The world is quickly moving to a more and more digital world, everything is online and computerized. This is convenient but also increases the amount of time spent in front of various types of devices and displays, not getting the exercise we as humans need. Gaming or the act of playing video games is very much a part of this and is traditionally thought of as a sedentary activity. However, there is a type of video games that does not fall into this category, that is exergames. Exergames distinguish themselves from sedentary games in that they use the human body for control, leading to their use to combat the lack of exercise. This thesis describes the implementation and testing of one such exergame that is a part of a larger project at Linköping University that aims to create a library of games to be used in organizations where sitting for long periods is common. The game is implemented using the game engine Godot and an ML solution called MediaPipe for movement tracking and recognition. The goal was to create an easy to playgame providing moderate to high physical activity. Testing showed that the game provided the desired physical exertion within a few consecutive rounds and exertion remained on roughly the same level even if the user was experienced.

Depuis de nombreuses années, la littérature s’attache à mettre en évidence que, malgré les déficits cognitifs liés à l’avancée en âge, chaque individu peut bénéficier de ses expériences afin de les réinvestir quotidiennement à travers une optimisation de ses comportements, via le maintien d’un certain niveau de plasticité cognitive (i.e., théorie de l’enrichissement cognitif). Dans cette perspective, ce travail vise à appréhender l’étendue de la plasticité comportementale des seniors via l’étude du transfert d’apprentissage issu des exergames. Son ambition est d’établir quels peuvent être les bienfaits de la pratique des exergames afin de lutter contre les effets délétères du vieillissement cognitif normal. Il s’agit, au travers de deux études d’entrainement, d’identifier le potentiel de transférabilité de nouvelles acquisitions cognitives et motrices via cet outil d’entrainement virtuel. La première étude a mis en évidence qu’un programme d’entrainement en exergames de trois mois permet l’amélioration des fonctions exécutives et de la vitesse de traitement de l’information chez des personnes âgées sédentaires. Ces résultats suggèrent que ces améliorations cognitives pourraient prendre leurs sources explicatives, d’une part, via la sollicitation physique se traduisant ici par des améliorations physiques notamment au niveau de l’endurance cardiorespiratoire, et d’autre part, via l’intermédiaire de la stimulation cognitive induite par le jeu qui, grâce à la diversité des tâches et des interactions, a engendré un transfert vers les tests neuropsychologiques. La seconde étude a pour objectif d’identifier l’occurrence d’un transfert virtuel-réel au travers d’un contexte de similarité entre les éléments constituant nos deux tâches expérimentales, à partir d’une tâche de putting au golf. La comparaison de performances des deux groupes d’âges entrainés selon deux contextes d’apprentissage (réel versus virtuel) a mis en évidence que les adultes jeunes étaient parvenus à réinvestir les habiletés acquises issues du virtuel dans le contexte réel, à la différence des adultes âgés qui, bien qu’ils aient atteint une réelle acquisition motrice en contexte virtuel, n’ont pas réussi à réengager de façon optimale leur acquisition antérieure. Ce travail doctoral atteste que les exergames peuvent, à travers une stimulation à la fois physique et cognitive, être un moyen efficace de lutter contre les effets délétères liés à l’avancée en âge. / For years, research literature has underlined that, notwithstanding the cognitive deficits related to advancing age, individuals may continue to benefit from their prior experiences in the optimization of their behavior, aided by the maintenance of a certain level of cognitive plasticity (i.e., concept of enrichment effects). The present research aims to understand the extent of seniors’ behavioral plasticity and establish how exergames may assist them in countering the deleterious effects of normal cognitive aging. This research consists of two studies which aim to identify the potential for cognitive and motor acquisitions via the use of virtual training devices. The first study highlights that a three month exergame training program improved both executive functions and the speed of processing in sedentary seniors. These results suggest that such cognitive improvements may be explained by (1) physical solicitation resulting in improved cardiorespiratory endurance, and (2) by the game-related cognitive stimulation (due to the variety of tasks and interactions) further transferring to neuropsychological tests. The second study is designed to identify the occurrence of a virtual-real transfer through context similarity between our two experimental tasks, both based on a golf-putting task. Compared performances between the two age groups, having trained in one of two learning conditions (real versus virtual) underlined that young adults were able to reinvest the acquired skills from the virtual to the real context, in contrast to older adults. Even though the latter acquired actual motor skills in virtual context, they failed to optimally re-engage prior acquisitions. This doctoral research attests that exergames, through both physical and cognitive stimulation, may be an effective means to counter the deleterious effects related to advancing age.

Physiotherapy patients, victims of accidents, strokes and injuries are submitted for several months of repetitive exercise in rehabilitation sessions, depending almost entirely of aid and monitoring of the physical therapist. The performed exercises should be supervised and evaluated regularly in order to measure the patient's progress in treatment. The evolution of new interaction technologies with the patient, through low-cost motion detection sensors, enables the creation for physical therapy support software. Furthermore, the introduction of Exergames and BrainTraining games in the fields of medicine and physical therapy has shown that serious games can be used to assist the treatment of diseases and patients in special conditions. However, few studies demonstrate the importance or relevant results regarding the usability of solutions. This paper presents the development and evaluation of a gaming system to assist physiotherapists in quality analysis and workout efficiency. The evaluation through specific questionnaires showed the quality of the developed system on the usability and functionality of the games. Also from the final collected data, it is presented an ideal standard for players movement data, that can be used as a reference during treatment of patients. / Pacientes de fisioterapia, vítimas de acidentes, derrames e lesões são submetidos por vários meses a sessões repetitivas de exercícios para reabilitação, dependendo quase que totalmente do auxílio e acompanhamento do fisioterapeuta. Os exercícios realizados devem ser supervisionados e avaliados regularmente, com o intuito de medir o progresso do paciente no tratamento. A evolução de novas tecnologias de interação com o paciente, através de sensores de detecção de movimentos de baixo custo, possibilita a criação de softwares de apoio ao tratamento fisioterapêutico. Além disso, a introdução de Exergames e BrainTraining games nos campos da medicina e fisioterapia tem demonstrado que é possível utilizar jogos sérios para auxiliar nos tratamentos de doenças e condições especiais dos pacientes. Contudo, poucos estudos demonstram a importância ou resultados relevantes quanto à usabilidade das soluções. Este trabalho apresenta o desenvolvimento e avaliação de um sistema de jogos para auxiliar fisioterapeutas na análise da qualidade e eficiência da sessão de exercícios. A avaliação realizada através de questionários específicos demonstrou a qualidade do sistema desenvolvido quanto à usabilidade e funcionalidade dos jogos apresentados. Também a partir dos dados finais coletados, apresenta-se um padrão ideal de dados para os movimentos dos jogadores, que pode ser usado como referência durante o tratamento de pacientes.

The problem addressed in this work is the lack of accessibility inexergames for people with movement impairments. It can bechallenging for these people to physically activate them selfbecause it’s easier said than done for them to access exerciseequipment that are adapted for them. Exergames and interactivegames have been shown to encourage physical activity, however,those games are not always developed for people with mobilityimpairments. Exergames aims to combine exercise and digitalgaming. The purpose of this study is to investigate what settingoptions should be available on exergames for people withmovement impairments to feel that it is accessible. The study alsoaims to investigate how these setting options should be design andpresented to be as accessible as possible.The study is based on semi-structured interviews with people withmobility impairments. The interviews were divided into tworounds, the reason for this was to be able to focus on which settingoptions informants perceive as most important during the firstinterview. During the second interview, the focus was on howthese setting options should be designed and presented so thatthey would be as accessible as possible.The results showed that in order for people with movementimpairment to experience exergames and videogames asaccessible, they should be able to modify the game settings basedon their own needs and abilities. The setting options that do existshould be able to be changed at an individual level and let theplayer decide exactly how the settings should be. The results alsoshows that the most important part may not be how the settingoptions are designed, the most important parts is that the playerget information about what setting options there is and how theywork. And how these setting options are presented to the player. / Problemet som adresseras i denna studie är brist på tillgänglighetinom exergames för personer med rörelsenedsättning. Det kanvara svårt för dessa personer att fysiskt aktivera sig på grund avsvårigheter att få tillgång till träningsutrustning som är anpassadeför dem. Exergames och interaktiva spel har visat sig uppmuntratill fysisk aktivitet, dock är inte alltid de spelen utvecklade förpersoner med rörelsenedsättningar. Exergames syftar till attkombinera motion och digitalt spel. Syftet med denna studie är attundersöka vilka anpassningsmöjligheter som bör finnas påexergames för att personer med rörelsenedsättningar ska upplevaatt de är tillgängliga. Studien syftar även till att undersöka hur dessa anpassningsmöjligheter bör designas och presenteras för attvara så tillgängliga som möjligt.En kvalitativ studie med användarperspektiv genomfördes genomsemistrukturerade intervjuer med personer medrörelsenedsättningar. Intervjuerna delades upp i två omgångar föratt under första intervjun lägga fokuset på vilkaanpassningsmöjligheter som informanterna uppfattar är viktigast.Under andra intervjun låg fokuset på hur dessaanpassningsmöjligheter bäst kan designas och presenteras för attde ska vara så tillgängliga som möjligt.Resultatet visade att för att personer med rörelsenedsättningar skauppleva exergames och videospel som tillgängliga bör de hamöjlighet att anpassa spelet utifrån sina egna behov och förmåga.De anpassningsmöjligheter som finns bör kunna ändras påindividnivå och låta spelaren själv få bestämma exakt hur det skavara. Resultatet visar också att det viktigaste kanske inte är huranpassningsmöjligheterna designas, det viktigaste är att spelarnafår information över vilka anpassningsmöjligheter som finns ochhur de fungerar. Samt hur anpassningsmöjligheter presenteras förspelaren.

Detta examensarbete har bestått av utvecklingen av en konceptuell mobilapplikation som ska uppmuntra barn till fysiskt aktiv lek. Arbetets involverade frågeställningar bestod av hur en mobilapplikation kan utformas för att uppmuntra barn till fysisk aktivitet, samt hur en mobilapplikation kan samverka med ett aktivitetsarmband för att förhöja användarupplevelsen. Utvecklingsarbetet har bestått av en produktutvecklingsprocess tidiga del, och har gått från förundersökning fram till skapandet av en high fidelity prototyp med tillhörande användartester. Produktutvecklingen har inkluderat human-centered design vilket har inneburit ett flertal tillfällen där barn, mellan 6 och 10 år gamla, har inkluderats i arbetet. Detta har påverkat de involverade metoderna samt resultatet. Arbetet resulterade i en konceptuell mobilapplikation där användaren kan ta hand om en figur med hjälp av poäng som samlats med fysisk aktivitet. Konceptet innehåller flera olika funktioner så som en affär där insamlade aktivitetspoäng kan spenderas, en garderob med ägda accessoarer, minispel i form av exergames och statistik över utförd fysisk ansträngning. För att förhöja användarens upplevelse av aktivitetsarmbandet skapades ett samband mellan detta och den konceptuella mobilapplikationen. Detta samband innebar att konceptets poäng samlas in med hjälp av armbandet för att sedan överföras till spelet med en synkroniseringsfunktion.

Many factors contribute to people's physical inactivity, but among the leading factors is a lack of motivation. Fitness trackers have been shown to encourage an increase in exercise, but they are frequently abandoned within a few short months. For this thesis I developed and asynchronous-play social gaming platform, FitPlay Games, to fill the gap in motivation left by current fitness trackers. By providing users with a variety of asynchronous cooperative and competitive gaming styles, this platform enable them to find a motivation technique that works best for their lifestyle and fitness prowess. The platform encourages prolonged use of fitness trackers, helping users to have more healthy lifestyles. Individual games are designed to allow both the novice and the maven to have a chance at winning, leveling the playing field, and increasing motivation to win. The effectiveness, usability, and enjoyability of the social games will be assessed, with an emphasis on understanding differences in play habits due to gender and lifestyle.

Technology such as television, computers, and video games are often in the line for reasons of why people lack physical activity and tend to gain weight and become obese. In the case of video games, with the advent of the so called “serious games initiative”, a new breed of video games have come into place. Such games are called “exergames” and they are intended to motivate the user to do physical activity. Although there is some evidence that some types of Exergames are more physically demanding than traditional sedentary games, there is also evidence that suggests that such games are not really providing the intensity of exert that is at the recommended levels for a daily exercise. Currently, most exergames have a passive approach. There is no real tracking of the players progress, there is no assessment of his/her level of exert, no contextual information, and there is no adaptability on the game itself to change the conditions of the game and prompt the desired physiological response on the player. In this thesis we present research work done towards the design and development of an architecture and related systems that support a shift in the exertion game paradigm. The contributions of this work are enablers in the design and development of exertion games with a strict serious game approach. Such games should have “exercising” as the primary goal, and a game engine that has been developed under this scheme should be aware of the exertion context of the player. The game should be aware of the level of exertion of the player and adapt the gaming context (in-game variables and exertion interface settings) so that the player can reach a predefined exertion rate as desired. To support such degree of adaptability in a multimedia, multimodal system, we have proposed a system architecture that lays down the general guidelines for the design and development of such systems.

Kurzfassung: Sport im Sinne eines regelmäßigen körperlichen Trainings sollte aus gesundheitlichen Gründen nach einer Schwangerschaft empfohlen werden. Jedoch müssen an diese Aktivitäten besondere Ansprüche gestellt werden. Die Beanspruchung sollte moderat und mit geringem Risiko sein. Weiters muss die körperliche Aktivität in den Tagesablauf einer jungen Mutter integrierbar sein. Hierzu könnten digitale Spiele mit Ganzkörperaktivitäten sinnvoll eingesetzt werden. Ziel dieser Trainingsstudie war es, möglichen Einsatz und mögliche Wirkung ausgewählter Übungen der Nintendo Wii Fit Plus bei postnatalen Frauen zu überprüfen. Dabei wurden subjektive Eindrücke wie das Spielerleben und wahrgenommene Beanspruchung erhoben. Die Wirkung auf die aerobe Ausdauerleistungsfähigkeit wurde durch eine 6-wöchige Intervention überprüft. An der Studie nahmen 8 Probandinnen (Alter 29,0 ± 4,6 Jahre, Größe 1,7 ± 0,1 m, Body-Mass-Index [BMI] 25,1 ± 3,1 kg/m², postnatal 6,3 ± 1,9 Wochen) teil. Ergebnisse: Die Probandinnen zeigten nach einmaligem Spielen eine hohe bis sehr hohe Motivation, dieses Spiel noch mal zu spielen. Es wurde als nicht stressig mit mittlerer Spielgeschwindigkeit bei einfacher und übersichtlicher Bedienung bewertet. Über den Beobachtungszeitraum nahmen die Frauen eine moderate (etwas anstrengende) Beanspruchung mit hohem Spaßempfinden wahr. Signifikante Gewichtsreduktionen sowie eine Verbesserung der aeroben Leistungsfähigkeit konnten nicht festgestellt werden. Schlussfolgernd bleibt festzuhalten, dass trotz nicht-signifikanter metabolischer und morphologischer Adaptionen eine hohe Motivation zu erwarten ist, was unter gegebenen Übungsvariationen der Nintendo Wii Fit Plus zu regelmäßigem Training führen kann. Da diese Studie nur Pilotcharakter hatte, wäre unter randomisierten kontrollierten Bedingungen eine Untersuchung mit größerem Probandenumfang durchzuführen. / Exercise after pregnancy should be recommended for health reasons. However, special considerations are necessary in the context of physical training. The intensity should be moderate and the activity itself lowrisk. In addition, the exercise has to be capable of being integrated in the daily routine of a young mother. This could also include digital games that involve whole body movements. The aim of this study was to investigate the possible use and the effects of selected exercises of the Nintendo Wii Fit Plus in postnatal women. Data on the subjective impressions of the game experience was collected as well as the perceived exertion during the activity. Furthermore, the effect on the aerobic performance after 6 weeks intervention was investigated. The study involved 8 female subjects (age 29.0 ± 4.6 years, height 1.7 ± 0.1 m, Body Mass Index 25.1 ± 3.1 kg/m², postnatal 6.3 ± 1.9 weeks). Results: The subjects showed a high to very high motivation to play the Wii Fit Plus again after the first game session. The game was assessed as causing no stress at medium speed with a simple and clear operation. During the observation period, the women showed a moderate (somewhat hard physical exertion) with a high sensation of fun. Significant weight reductions and improvements in aerobic capacity could not be proven. Summing up, using the Wii Fit Plus, a high level of motivation can be expected despite any significant metabolic and morphological adaptations, which may lead to a regular participation in exercise activities. Since this study only had pilot-character, it would be advisable to conduct further research using a larger number of subjects under randomized controlled conditions.

Sports video games should be inherently competitive, but they fall short in providing competition between player skills. The translation of real-world physical activities to a game controller and the emphasis on statistical simulations in traditional sports video games leads to a limited opportunity for expertise development, individual differentiation, and fatigue. These are three very important aspects of real-world sports that are lacking in sports video games. One possible solution to these difficulties is to use small-scale exertion. This method requires the design of an input mechanic that requires only the use of hands and fingers (or feet). We created two small-scale exertion sports video games (Track and Field Racing and Jelly Polo) and ran four studies to compare our small-scale exertion games to traditional rate-based sports video games. Qualitative and quantitative results suggest that using small-scale exertion increases the amount of expertise development, individual differentiation, and fatigue in sports video games. Results also suggest small-scale exertion controls are more engaging than traditional rate-based controls. By using small-scale exertion to add physicality into sports video games, we are able to increase richness, competitiveness, and realism in order to create a game which is competitive, in terms of player skill, and sport-like.

Technology such as television, computers, and video games are often in the line for reasons of why people lack physical activity and tend to gain weight and become obese. In the case of video games, with the advent of the so called “serious games initiative”, a new breed of video games have come into place. Such games are called “exergames” and they are intended to motivate the user to do physical activity. Although there is some evidence that some types of Exergames are more physically demanding than traditional sedentary games, there is also evidence that suggests that such games are not really providing the intensity of exert that is at the recommended levels for a daily exercise. Currently, most exergames have a passive approach. There is no real tracking of the players progress, there is no assessment of his/her level of exert, no contextual information, and there is no adaptability on the game itself to change the conditions of the game and prompt the desired physiological response on the player. In this thesis we present research work done towards the design and development of an architecture and related systems that support a shift in the exertion game paradigm. The contributions of this work are enablers in the design and development of exertion games with a strict serious game approach. Such games should have “exercising” as the primary goal, and a game engine that has been developed under this scheme should be aware of the exertion context of the player. The game should be aware of the level of exertion of the player and adapt the gaming context (in-game variables and exertion interface settings) so that the player can reach a predefined exertion rate as desired. To support such degree of adaptability in a multimedia, multimodal system, we have proposed a system architecture that lays down the general guidelines for the design and development of such systems.