Games for Health

Health is an elementary foundation of prosperous human life. Average human life expectancy has never been as long as it is today and medical advances have greatly improved overall population health. However, modern societies are burdened by new complications in the form of lifestyle diseases which arise due to various aspects of modern life, such as sedentary behavior. The pressure on public health systems is ever increasing with the emergence of further complex and expensive treatment options, and due to the complications resulting from demographic change. The technological advancements of the industrial and information age, the computational revolution in general, and video games for entertainment specifically contribute to the prevalence of some prevalent lifestyle-related health issues. At the same time, computing devices and interactive applications also play an important role in improving all areas of individual and public health. Recent research and early commercial releases deliver convincing evidence that playful applications and games for health in particular offer approaches that can help overcome the motivational barriers which often restrain successful health treatments or preventive actions and behavior. This chapter provides an overview of the arguments that motivate the application of play and game techniques for personal and public health. It summarizes the basic promises and challenges of games for health research and development, provides starting points regarding their design and implementation, illustrates selected aspects along the lines of exemplary applications, and hints at pressing open challenges as well as promising avenues for further research and developments. A selection of quality references for further reading is included in the last section.

[1]  Gregorio Patrizi,et al.  Play to Become a Surgeon: Impact of Nintendo WII Training on Laparoscopic Skills , 2013, PloS one.

[2]  Jannicke Baalsrud Hauge,et al.  Value Propositions for Serious Games in Health and Well-Being , 2012, SGDA.

[3]  Matthew K. Miller,et al.  Effects of balancing for physical abilities on player performance, experience and self-esteem in exergames , 2014, CHI.

[4]  Lucio Tommaso De Paolis,et al.  A Comprehensive Review of Serious Games in Health Professions , 2014, Int. J. Comput. Games Technol..

[5]  E. Deci,et al.  The "What" and "Why" of Goal Pursuits: Human Needs and the Self-Determination of Behavior , 2000 .

[6]  Vishnu Kotrajaras,et al.  Automatic Level Difficulty Adjustment in Platform Games Using Genetic Algorithm Based Methodology , 2009 .

[7]  Vero Vanden Abeele,et al.  Designing meaningful play within the psycho-social context of older adults , 2010, Fun and Games '10.

[8]  Marc Herrlich,et al.  Exergames for Physiotherapy and Rehabilitation: A Medium-term Situated Study of Motivational Aspects and Impact on Functional Reach , 2015, CHI.

[9]  A. Bandura Self-efficacy mechanism in human agency. , 1982 .

[10]  Valérie Gay,et al.  User Adoption of Mobile Apps for Chronic Disease Management: A Case Study Based on myFitnessCompanion® , 2012, ICOST.

[11]  Paul A. Cairns,et al.  The Placebo Effect in Digital Games: Phantom Perception of Adaptive Artificial Intelligence , 2015, CHI PLAY.

[12]  Karolien Poels,et al.  Digital game design for elderly users , 2007, Future Play.

[13]  Kathrin Maria Gerling,et al.  Designing and evaluating digital games for frail elderly persons , 2011, Advances in Computer Entertainment Technology.

[14]  Gazihan Alankus,et al.  Stroke Therapy through Motion-Based Games: A Case Study , 2010, TACC.

[15]  Paul Lukowicz,et al.  Smart-mat: recognizing and counting gym exercises with low-cost resistive pressure sensing matrix , 2014, UbiComp.

[16]  Sandra L. Calvert,et al.  The promise of exergames as tools to measure physical health , 2011, Entertain. Comput..

[17]  Dirk Wenig,et al.  Exercise My Game: Turning Off-The-Shelf Games into Exergames , 2013, ICEC.

[18]  Ben Medler,et al.  Using Recommendation Systems to Adapt Gameplay , 2009, Int. J. Gaming Comput. Mediat. Simulations.

[19]  Marc Herrlich,et al.  Motivational Effects of a Gamified Training Analysis Interface , 2014, MuC.

[20]  Matthew K. Miller,et al.  How Self-Esteem Shapes our Interactions with Play Technologies , 2015, CHI PLAY.

[21]  A. Sundbom,et al.  Home exercise and compliance in inflammatory rheumatic diseases--a prospective clinical trial. , 1997, The Journal of rheumatology.

[22]  Mark Jensen,et al.  The Effectiveness of Virtual Reality for Dental Pain Control: A Case Study , 2001, Cyberpsychology Behav. Soc. Netw..

[23]  Craig A. Lindley,et al.  Game Play Schemas: From Player Analysis to Adaptive Game Mechanics , 2008, Int. J. Comput. Games Technol..

[24]  P. M. Kato,et al.  A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial , 2008, Pediatrics.

[25]  Paul F. M. J. Verschure,et al.  Social Integration of Stroke Patients through the Multiplayer Rehabilitation Gaming System , 2014, GameDays.

[26]  Darryl Charles,et al.  Optimising engagement for stroke rehabilitation using serious games , 2009, The Visual Computer.

[27]  Philip Hingston,et al.  Considerations for the design of exergames , 2007, GRAPHITE '07.

[28]  Jeffrey Heer,et al.  Balancing exertion experiences , 2012, CHI.

[29]  Alex Gekker,et al.  Health Games - Taxonomy Analysis and Multiplayer Design Suggestions , 2012, SGDA.

[30]  Josef Wiemeyer,et al.  Personalized Adaptive Control of Training Load in Exergames from a Sport-Scientific Perspective - Towards an Algorithm for Individualized Training , 2014, GameDays.

[31]  Lynne Baillie,et al.  Exploring & designing tools to enhance falls rehabilitation in the home , 2013, CHI.

[32]  Martin Levesley,et al.  A system in the wild: deploying a two player arm rehabilitation system for children with cerebral palsy in a school environment , 2013 .

[33]  Regan L. Mandryk,et al.  Full-body motion-based game interaction for older adults , 2012, CHI.

[34]  Andrew K. Przybylski,et al.  The Motivational Pull of Video Games: A Self-Determination Theory Approach , 2006 .

[35]  A. Bandura GUIDE FOR CONSTRUCTING SELF-EFFICACY SCALES , 2006 .

[36]  Lynne Baillie,et al.  Investigating the long-term use of exergames in the home with elderly fallers , 2014, CHI.

[37]  Alon Wolf,et al.  Adaptive rehabilitation games. , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[38]  Marc Herrlich,et al.  Strong and Loose Cooperation in Exergames for Older Adults with Parkinson s Disease , 2013, Mensch & Computer Workshopband.

[39]  N. Anderson,et al.  Comprar Interdisciplinary Research Case studies from health and social science | Frank Kessel | 9780195324273 | Oxford University Press , 2008 .

[40]  Deborah I Thompson Designing Serious Video Games for Health Behavior Change: Current Status and Future Directions , 2012, Journal of diabetes science and technology.

[41]  Alex Sandro Gomes,et al.  Dynamic Game Balancing: An Evaluation of User Satisfaction , 2006, AIIDE.

[42]  Kathrin Maria Gerling,et al.  Anpassbare Computerspiele für Senioren , 2014, Informatik-Spektrum.

[43]  Kathrin Maria Gerling,et al.  Game Design for Older Adults: Effects of Age-Related Changes on Structural Elements of Digital Games , 2012, ICEC.

[44]  Changchun Liu,et al.  Dynamic Difficulty Adjustment in Computer Games Through Real-Time Anxiety-Based Affective Feedback , 2009, Int. J. Hum. Comput. Interact..

[45]  S Weisman,et al.  Computer games for the frail elderly. , 1983, The Gerontologist.

[46]  Jean-Bernard Martens,et al.  Rehabilitation of handwriting skills in stroke patients using interactive games: a pilot study , 2009, CHI Extended Abstracts.

[47]  Hayeon Song,et al.  Promoting Exercise Self-Efficacy With an Exergame , 2011, Journal of health communication.

[48]  Jörg-Tobias Kuhn,et al.  Dyskalkulie vs. Rechenschwäche: Basisnumerische Verarbeitung in der Grundschule , 2013 .

[49]  Cynthia Kratzke,et al.  Smartphone Technology and Apps: Rapidly Changing Health Promotion. , 2012 .

[50]  P. Olivier,et al.  Accuracy of the Microsoft Kinect sensor for measuring movement in people with Parkinson's disease. , 2014, Gait & posture.

[51]  Russell A. McCann,et al.  mHealth for mental health: Integrating smartphone technology in behavioral healthcare. , 2011 .

[52]  Chris Crawford,et al.  The Art of Computer Game Design , 1984 .

[53]  G. Pichierri,et al.  Use of virtual reality technique for the training of motor control in the elderly , 2010, Zeitschrift für Gerontologie und Geriatrie.

[54]  Nathan Franklin,et al.  The UX book: Process and guidelines for ensuring a quality user experience by Rex Hartson and Pardha A. Pyla, San Diego: Morgan Kaufmann. 2012. , 2013, CDQR.

[55]  Marc Herrlich,et al.  Comparing modalities for kinesiatric exercise instruction , 2014, CHI Extended Abstracts.

[56]  Pedro Miguel Moreira,et al.  Serious games for rehabilitation: A survey and a classification towards a taxonomy , 2010, 5th Iberian Conference on Information Systems and Technologies.

[57]  Arthur F Kramer,et al.  Exergaming and older adult cognition: a cluster randomized clinical trial. , 2012, American journal of preventive medicine.

[58]  Yin Leng Theng,et al.  Wii as entertainment and socialisation aids for mental and social health of the elderly , 2012, CHI Extended Abstracts.

[59]  Peter Wolf,et al.  Cognitive and cognitive-motor interventions affecting physical functioning: A systematic review , 2011, BMC geriatrics.

[60]  Kathrin Gerling,et al.  Motion-Based Video Games for Older Adults in Long-Term Care , 2014 .

[61]  Ernest Adams,et al.  Fundamentals of Game Design , 2006 .

[62]  K D Henry,et al.  Effect of number of home exercises on compliance and performance in adults over 65 years of age. , 1999, Physical therapy.

[63]  Marc Herrlich,et al.  Adaptive difficulty in exergames for Parkinson's disease patients , 2013, Graphics Interface.

[64]  R. Ice,et al.  Long-term compliance. , 1985, Physical therapy.

[65]  Maged N Kamel Boulos,et al.  Digital Games for Type 1 and Type 2 Diabetes: Underpinning Theory With Three Illustrative Examples , 2015, JMIR serious games.

[66]  Maarten J. IJzerman,et al.  Systematic review of the effect of robot-aided therapy on recovery of the hemiparetic arm after stroke. , 2006, Journal of rehabilitation research and development.

[67]  D. Kort,et al.  Senior gamers : preferences, motivations and needs , 2009 .

[68]  Valerie J. Shute,et al.  The power of play: The effects of Portal 2 and Lumosity on cognitive and noncognitive skills , 2015, Comput. Educ..

[69]  Kazuya Okamoto,et al.  Concept Software Based on Kinect for Assessing Dual-Task Ability of Elderly People. , 2012, Games for health journal.

[70]  M. Csíkszentmihályi Flow: The Psychology of Optimal Experience , 1990 .

[71]  G. Kok,et al.  Correlates of exercise compliance in physical therapy. , 1993, Physical therapy.

[72]  B. J. Fogg,et al.  A behavior model for persuasive design , 2009, Persuasive '09.

[73]  Camarin E. Rolle,et al.  Video game training enhances cognitive control in older adults , 2013, Nature.

[74]  Martin Schrepp,et al.  Construction and Evaluation of a User Experience Questionnaire , 2008, USAB.

[75]  Julita Vassileva,et al.  Tailoring persuasive health games to gamer type , 2013, CHI.

[76]  Regan L. Mandryk,et al.  How to Present Game Difficulty Choices?: Exploring the Impact on Player Experience , 2016, CHI.

[77]  Eric Horvitz,et al.  The Lumière Project: Bayesian User Modeling for Inferring the Goals and Needs of Software Users , 1998, UAI.

[78]  A. Krichevets,et al.  Computer games as a means of movement rehabilitation. , 1995, Disability and rehabilitation.

[79]  Richard M. Ryan,et al.  Glued to Games: How Video Games Draw Us In and Hold Us Spellbound , 2011 .

[80]  J. Wiemeyer,et al.  Serious games in prevention and rehabilitation—a new panacea for elderly people? , 2012, European Review of Aging and Physical Activity.

[81]  Ellen Brox,et al.  Healthy Gaming – Video Game Design to promote Health , 2011, Applied Clinical Informatics.

[82]  E. Deci Effects of Externally Mediated Rewards on Intrinsic Motivation. , 1971 .

[83]  Marc Herrlich,et al.  Motion-Based Games for Parkinson's Disease Patients , 2011, ICEC.

[84]  C. Anandan,et al.  The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview , 2011, PLoS medicine.

[85]  Lennart E. Nacke,et al.  From game design elements to gamefulness: defining "gamification" , 2011, MindTrek.

[86]  Matthew K. Miller,et al.  Designing Wheelchair-Based Movement Games , 2015, ACM Trans. Access. Comput..

[87]  M. Csíkszentmihályi Flow and the Foundations of Positive Psychology , 2014 .

[88]  Guillaume Chanel,et al.  Boredom, engagement and anxiety as indicators for adaptation to difficulty in games , 2008, MindTrek '08.

[89]  Luis Fernández-Luque,et al.  Exergames for elderly: Social exergames to persuade seniors to increase physical activity , 2011, 2011 5th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops.

[90]  Barbara L. Ciaramitaro Mobile Technology Consumption: Opportunities and Challenges , 2011 .

[91]  Thomas Gärtner,et al.  Player Modeling for Intelligent Difficulty Adjustment , 2009, LWA.

[92]  B. Primack,et al.  Role of video games in improving health-related outcomes: a systematic review. , 2012, American journal of preventive medicine.

[93]  Anthony G. Schneiders,et al.  Exercise therapy compliance in acute low back pain patients , 1998 .

[94]  Marc Herrlich,et al.  The Influence of Music on Player Performance in Exergames for Parkinson's Patients , 2012, ICEC.

[95]  Regan L. Mandryk,et al.  Control your game-self: effects of controller type on enjoyment, motivation, and personality in game , 2013, CHI.

[96]  Kathrin Maria Gerling,et al.  Visual complexity, player experience, performance and physical exertion in motion-based games for older adults , 2013, ASSETS.

[97]  J. B. Brooke,et al.  SUS: A 'Quick and Dirty' Usability Scale , 1996 .

[98]  Marc Herrlich,et al.  Anticipation in Motion-Based Games for Health , 2017 .

[99]  Pamela M. Kato,et al.  Video Games in Health Care: Closing the Gap , 2010 .

[100]  Jenova Chen,et al.  Flow in games (and everything else) , 2007, CACM.

[101]  J. Richards,et al.  Agreement between physiotherapists on quality of movement rated via videotape , 2003, Clinical rehabilitation.

[102]  Marc Herrlich,et al.  MoviTouch: Mobile Movement Capability Configurations , 2015, ASSETS.

[103]  T. C. Nicholas Graham,et al.  Design of an exergaming station for children with cerebral palsy , 2012, CHI.

[104]  Ralf Steinmetz,et al.  Serious games for health: personalized exergames , 2010, ACM Multimedia.

[105]  Chris McCarthy,et al.  Innovation with information technologies in healthcare , 2013 .

[106]  Harri Oinas-Kukkonen,et al.  Persuasive Systems Design: Key Issues, Process Model, and System Features , 2009, Commun. Assoc. Inf. Syst..

[107]  Marc Herrlich,et al.  Achievements in Exergames for Parkinson s Patients , 2012, Mensch & Computer.

[108]  Antonio Frisoli,et al.  Relive: a serious game to learn how to save lives. , 2014, Resuscitation.

[109]  Predrag V. Klasnja,et al.  Mind the theoretical gap: interpreting, using, and developing behavioral theory in HCI research , 2013, CHI.

[110]  Nadia Hocine,et al.  Motivation based difficulty adaptation for therapeutic games , 2011, 2011 IEEE 1st International Conference on Serious Games and Applications for Health (SeGAH).

[111]  Dirk Wenig,et al.  Sportal: A First-Person Videogame turned Exergame , 2013, Mensch & Computer Workshopband.

[112]  Tracy Fullerton,et al.  Game Design Workshop: Designing, Prototyping, and Playtesting Games , 2004 .

[113]  Kenneth R. Koedinger,et al.  Optimizing challenge in an educational game using large-scale design experiments , 2013, CHI.

[114]  Terry E. Duncan,et al.  Psychometric properties of the Intrinsic Motivation Inventory in a competitive sport setting: a confirmatory factor analysis. , 1989, Research quarterly for exercise and sport.

[115]  J. Deutsch,et al.  Use of a Low-Cost, Commercially Available Gaming Console (Wii) for Rehabilitation of an Adolescent With Cerebral Palsy , 2008, Physical Therapy.

[116]  Yi Zhang,et al.  Bayesian adaptive user profiling with explicit & implicit feedback , 2006, CIKM '06.

[117]  Deborah I Thompson,et al.  Playing for real: video games and stories for health-related behavior change. , 2008, American journal of preventive medicine.

[118]  Rainer Malaka,et al.  How Computer Games Can Improve Your Health and Fitness , 2014, GameDays.

[119]  H. Stam,et al.  ''Playstation eyetoy games'' improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial. , 2008, European journal of physical and rehabilitation medicine.

[120]  Ivan L. Beale Video Games for Health: Principles and Strategies for Design and Evaluation , 2011 .

[121]  David Benyon,et al.  Adaptive systems: A solution to usability problems , 1993, User Modeling and User-Adapted Interaction.

[122]  Robin Hunicke,et al.  The case for dynamic difficulty adjustment in games , 2005, ACE '05.

[123]  Gerd Kempermann,et al.  Why and How Physical Activity Promotes Experience-Induced Brain Plasticity , 2010, Front. Neurosci..

[124]  Cynthia Putnam,et al.  Towards Efficacy-Centered Game Design Patterns For Brain Injury Rehabilitation: A Data-Driven Approach , 2015, ASSETS.

[125]  Tyler Sax,et al.  Just a Fad? Gamification in Health and Fitness Apps , 2014, JMIR serious games.

[126]  Pierre Jouvelot,et al.  Motivation-driven educational game design: applying best practices to music education , 2005, ACE '05.

[127]  G.C. Burdea,et al.  Virtual reality-enhanced stroke rehabilitation , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[128]  Philip Hingston,et al.  Exergame development using the dual flow model , 2009 .

[129]  Nadia Hocine,et al.  Dynamic Difficulty Adaptation in Serious Games for Motor Rehabilitation , 2014, GameDays.

[130]  Lakhmi C. Jain,et al.  Technologies of Inclusive Well-Being - Serious Games, Alternative Realities, and Play Therapy , 2014, Technologies of Inclusive Well-Being.

[131]  Darren Edge,et al.  Supporting the creative game design process with exertion cards , 2014, CHI.

[132]  H. Hoffman,et al.  Virtual Reality Pain Control During Burn Wound Debridement in the Hydrotank , 2008, The Clinical journal of pain.

[133]  Pat Langley,et al.  User modeling in adaptive interfaces , 1999 .

[134]  Kristy Elizabeth Boyer,et al.  Automatically Recognizing Facial Expression: Predicting Engagement and Frustration , 2013, EDM.

[135]  Samay Jain,et al.  Perceptions of a Videogame-Based Dance Exercise Program Among Individuals with Parkinson's Disease. , 2013, Games for health journal.

[136]  Yue Gao,et al.  The acute cognitive benefits of casual exergame play , 2012, CHI.

[137]  Albert A. Rizzo,et al.  Towards pervasive physical rehabilitation using Microsoft Kinect , 2012, 2012 6th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops.