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- Supporting physical training in healthy older adults through biocybernetic adaptation and exergamingPublication . Muñoz Cardona, John Edison; Bermúdez i Badia, Sergi; Gouveia, Élvio Rúbio Quintal; Cameirão, Mónica da SilvaPhysical inactivity in older adults is commonly associated with the development of chronic diseases, poor maintenance of functional status, possible cognitive declines and the loss of physical independence. With the aim of reducing the social and economic burdens generated by the high percentages of older adults in the population, active aging programs have been intensively promoted. These programs, however, suffer from low rates of adherence and a lack of exercise’s personalization that end up in demotivated older adults. Exercise videogames (Exergames) have been established as a fun and enjoyable method to promote physical activity, by using competition, timely feedback, and fun, they counteract the monotony of exercise routines. Although frequently attractive, the use of Exergames for exercise promotion in older adults still faces challenges in demonstrating effectiveness regarding functional fitness, cognitive functions, and game user experience. Moreover, the long-term effects of using Exergames as a structured exercise program in the older population have been rarely investigated. To tackle these limitations in Exergaming research, this thesis uses two different Human-Computer Interaction (HCI) techniques: humancentered design and physiological computing. The main objective is to maximize Exergaming effectiveness via: i) providing a more personalized, diversified and enjoyable game experience through custom-made Exergames and ii) optimizing the body responses while exercising with a physiologically intelligent software layer. First, a set of four Exergames that covers aerobic endurance, muscular strength and motor ability fitness domains were carefully designed via contextual design. Secondly, the biocybernetic loop construct from physiological computing is used to improve the cardiovascular performance of older adults through an Exergame that adapts its difficulty based on game performance and exertion levels, thus persuading players to exert in the desired and recommended levels. Two cross-sectional and two longitudinal controlled studies were completed in local senior gymnasiums with active older adults addressing multiple research questions to unveil the role of customized and adaptive Exergames in promoting physical activity. We demonstrated how attractiveness and effectiveness can be successfully combined in Exergaming design to deliver encouraging and motivating exercises that are equivalent (or sometimes better) to conventional training methods. Moreover, we illustrated the design of a set of physiological computing software tools that can be extensively used for biocybernetic adaptation in videogames, and physiological signal post-processing and interpretation.
- Closing the loop in exergaming - Health benefits of biocybernetic adaptation in senior adultsPublication . Muñoz, John Edison; Cameirão, M.; Bermúdez i Badia, S.; Gouveia, E. RubioExergames help senior players to get physically active by promoting fun and enjoyment while exercising. However, most exergames are not designed to produce recommended levels of exercise that elicit adequate physical responses for optimal training in the aged population. In this project, we developed physiological computing technologies to overcome this issue by making real-time adaptations in a custom exergame based on recommendations for targeted heart rate (HR) levels. This biocybernetic adaptation was evaluated against conventional cardiorespiratory training in a group of active senior adults through a floor-projected exergame and a smartwatch to record HR data. Results showed that the physiologically-augmented exergame leads players to exert around 40% more time in the recommended HR levels, compared to the conventional training, avoiding over exercising and maintaining good enjoyment levels. Finally, we made available our biocybernetic adaptation software tool to enable the creation of physiological adaptive videogames, permitting the replication of our study.
- Effects of prolonged multidimensional fitness training with exergames on the physical exertion levels of older adultsPublication . Gonçalves, Afonso Rodrigues; Muñoz, John Edison; Gouveia, Élvio Rúbio; Cameirão, Mónica da Silva; Bermúdez i Badia, SergiWhile exergames have been used with older adults in an attempt to promote higher physical activity (PA) levels, and its subsequent health benefits, there is a lack of research that objectively quantifies the PA levels that custom-made exergames can produce throughout an extended training program. In this paper, we describe a 3-month intervention study that aimed to measure the participants PA levels during exergames’ sessions and their effectiveness in eliciting the recommended activity levels. Over the course of the study, two groups of older adults participated in either a conventional multidimensional fitness training program of two sessions of exercise per week (n = 16) or in an equivalent combined program (n = 15), of one conventional and one exergame session per week. Both the objective PA levels (through accelerometry) and subjective effort (perceived exertion) were collected in each session. Results revealed that while participants spent more time in moderateto-vigorous PA during exergaming than during conventional sessions, they also spent less energy, thus working out at lower intensities but for a more sustained amount of time. The self-reported exertion was consistently higher for the sessions of the combined exercise program. We showed that a set of custom-made exergames can be successfully used by trainers to set up personalized training sessions and can be used in combination with regular exercise for sustained long-term training, exposing differences between the two training regimes in terms of efficiency, elicited PA, and perceived effort.