fitness level, relative intensity
is also important to consider for intensity. The 2008 physical activity guidelines used the simpler
definition that a “relatively moderate-intensity activity is a level of effort of 5 or 6 on a scale of 0
to 10, where 0 is the level of sitting, and 10 is maximal effort. Relatively vigorous-intensity ac-
tivity is a 7 or 8 on this scale” (U.S. Department of Health & Human Services, 2008, p. 55) Us-
ing this recommendation of moderate to vigorous physical activity focused on cardiorespiratory
endurance will provide health benefits.
If one tried to improve one’s balance by playing Wii Fit balance games, the player will
probably not expend enough energy to meet this recommendation. Since people need to improve
all around health-related fitness components, considering only energy expenditure is problem-
atic.
As exergaming researchers, especially those who have health-related backgrounds, many
want to see if exergaming has the potential to improve one’s health; therefore, we would also
like to consider other components of health-related and skill-related fitness. Health-related fit-
ness components such as cardiorespiratory endurance, muscular endurance, strength, body com-
position, and flexibility while including balance from the skill-related fitness components since it
is critical in maintaining one’s health especially for older adults (U.S. Department of Health &
Human Services, 2008). By including this one skill-related component, we avoid having the ma-
jority of sedentary skill-based games, like TF2, considered exergames.
We propose the new definitions of exergame and exergaming: An exergame is a video
game that promotes (either via using or requiring) players’ physical movements (exertion) that is
generally more than sedentary and includes strength, balance, and flexibility activities. Exergam-
ing is an experiental activity where playing exergames, videogames, or computer-based is used
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to promote physical activity that is more than sedentary activites and also includes strength, bal-
ance, and flexibility activities (See figure 1). Figure 1 shows that exergaming is part of playing
video games for a healthy lifestyle. This will allow the inclusion of playing any video games
while using a stationary bike or similar equipment that is not necessarily contextually connected
to the particular video games.
Conclusion
We explored the various terms used for exergames (e.g., active video game, interactive
video game, activity promoting video games, etc) in current literature. We found that the term
exergames may have started without consideration of traditional definition of exercise. Health-
related researchers may be aware of the link to the definition of exercise and therefore may pur-
posely try to avoid using it.
After reviewing how exergames are defined in the research literature (Table 2), most of
them define exergames as videogames that require physical activity in order to play. We think
that although the term “exergames” is often refers to exercise and video games (Bogost, 2007),
many exergaming researchers have used exercise interchangeably with physical activity. We dis-
cussed how the definition of “exergame” is different from the one of “physical activity” (Casper-
son et al, 1985).
Based on the reviewed literature, we propose the new definition of exergaming as an ex-
periental activity in which playing exergames or any videogames that requires physical exertion
or movements that are more than sedentary activities and also include strength, balance, and
flexibility activities. This new definition of exergame will hopefully clear the confusion on how
to define exergames and reduce the inconsistency of its use in future studies.
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Table 1
Various terms for exergames
Exergame (10)
Exertainment (2)
Dance simulation video game (3)
Interactive video game (4)
Activity promoting video game (3)
Active video game (5)
(Kin)aesthetic of video gaming (1)
Physical activity-change games (1)
Tan et al. (2002)
Unnithan et al.(2006)
Chin A Paw et al. (2008)
DiRico et al. (2009)
Schuler et al. (2009)
Epstein et al. (2007)
Warburton et al. (2007)
Lannigham-Foster et al.
(2006; 2009)
Graves et al. (2007)
de Vries et al. (2009)
Brown et al. (2009)
Mellecker et al. (2008)
Baranowski et al. (2008)
Maddison et al. (2007)
Health-related
researchers
Yang et al. (2008; 2009)
Bogost (2005; 2007)
Sinclair et al. (2007;
2009)
Sall et al. (2007)
Behrenshausen (2007)
Klein at al. (2008)
Wylie (2008)
Suhonen (2008)
Non-Health related re-
searchers
Adams (2009)
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Table 2
Elements of definitions of exergame
Videogame(23)
Physical Activity(14)
Exercise (8)
Physical input device(2)
Exercise equipment(1)
Tan et al. (2002)
Unnithan et al.(2006)
Chin A Paw et al. (2008)
DiRico et al. (2009)
Schuler et al. (2009)
Epstein et al. (2007)
Warburton et al. (2007)
Lannigham-Foster et al.
(2006; 2009)
Graves et al. (2007)
de Vries et al. (2009)
Brown et al. (2009)
Mellecker et al. (2008)
Baranowski et al. (2008)
Maddison et al. (2007)
Health-related
researchers
Yang et al. (2008; 2009)
Bogost (2005; 2007)
Sinclair et al. (2007; 2009)
Sall et al. (2007)
Behrenshausen (2007)
Klein at al. (2008)
Wylie (2008)
Suhonen (2008)
Non-Health related
researchers
Adams (2009)
17
Figure 1
Relationship of Physical activity, exercise, exergaming, and playing video games
... /fpubh. . and disparate definitions, particularly between health-related and non-health-related domains (69). In this context a wide range of terms has been employed, such as game-based exercising, active play video games, active gaming, exergaming, exertion games, health games, or embodied interactive video games (69). ...
... and disparate definitions, particularly between health-related and non-health-related domains (69). In this context a wide range of terms has been employed, such as game-based exercising, active play video games, active gaming, exergaming, exertion games, health games, or embodied interactive video games (69). It should be noted that the terms used in game design are connected to different underlying approaches. ...
... The network analysis shows that different procedures are often strongly interconnected, with terms such as exergame, gamification, and game often occurring together in the same articles. This pattern aligns with findings from UXG research, which identified a lack of consistent terminology (69). For example, the terms gamification and game design are clearly distinguished from each other, particularly concerning their processes and implementation (68,70,71). ...
Article
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Introduction Falls pose significant health risks to older adults, impacting their quality of life. Preventive strategies are crucial, as research shows that fall prevention interventions can effectively reduce fall risks. However, these interventions often suffer from low adherence and uptake. Digital, interactive interventions, incorporating experience-, and game-related aspects, offer a promising solution, making this topic inherently cross-disciplinary. Objective This review aims to assess the current landscape of digital interactive experience and game-based fall interventions for community-dwelling, healthy older adults. It focuses on integrating Human Movement Science and User Experience & Game Design perspectives, emphasizing the cross-disciplinary nature of this research. Methods We employed a cross-disciplinary literature search framework, searching the databases ACM-DL, IEEE-Xplore, ScienceDirect, PubMed, Scopus, and Web of Science. The review focused on healthy community-dwelling older adults (50+), including those at risk of falling. Excluded were studies involving chronic diseases, non-age-related impairments, other age groups, or individuals receiving care. Only digital, interactive fall prevention interventions without commercial software were considered. Studies published between 2000–2024 were included. A qualitative thematic synthesis was conducted, focusing on four categories: Objectives (O), Design and Development (D), Types of Intervention (T), and Evaluation Methods (E). Results The search yielded 2,747 results, with 59 articles included in the final synthesis. Objectives were mainly driven by a combination of HMS and UXG rather than a single aspect. In Design and Development it was observed that concept-based design was scarce, with most being procedure-based. Descriptions of interventions frequently lacked specificity, particularly in-depth experience-related terminology and exercise descriptions. Evaluation methods were found to be more frequently informed by both HMS and UXG, although only four studies used a mixed-method approach to explore their interplay. Among included articles, most aspects incorporated both HMS and UXG across all four categories: O(n = 37), D(n = 37), T(n = 54), and E(n = 21). Conclusion The review underscores the importance of digital interactive experience- and game-based fall prevention interventions. It highlights the need for enhanced cross-disciplinary collaboration between HMS and UXG to address gaps, such as the lack of a shared thesaurus and standardized guidelines, which are vital for improving transparency, reproducibility, and the refinement of these interventions.
... II. STATE OF THE ART Despite the ongoing debate over the definition of the term "exergame" [4], we use it here to describe video games designed to promote physical exercise and support rehabilitation practices. As already highlighted in the 2015 Canadian Stroke Best Practice Recommendations [5], virtual reality, including both immersive and nonimmersive technologies such as gaming devices, can serve as an adjunct to traditional rehabilitation therapies, offering additional opportunities for engagement, feedback, repetition, intensity, and task-oriented training. ...
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Telerehabilitation solutions are a concrete answer to many needs in the healthcare framework since they enable remote support for patients and foster continuity of care. This paper explores telerehabilitation using the ReMoVES system, a markerless approach that facilitates remote exercise guidance. Focusing on the sit-to-stand (STS) task, which is crucial for daily activities, this study employs the Microsoft Kinect sensor for human movement monitoring. Emphasizing preprocessing and analysis, the research extracts reliable parameters, enabling remote observation and evaluation of patient performance. This study highlights the importance of noise reduction and automatic segmentation for feature extraction, which are essential for assessing task execution and identifying compensatory movements. By utilizing a diverse healthy subject group, a reference model is established, providing optimal features for accurate exercise execution. Statistical analyses involving both healthy subjects and patients revealed key features for remote exercise observation. Automatic feature extraction related to poses and body movements, together with homogeneity within control group sessions, forms the basis for a quantitative parametric model. This model describes and compares accurate exercise execution, offering a method to remotely evaluate and adapt individual rehabilitation plans on the basis of robust and reliable parameters.
... In [22], Oh et al. explained exergames and exergaming. They mentioned exergames as video games that promote players' physical movements or exertions. ...
Article
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Musculoskeletal disorders (MSDs) can significantly impact individuals’ quality of life (QoL), often requiring effective rehabilitation strategies to promote recovery. However, traditional rehabilitation methods can be expensive and may lack engagement, leading to poor adherence to therapy exercise routines. An exergame system can be a solution to this problem. In this paper, we investigate appropriate hand gestures for controlling video games in a rehabilitation exergame system. The Mediapipe Python library is adopted for the real-time recognition of gestures. We choose 10 easy gestures among 32 possible simple gestures. Then, we specify and compare the best and the second-best groups used to control the game. Comprehensive experiments are conducted with 16 students at Andalas University, Indonesia, to find appropriate gestures and evaluate user experiences of the system using the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). The results show that the hand gestures in the best group are more accessible than in the second-best group. The results suggest appropriate hand gestures for game controls and confirm the proposal’s validity. In future work, we plan to enhance the exergame system by integrating a diverse set of video games, while expanding its application to a broader and more diverse sample. We will also study other practical applications of the hand gesture control function.
... Besides those, another form that has emerged with new technologies is the rehabilitation with Exergames which refers to video games that require body movements or physical effort of the players to interact with the game environment and control the game mechanics, in this case, the potential applications of Exergames extend beyond the promotion of physical activity and health [6]. Studies have shown significant promise in therapeutic and rehabilitation settings, where motor skills training, balance improvement, and cognitive rehabilitation can be aided [7]. When talking about systems that use exergame in rehabilitation, it is essential to understand that, like other systems, they must have robustness and functionality characteristics to fulfill their purpose. ...
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This article aims to make a scoping review of Validating Questionnaires used in the field of lower limb (LL) rehabilitation in which systems, devices or exergames are used. Its main objective is to provide a more comprehensive understanding of the results obtained in the validation of questionnaires, as well as to identify specific criteria for evaluating systems, devices or exergames in the area of LL rehabilitation, through the analysis of validating instruments and their application in different associated contexts. The article details the methodology employed, a PRISMA ScR method review which included database research and an evaluation of the selected studies. Inclusion and exclusion criteria were applied to select all relevant studies, resulting in 81 studies after initial review based on titles and abstracts. Subsequently, the criteria were again applied to read the full text, resulting in 58 final studies. The document distinguishes between standardized and non-standardized validating questionnaires, emphasizing that standardized validating questionnaires have undergone rigorous statistical processes to ensure their validity, reliability and consistency. The information compiled in the tables provides a solid basis for identifying and evaluating validation questionnaires in the above-mentioned context. This resource constitutes an accurate and reliable reference for selecting the most appropriate instruments for future research and comparisons with similar work. This article is a valuable resource for those interested in the validation of questionnaires used in the field of lower limb rehabilitation systems/devices/exergames.
... In this line, several studies have shown that exergaming can effectively support rehabilitation in terms of physical health and quality of life [2]. Exergaming refers to an experiential activity involving playing exergames or any videogames that require physical exertion or movements that are more than sedentary activities and also include strength, balance, and flexibility activities [3]. ...
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This work presents the design of a new game controller device and the development of two exergames (Peter Jumper and Andromeda) for upper limb rehabilitation. The eJamar controller is a novel electromechanical device designed to measure wrist and hand movements, such as pronation/supination, flexion/extension, and ulnar/radial deviation, enabling users to perform control actions in the exergames. One of eJamar’s most significant features is its ability to measure hand grip strength, a function not available in commercial gaming controllers. The exergame Peter Jumper involves a character jumping over obstacles in various environments, promoting hand grip exercises. The exergame Andromeda involves shooting enemy ships, promoting coordination between hand movements and grip strength, making it suitable for different rehabilitation techniques. A testing protocol was applied with eight healthy participants (5F and 3M), who completed a survey evaluating gameplay, usability, and satisfaction of the system. The results demonstrated that the developed exergames are intuitive and easy to play, with participants reporting that a therapist’s presence is not required for gameplay. Hence, it suggests that the developed system can improve the rehabilitation process, promoting wrist–arm movements and grasping actions.
... "Exergames" are active (video) games that require physical interaction in response to visual or auditory stimuli (31). These games fall under the Games for Health Taxonomy and are primarily classified as "preventative" interventions, with their therapeutic use in conditions like dementia referred to as "Rehabilitainment" (32). ...
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Dual-task training and exergaming interventions are increasingly recognized for their potential to enhance cognitive, physical, and mood outcomes among older adults and individuals with neurological conditions. Despite this, clinical and community programs that use these interventions are limited in availability. This paper presents the “FitBrain” program, an outpatient clinical model that combines dual-task and exergaming interventions to promote cognitive and physical health. We review the scientific rationale supporting these methods, detail the structure and methodology of the FitBrain program, and provide examples of session designs that integrate dual-tasking through exergaming. The paper also addresses implementation considerations, such as tailoring interventions to specific populations, ensuring user-centered design, and leveraging accessible technologies. We discuss key challenges, including limited research on programs utilizing multiple technologies and cost constraints, and propose directions for future research to refine best practices and evaluate the comparative effectiveness of multimodal vs. singular interventions. This paper aims to inform clinicians and program developers on implementing dual-task and exergaming interventions within diverse clinical and community settings by offering a structured model and practical guidelines.
... In recent years, the rapid global growth in the use of video games has opened up new avenues in the health sector through the development of exergames, or active video games. These exergames encourage physical activity by utilizing screens or virtual environments, leveraging advanced technologies such as motion capture systems, sensors, controllers, platforms, and various methods for providing real-time feedback [1,2]. Research indicates that these types of video games can effectively improve functional status across different age groups while enhancing exercise experience in terms of engagement and motivation [3][4][5]. ...
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(1) Background: Growth in the use of video games has spurred innovations in the health sector, especially through exergames, which promote physical activity using interactive technologies like augmented reality. Exergames are shown to enhance exercise motivation and engagement, yet enjoyment remains inconsistent across studies. This pilot study aims to provide evidence on how different exergaming doses affect exercise heart rate, perceived exertion, adverse effects, and enjoyment in older adults. (2) Methods: A pilot randomized controlled trial was conducted to compare different doses of exercise through video games (13 vs. 28 min) in older adults living in a nursing home. A single bout of exergaming was provided to assess the outcomes: heart rate, rate of perceived exertion, physical activity enjoyment scale score, and adverse effects. (3) Results: Thirty-two older adults were recruited. This study revealed no significant differences in heart rate between groups (p = 0.1). There is a weak correlation between the rate of perceived exertion and the level of enjoyment (rs = −0.193) and between the total time of the intervention and the incidence of adverse effects (rs = 0.295). (4) Conclusions: The use of a higher dose of exergaming is effective in achieving moderate physical intensity. Also, the results suggest the intervention was generally well tolerated and enjoyed by older adults, with no serious adverse effects reported.
Thesis
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L’état actuel de la recherche sur les effets des jeux vidéo a de quoi donner le vertige. D’un côté, un courant historiquement prévalent dénonce leurs effets supposés sur les comportements et affects agressifs des consommateurs ; de l’autre, une littérature émergente vante haut et fort leurs mérites pour les fonctions cognitives, à coup de programmes d’entraînement cérébral et de jeux éducatifs. Comment s’y retrouver à travers ces conclusions en apparence paradoxales ? Ce mémoire se propose d’éclairer la question, à travers l’étude des contributions de la psychologie cognitive dans une approche lifespan, de la psychologie sociale et de la psychopathologie. La confrontation des deux pans de la recherche sur les jeux vidéo met en évidence l’existence de bénéfices aussi bien pour le fonctionnement cognitif que pour la socialisation, avec des risques présents mais maîtrisables. Une éducation des usagers apparaît aujourd’hui nécessaire et devrait être intégrée dans les politiques contemporaines.
Chapter
The so-called second wave of VR has brought to research and market a lot of new displays, input devices, and content solutions during the last few years. Not only has new hardware entered the consumer market with low-cost price patterns, but whole new technologies are also being designed and developed.
Chapter
The methodology that was used for this research is presented in the overview based on the selected influencing subfactors and related research questions that have been the main focus of this work. As part of it, several different VR applications, each centered on a different set of features, were developed with the goal of investigating UX in VR serious gaming through empirical investigations done in a laboratory.
Article
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Purpose The USA is facing an obesity crisis so large that for the first time in history, this generation of children may have a life span that does not exceed that of its parents. Simultaneously, the gaming industry has introduced a form of video gaming (e.g. Nintendo Wii) that requires the participant to be physically involved in the game. For example, a live player will have a tennis racquet that he/she swings to compete with a virtual opponent on screen. This form of entertainment has been termed “exergaming.” People are buying these games for the purpose of entertainment. However, this paper aims to propose that there are possible unanticipated physical benefits of this new gaming technology. Design/methodology/approach A survey method is used to examine attitudes about exercise, video gaming and exergaming. Findings Results indicate a positive attitude toward exergaming, particularly with the more self‐identified sedentary respondents. Research limitations/implications This topic would benefit from a longitudinal study examining the adoption rate of this technology by previously inactive individuals and how its use translates into increased physical activity both with the video game system and other outside fitness activities. Practical implications The findings support exergaming as one way to get children to exercise. Originality/value The exercise potential of new gaming technology, i.e. “exergaming” is researched.
Article
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This article discusses a new genre of video games that require players to physically move in order to control onscreen actions. This combination of exercise and games is aptly termed exergame or exertainment. Although not ideal, playing exergames is arguably a better alternative for youngsters than sitting and twiddling their thumbs. Children who find traditional exercise boring and/or intimidating may be motivated to play video games that ask them to dance, do yoga with a virtual trainer, or ride virtual surfboards for extended periods. That is, youngsters may voluntarily engage in physical activity when it becomes part of a virtual experience, especially if they are already video game enthusiasts. We are interested in understanding whether the physical activity required to play exergames can lead to increased health and fitness. More so, because young children often choose to play exergames, they may be beneficial for preventing childhood overweight and obesity when introduced into homes and school-based physical education programs. In the article, we present a survey of current exergames and issues in need of further research in order to understand their effectiveness and possible adoption in physical education curricula.
Conference Paper
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Exergames are video games that use exertion-based interfaces to promote physical activity, fitness, and gross motor skill development. The purpose of this paper is to describe the development of an organizing framework based on principles of learning theory to classify and rank exergames according to embedded behavior change principles. Behavioral contingencies represent a key theory-based game design principle that can be objectively measured, evaluated, and manipulated to help explain and change the frequency and duration of game play. Case examples are presented that demonstrate how to code dimensions of behavior, consequences of behavior, and antecedents of behavior. Our framework may be used to identify game principles which, in the future, might be used to predict which games are most likely to promote adoption and maintenance of leisure time physical activity.
Book
An exploration of the way videogames mount arguments and make expressive statements about the world that analyzes their unique persuasive power in terms of their computational properties. Videogames are an expressive medium, and a persuasive medium; they represent how real and imagined systems work, and they invite players to interact with those systems and form judgments about them. In this innovative analysis, Ian Bogost examines the way videogames mount arguments and influence players. Drawing on the 2,500-year history of rhetoric, the study of persuasive expression, Bogost analyzes rhetoric's unique function in software in general and videogames in particular. The field of media studies already analyzes visual rhetoric, the art of using imagery and visual representation persuasively. Bogost argues that videogames, thanks to their basic representational mode of procedurality (rule-based representations and interactions), open a new domain for persuasion; they realize a new form of rhetoric. Bogost calls this new form "procedural rhetoric," a type of rhetoric tied to the core affordances of computers: running processes and executing rule-based symbolic manipulation. He argues further that videogames have a unique persuasive power that goes beyond other forms of computational persuasion. Not only can videogames support existing social and cultural positions, but they can also disrupt and change these positions themselves, leading to potentially significant long-term social change. Bogost looks at three areas in which videogame persuasion has already taken form and shows considerable potential: politics, advertising, and learning.
Article
Interactive immersive entertainment, or videogame playing, has emerged as a major entertainment and educational medium. As research and development initiatives proliferate, educational researchers might benefit by developing more grounded theories about them. This article argues for framing game play as a designed experience. Players’ understandings are developed through cycles of performance within the gameworlds, which instantiate particular theories of the world (ideological worlds). Players develop new identities both through game play and through the gaming communities in which these identities are enacted. Thus research that examines game-based learning needs to account for both kinds of interactions within the game-world and in broader social contexts. Examples from curriculum developed for Civilization III and Supercharged! show how games can communicate powerful ideas and open new identity trajectories for learners.
Article
Against the hegemony of ocularcentrism currently pervading video game theory, the author situates the practice of video gaming for further inquiry by performance studies to account for it as a wholly embodied phenomenon. Personal narratives of players engaging in performances of the game Dance Dance Revolution indicate the necessity of accounting for both the intersubjective and interobjective elements of video game play. The performativity of video gaming insists on a consideration of its material and discursive dimensions that not only refuses to metonymically reduce the gamer's body to a pair of eyes but also complicates popular dualistic understandings of the player—game relationship.
Article
Recently videogames that use physical input devices have been dubbed "exergames" — games that combine play and exercise. This paper offers a historical perspective on exergames, from early arcades to the Atari 2600 through contemporary consoles, as well as a theoretical analysis of the different rhetorics such games deploy to influence players toward physically-active gameplay.
Conference Paper
Combining engaging gameplay and educational aspects promoting health awareness gives an interesting challenge to game designers. This case study explores adolescents' (aged 13--16) technology usage, gaming habits and gaming motivations, as well as the elements affecting the user experience in serious games. Findings emphasize the importance of social aspects in gaming in form of presence of friends while gaming, or in offline or online multiplayer gaming. According to the findings games should offer challenges matching the player's competence and enable improvement, advancement and developing skills. Modifying characters, exploring the game world and physical activity were also important. The causes and consequences of selections in game and their relation to real-life were wished to be shown clearly in games. Design implications for designing games that promote health awareness are presented.
Article
Physical gaming is a genre of computer games that has recently been made available for the home. But what does it mean to bring games home that were originally designed for play in the arcade? This paper describes an empirical study that looks at physical gaming and how it finds its place in the home. We discuss the findings from this study by organizing them around four topics: the adoption of the game, its unique spatial needs, the tension between visibility and availability of the game, and what it means to play among what we describe as the gaming circle, or players and non-players alike. Finally, we discuss how physical gaming in the home surfaces questions and issues for householders and researchers around adoption, gender and both space and place.
Article
A framework for simulating physiological responses to exercise lets exergame developers more efficiently test their games during development. An example implementation combines software that simulates heart-rate responses with a custom hardware setup. Simulated heart-rate responses closely match the real physiological responses, demonstrating the approach's validity and potential.