A multidisciplinary journal on gaming and gamification for health education/promotion, teaching and social change.

Background: Restoring hand and finger function after a traumatic hand injury necessitates a regimen of consistent and conscientious exercise. However, motivation frequently wanes due to unchallenging repetitive tasks or discomfort, causing exercises to be performed carelessly or avoided completely. Introducing gamification to these repetitive tasks can make them more appealing to patients, ultimately increasing their motivation to exercise consistently. Objective: This study aims to iteratively develop a serious virtual reality game for hand and finger rehabilitation within an appealing and engaging digital environment, encouraging patient motivation for at least 2 weeks of continuous therapy. Methods: The development process comprised 3 distinct stages, each of which was subject to evaluation. Initially, a prototype was created to encompass the game’s core functionalities, which was assessed by 18 healthy participants and 7 patients with impaired hand function. Subsequently, version 1 of the game was developed and evaluated with 20 patients who were divided into an investigation group and a control group. On the basis of these findings, version 2 was developed and evaluated with 20 patients who were divided into an investigation group and a control group. Motivation was assessed using the Intrinsic Motivation Inventory (IMI), while the application’s quality was rated using the Mobile Application Rating Scale and the System Usability Scale. User feedback was gathered using semistructured interviews. Results: The prototype evaluation confirmed the acceptance and feasibility of the game design. Version 1 significantly increased motivation in 2 IMI subscales, effort (P<.001) and usefulness (P=.02). In version 2, a significant increase in daily performed exercises was achieved (P=.008) compared to version 1, with significantly higher motivation in the IMI subscale effort (P=.02). High Mobile Application Rating Scale scores were obtained for both versions 1 and 2, with version 2 scoring 86.9 on the System Usability Scale, indicating excellent acceptability. User feedback provided by the semistructured interviews was instrumental in the iterative development regarding improvements and the expansion of the playable content. Conclusions: This study presented a virtual reality serious game designed for hand and finger rehabilitation. The game was well received and provided an environment that effectively motivated the users. The iterative development process incorporated user feedback, confirming the game’s ease of use and feasibility even for patients with severely limited hand function.

Rehabilitation concepts for upper limb amputees traditionally rely on the execution of repetitive movements. Video game-based therapies are a stimulating way to increase patient motivation, effort and performance during those otherwise monotonous neuromuscular exercises. Myoelectric signals needed to control an upper limb prosthesis are intuitively trained and the patient benefits from increased prosthesis usability. In this study, a clinically feasible and entertaining virtual rehabilitation intervention has been developed and evaluated for short-term improvement of EMG control and engaging gameplay elements. Seven upper limb amputees completed the three assessment sessions and the video game intervention. Results show an improvement in overall EMG control, fine muscle activation and electrode separation. Patients report that racing games seem to be slightly superior regarding the fun factor, but rhythm games provide a more challenging EMG control option.

Background: A growing number of cancer and hematopoietic stem cell transplant (HSCT) survivors require long-term follow-up with optimal communication schemes, and patients' compliance is crucial. Adolescents have various unmet needs. Regarding self-report of symptoms and health status, users of mobile apps showed enhanced compliance. Currently, HSCT aftercare at the HSCT outpatient clinic of the St. Anna Children’s Hospital in Vienna, Austria, is based on handwritten diaries, carrying various disadvantages. Recently, we developed the prototype of a web-based, self-monitoring gamified mobile app tailored for adolescents: the INTERACCT (Integrating Entertainment and Reaction Assessment into Child Cancer Therapy) app. Objective: This observational, prospective study evaluated the usability of the INTERACCT app for tracking real-time self-reported symptoms and health status data in adolescent HSCT patients and a healthy matched control group. The primary outcome of the study was the quality of the self-reported medical information. We hypothesized that the mobile app would provide superior medical information for the clinicians than would the handwritten diaries. Methods: Health data were reported via paper diary and mobile app for 5 consecutive days each. The quality of medical information was rated on a 5-point scale independently and blinded by two HSCT clinicians, and the duration of use was evaluated. A total of 52 participant questionnaires were assessed for gaming patterns and device preferences, self-efficacy, users’ satisfaction, acceptability, and suggestions for improvement of the mobile app. Interrater reliability was calculated with the intraclass correlation coefficient, based on a two-way mixed model; one-way repeated-measures analysis of variance and t tests were conducted post hoc. Descriptive methods were used for correlation with participants’ demographics. For users’ satisfaction and acceptability of the mobile app, the median and the IQR were calculated. Results: Data from 42 participants—15 patients and 27 healthy students—with comparable demographics were evaluated. The results of our study indicated a superiority of the quality of self-reported medical data in the INTERACCT app over traditional paper-and-pencil assessment (mobile app: 4.14 points, vs paper-based diary: 3.77 points, P=.02). The mobile app outperformed paper-and-pencil assessments mainly among the patients, in particular among patients with treatment-associated complications (mobile app: 4.43 points, vs paper-based diary: 3.73 points, P=.01). The mobile app was used significantly longer by adolescents (≥14 years: 4.57 days, vs ≤13 years: 3.14 days, P=.03) and females (4.76 days for females vs 2.95 days for males, P=.004). This corresponds with a longer duration of use among impaired patients with comorbidities. User satisfaction and acceptability ratings for the mobile app were high across all groups, but adherence to entering a large amount of data decreased over time. Based on our results, we developed a case vignette of the target group. Conclusions: Our study was the first to show that the quality of patient-reported medical information submitted via the INTERACCT app embedded in a serious game is superior to that submitted via a handwritten diary. In light of these results, a refinement of the mobile app supported by a machine learning approach is planned within an international research project.

In the ongoing process of the digital transformation of society, corresponding competencies are required from children more than ever. The concept of computational empowerment (CE) promotes confident and reflective engagement with digital technology, which often falls short in formal education. This work outlines how both entertainment and serious games can be used to support the cause of CE and what opportunities they offer for more empowering learning in school settings. The use of digital games appears to be a promising way to connect with the lifeworld of young people and thus offering a low-threshold and differentiated starting point. In this context, the focus should be placed on a stronger establishment of the protagonist role to empower students to engage with digital technologies in depth. In the Serious Game Changers project, students created their own educational modules on specific Sustainable Development Goals (SDGs) using digital games and creating new artifacts as learning objects through remixing game elements. In this project, students should be empowered to become active participants by designing with the help of commercial and serious games. Thus giving them their own voice in future (formal) educational settings and promoting future skills in order to make them self-confident 'protagonists' of their surroundings.

This paper gives an introduction into the principles of interactivity in music video games. Music video games are an old but small genre of games. The earliest direct ancestors emerged in the 1970ies. Some recent music video games were hugely successful. Until today, there are only a few different approaches to their design. The purpose of this article is to shed light on what these design principles are, and how the player is immersed. By analysing several games qualitatively, we extracted certain typical features of games of this genre: active scores, rhythm action, quantisation, synaesthesia, play as performance, free-form play, and sound agents. All these aspects of music video games are discussed in this paper with the aim of describing how they affect the interactivity of the games. The result is a grammar of the language of music video games. Linked to adequate metaphors, this grammar can build a veritable repository for rhythm based, melodically interactive games and digital electronic instruments.