Serious Games:
Health, Rehabilitation, Education,
Industrial Simulation and Engineering

ClinicalTrials.gov (2015-17)

• Serious Game for Parkinson's Disease Patients (PARKGAME)

Official Title:

"Feasibility and Acceptability Study of Serious Game Rehabilitation Program in
Parkinson's Disease Patients With Resistant Gait and Balance Disorders"

ClinicalTrials.gov: A service of the U.S. National Institutes of Health (NIH-USA)
This study is currently recruiting participants.
Verified April 2016 by "Institut National de la Santé Et de la Recherche Médicale", France


Purpose:

"In this study the investigators aim to assess the feasibility and acceptability of a serious game to rehabilitate gait and balance disorders in 10 patients with Parkinson's disease previously operated for deep brain stimulation of the sub thalamic nucleus."

Further study details as provided by Institut National de la Santé Et de la Recherche Médicale, France:

a- Primary Outcome Measures:
Feasibility questionnaire [ Time Frame: once a week ] [ Designated as safety issue: No ] - self-assessment questionnaire

b- Secondary Outcome Measures:
b1- Acceptability questionnaire [ Time Frame: once a week ] [ Designated as safety issue: No ] - self-assessment questionnaire
b2- biomechanical parameters of gait and balance [ Time Frame: at inclusion, 3 weeks, 6 weeks and 18 weeks ] [ Designated as safety issue: No ] - recordings of centres of foot and mass displacements and velocities
b3- kinematics parameters of gait and balance [ Time Frame: at inclusion, 3 weeks, 6 weeks and 18 weeks ] [ Designated as safety issue: No ] - range of motion of hip, knee and ankle angles

Estimated Enrollment: 10
Study Start Date: June 2015
Estimated Study Completion Date: May 2017
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)

Commercial software for clinical use

• Doctor Kinetic (NL): Functional rehabilitation in Virtual Reality

"Doctor Kinetic is a medical systems manufacturer, headquartered in Breda, the Netherlands. We also have offices in Berlin, Germany and in Poznan, Poland. The company has developed a platform for evaluation and training in Virtual Reality for rehabilitation patients.
We are proudly working with all of our customers also several research partners with the largest European, Asian and American university hospitals among them."


• imaginary srl (IT): Rehability

"REHABILITY: suite of pathology-specific rehabilitation solutions
REHABILITY'S motor and cognitive games are the result of many years of European Scientific Research. This award-winning solution represents the most advanced motivational tool for tele-rehabilitation and incorporates highly personalised therapy plans under specialist control and guidance.
Available in many languages, REHABILITY is now working on eight different versions, each one dedicated to very specific rehabilitation needs: Neuro, Cardio, Pneumo, Cogni, Kids, Lite, Reuma, Orto. "

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Congressos/Conferences

• Serious Games and Applications for Health - SeGAH

"SeGAH 2020 - Fully Online Conference - 12th to 14th August 2020
Upon careful evaluation of the current level of uncertainty caused by COVID-19 and the conditions in August to hold the conference at the Centre for Digital Media in Vancouver, the organizers of SeGAH 2020 have decided to change the entire conference to a fully online event. This decision does not affect the conference review, publication, indexing, presentation and discussion process, which will follow IEEE guidelines.

"Scope
The overall objectives of the conference are the discussion and sharing of knowledge, experiences and scientific and technical results, related to state-of-the-art solutions and technologies on serious games and applications for health and healthcare, as well as the demonstration of advanced products and technologies."

Erasmus University Rotterdam

• Massive Open Online Course (MOOC): Serious Gaming

"The MOOC Serious Gaming is always available online. Once you enrol, you'll have access to all videos, quizzes, and programming assignments (if applicable). Peer review assignments can only be submitted and reviewed once the MOOC has begun, which is every 4 weeks.

Course information
In this MOOC you will learn the ins and outs of games that are designed with exactly those purposes in mind: serious games. We will define serious games and discuss the different types that have been developed. We will explain why people like to play them and what impact they may have. State of the art theories from game studies, philosophy and media psychology will be used to help you understand how serious games work and how they appeal to players. The potential impact of gaming is addressed in detail by discussing persuasive games, which aim at changing the player's attitude. Throughout the MOOC, theoretical insights will be illustrated with playful animations and case studies of serious games that are developed by world-class companies in the city of Rotterdam."

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International Societies

• Serious Games Society
"The Serious Games Society (SGS) is the think tank where the future of games for learning can be discussed and put in practice.

Mission
The SGS has been designed to bring together the cutting edge companies, institutions and individuals researching on and developing Serious Games. We focus on helping members in connecting and benefiting from the wide range of resources available in the Serious Games space.
The SGS aims at becoming the reference point on Serious Games and Gamification at the scientific, technological and professional level.
The SGS's core purpose is to foster technological innovation and excellence in the field of Serious Games and Gamification for the benefit of all the people. The SGS fosters research and technology transfer between research, industry and educational establishment in the multiple disciplines involved in SGs design, development and deployment.

Vision
In our vision, SGs will become a new, reliable tool for learning, training and improvement. Educators, trainers, consultants etc. will be able to exploit reliable information and services to select the most suited games for their specific needs and objectives."

Publicações Científicas

• Elsevier: Special Issue on Serious Games and Applications for Health

"The overall objectives of SEGAH are the discussion and sharing of knowledge, experiences and scientific and technical results, related to state-of-the-art solutions, technologies and applications of serious games in health and healthcare, as well as the demonstration of advanced products and technologies for health. We believe that SEGAH 2016, held in Orlando, USA, will further enlarge the audience of this conference and thus keep improving the quality of the papers submitted. Therefore, the authors of SEGAH 2016 proceeding papers are invited to submit extended versions of their papers to the special issue “Serious games and Applications for Health” from the Entertainment Computing Journal (ECJ). The selected authors interested in extending their conference papers must be aware that the final manuscript to be submitted to ECJ must provide a minimum of 1/3 new content and do not exceed 1/3 copy/paste and 1/3 rephrased content from proceedings paper. Each manuscript will be double blind reviewed by ECJ guest editors."


• Elsevier: Special issue on Participatory Design for Serious Games

"Participatory design (PD) approaches are gaining traction across the field of HCI. However, their use in serious game design remains less frequent. While the application of PD is a situated phenomenon, it is still possible to distil some shared causes for this that apply across contexts, including historically “designer-led” game design processes, difficulties reaching common ground within interdisciplinary teams involved in serious games design, and end users’ lack of domain expertise. The aim of this special issue is to make progress in advancing epistemological and related methodological developments. We seek case studies of how PD has been used in different stages of serious game design processes, specific methods appropriated or developed for doing so, and details of (problematic) dynamics between PD processes and serious game design. Authors are asked to engage in critical reflections with a particular focus on the complex interaction between the values of PD, the pedagogical and entertainment requirements of serious games, and the multi-faceted perspectives that design stakeholders often introduce. The special issue is expected to be of interest to both researchers and practitioners of the games, educational technologies and PD communities."


• International Journal of Serious Games

"This first issue represents the beginning of a new period that is even more challenging. The time of SG development as an artisanal process is ending, SG design, implementation and deployment is a scientific field well positioned in this new scientific era where multi-disciplinarity is the core of any research."

Alessandro De Gloria - Università degli Studi di Genova (IT)

Computer Graphics, Computing in Social science, Arts and Humanities, Human-computer Interaction





Papers and Dissertations

• A Serious Games Framework for Health Rehabilitation

Paula Alexandra Rego, Pedro Miguel Moreira, Luís Paulo Reis

Abstract

"Serious Games is a field of research that has evolved substantially with valuable contributions to many application domains and areas. Patients often consider traditional rehabilitation approaches to be repetitive and boring, making it difficult for them to maintain their ongoing interest and to assure the completion of the treatment program. This paper reviews Serious Games and the natural and multimodal user interfaces for the health rehabilitation domain. Specifically, it details a framework for the development of Serious Games that integrates a rich set of features that can be used to improve the designed games with direct benefits to the rehabilitation process. Highlighted features include natural and multimodal interaction, social skills (collaboration and competitiveness) and progress monitoring. Due to the rich set of features supported by the framework, the games' rehabilitation efficacy can be enhanced primarily from an increase in the patient's motivation when exercising the rehabilitation tasks."



• Design and implementation of patient specific virtual reality systems for motor rehabilitation

A Dissertation Presented by Mark Langdon Sivak to The College of Engineering in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the field of Interdisciplinary Engineering

Northeastern University, Boston, Massachusetts - USA
August 2012

Abstract

"There is a need for low-cost, in-home rehabilitation systems with increasing numbers of strokes per year. Therefore a virtual reality system for home use in rehabilitation of the hand and wrist that included hardware, middleware, and software was created and tested with healthy subjects. The Angle Tracking and Location At-home System (ATLAS) was created with potentiometer bend sensors to track finger angle and inertial measurement units (IMUs) to track hand orientation and position. To facilitate the communication between the ATLAS and a computer the Device Agnostic Virtual Environment (DAVE) was created as the middleware solution. Patient specific virtual environments have been created for the ATLAS with the goal of increasing subject motivation and outcomes. The ATLAS was found to fit the requirements for a low-cost, in home system for motor rehabilitation."



• Design guidelines for developing customised serious games for PD

Design guidelines for developing customised serious games for Parkinson's Disease rehabilitation
using bespoke game sensors

Ioannis Theoklitos Paraskevopoulosa, Emmanuel Tseklevesb, Cathy Craigc, Caroline Whyattc, John Cosmasd

Abstract

"The research presented in this paper proposes a set of design guidelines in the context of a Parkinson's Disease (PD) rehabilitation design framework for the development of serious games for the physical therapy of people with PD. The game design guidelines provided in the paper are informed by the study of the literature review and lessons learned from the pilot testing of serious games designed to suit the requirements of rehabilitation of patients with Parkinson’s Disease. The proposed PD rehabilitation design framework employed for the games pilot testing utilises a low-cost, customized and off-the-shelf motion capture system (employing commercial game controllers) developed to cater for the unique requirement of the physical therapy of people with PD. Although design guidelines have been proposed before for the design of serious games in health, this is the first research paper to present guidelines for the design of serious games specifically for PD motor rehabilitation."



• Serious Games for Home-based Stroke Rehabilitation

Friedrich R, Hiesel P, Peters S, Siewiorek DP, Smailagic A, Brügge B

Abstract

"On average, two thousand residents in the United States experience a stroke every day. These circumstances account for $28 billion direct costs annually and given the latest predictions, these costs will more than triple by 2030. In our research, we propose a portfolio of serious games for home-based stroke rehabilitation. The objective of the game approach is to enrich the training experience and establish a higher level of compliance to prescribed exercises, while maintaining a supportive training environment as found in common therapy sessions. Our system provides a collection of mini games based on rehabilitation exercises used in conventional physical therapy, monitors the patient's performance while exercising and provides clinicians with an interface to personalize the training. The clinician can set the current state of rehabilitation and change the playable games over time to drive diversification. While the system still has to be evaluated, an early stage case study with one patient offered positive indications towards this concept."



• Serious Games in Physical Rehabilitation

Bruno Bonnechère

Abstract

"Before discussing the possibility of integrating serious games into conventional treatment of pathologies, it is important to differentiate the kind of approaches that can be used. The integration of existing commercial video games (VG) into the rehabilitation program (serious gaming) or the use of specially designed games adapted for one particular pathology/group of patients (serious games, SG).

The following chapter focuses on the use of serious games/gaming in physical rehabilitation in general: number of patients included, type of devices used, duration of the intervention."

• Serious games for physical rehabilitation

Serious games for physical rehabilitation: designing highly configurable and adaptable games

L'ubos Omelina, Bernhard Jansen, Bruno Bonnechère, Serge L. Van Sint Jan, Jan Cornelis

ABSTRACT

"Computer games have been recognized as a motivational tool in rehabilitation for a decade. Traditional rehabilitation includes exercises which are often considered as repetitive, boring and requires supervision by the therapist. New opportunities in rehabilitation have risen with the emerging popularity of computer games and novel input sensors like 3D cameras, balance boards or accelerometers. Despite active research in this area, there is still lack of available games for rehabilitation mainly due to many different requirements that have to be met for each type of therapy. In this paper we propose a specialized configurable architecture for revalidation games, focusing on neuro-muscular rehabilitation. The proposed architecture enables a therapist to define game controls depending on the patient needs and without any programing skills. We have also implemented a system meeting this architecture and four games using the system in order to verify correctness and functionality of the proposed architecture."

ICT4Rehab / VR4REHAB / VREPAR

• Serious Games for Upper Limb Rehabilitation Following Stroke

James William Burke, Michael McNeill, Darryl Charles

Abstract

"Stroke is a leading cause of severe physical disability, causing a range of impairments. Frequently stroke survivors are left with partial paralysis on one side of the body and movement can be severely restricted in the affected side’s hand and arm. We know that effective rehabilitation must be early, intensive and repetitive, which leads to the challenge of how to maintain motivation for people undergoing therapy. This paper discusses why games may be an effective way of addressing the problem of engagement in therapy and analyses which game design patterns may be important for rehabilitation. We present a number of serious games that our group has developed for upper limb rehabilitation. Results of an evaluation of the games are presented which indicate that they may be appropriate for people with stroke."

• The end of active video games and the consequences for rehabilitation

Bruno Bonnechère, Lubos Omelina, Katarina Kostkova, Serge Van Sint Jan, Bart Jansen

"In 2006, Nintendo commercialized a revolutionary new novel gaming system, the Wii with remote controller and added the balance board in 2007. Instead of controlling the games passively with classic controllers, typically sitting in a sofa, the players have to be active and move in order to steer through the games. In 2010, Microsoft also announced a solution for active video games (AVG): the Microsoft Kinect, a markerless camera system that reconstructs a crude skeleton of the players to interact with the games. Their advertisement was "you are the controller." The third dominating console on the market, the PlayStation from Sony, also came with AVG (the PlayStation move, PlayStation Eye and PlayStation Camera). AVG were developed by the companies to contest against players' sedentary behaviour, to increase the level of physical activity and therefore contribute to address obesity and overweight epidemics (Bailey & McInnis, 2011)."

"Clinicians and researchers have quickly seen the potential offered by these solutions in physical rehabilitation and have tried to integrate AVGs in the conventional treatment of various pathologies."

"Despite this interest, various clinicians found that the AVG are not adapted for rehabilitation or that the patients were not able to play adequately because of their limitations. However, the devices used to control the AVG (the Wii Remote/Balance Board and the MS Kinect) could still offer possibilities in the rehabilitation field if the games were adapted for the abilities of the patients and their environments."



• Virtual reality for stroke rehabilitation (Review)

Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M

Abstract

Background
Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinica l settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015.

Objectives
Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity.

Secondary objectives: to determine the efficacy of virtual reality compared with an alternative intervention or no intervent ion on: gait and balance, global motor function, cognitive function, activity limitation, participation restriction, quality of life, and adverse events.

Search methods
We searched the Cochrane Stroke Group Trials Register (April 2017), CENTRAL, MEDLINE, Embase, and seven additional databases. We also searched trials registries and reference lists.

Selection criteria
Randomised and quasi-randomised trials of virtual reality ("an advanced form of human-computer interface that allows the user to 'interact' with and become ’immersed’ in a computer-generated environment in a naturalistic fashion") in adults after stroke. The primary outcome of interest was upper limb function and activity. Secondary outcomes included gait and balance and global motor function.

Data collection and analysis
Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data, and assessed risk of bias. A third review author moderated disagreements when required. The r eview authors contacted investigators to obtain missing information"