BackgroundComputer based gaming systems, such as the Microsoft Kinect (Kinect), can facilitate complex task practice, enhance sensory feedback and action observation in novel, relevant and motivating modes of exercise which can be difficult to achieve with standard physiotherapy for people with Parkinson’s disease (PD). However, there is a current need for safe, feasible and effective exercise games that are appropriate for PD rehabilitation. The aims of this study were to i) develop a computer game to rehabilitate dynamic postural control for people with PD using the Kinect; and ii) pilot test the game’s safety and feasibility in a group of people with PD.MethodsA rehabilitation game aimed at training dynamic postural control was developed through an iterative process with input from a design workshop of people with PD. The game trains dynamic postural control through multi-directional reaching and stepping tasks, with increasing complexity across 12 levels of difficulty. Nine people with PD pilot tested the game for one session. Participant feedback to identify issues relating to safety and feasibility were collected using semi-structured interviews.ResultsParticipants reported that they felt safe whilst playing the game. In addition, there were no adverse events whilst playing. In general, the participants stated that they enjoyed the game and seven of the nine participants said they could imagine themselves using the game at home, especially if they felt it would improve their balance. The Flow State Scale indicated participants were immersed in the gameplay and enjoyed the experience. However, some participants reported that they found it difficult to discriminate between different types and orientations of visual objects in the game and some also had difficulty with the stepping tasks, especially when performed at the same time as the reaching tasks.ConclusionComputer-based rehabilitation games using the Kinect are safe and feasible for people with PD although intervention trials are needed to test their safety, feasibility and efficacy in the home.

Parkinson's is a complex and multifaceted condition with a myriad of symptoms, thus, designing for and with this user group requires careful consideration. We reflect upon two studies, employing different design methodologies, relating to the design of rehabilitative exergames in Parkinson's. The first explored the concept of designing 'for' People with Parkinson's (PwP) and focused on specifications outlined by clinical stakeholders. The second used a designing 'with' approach and modified a pre-established participatory design method for use with PwP. We call attention to the importance of carrying out design work with PwP and contribute; an empathic understanding of living with Parkinson's, a set of recommendations for how to design with PwP and a set of wider considerations for developing rehabilitative exergames for PwP.

Implementation of I-PASS has been associated with substantial improvements in patient safety and can be applied to a variety of disciplines and types of patient handoffs. Widespread implementation of I-PASS has the potential to substantially improve patient safety in the United States and beyond.

Here we review 18 articles that describe the design and evaluation of 1 or more games for diabetes from technical, methodological, and theoretical perspectives. We undertook searches covering the period 2010 to May 2015 in the ACM, IEEE, Journal of Medical Internet Research, Studies in Health Technology and Informatics, and Google Scholar online databases using the keywords "children," "computer games," "diabetes," "games," "type 1," and "type 2" in various Boolean combinations. The review sets out to establish, for future research, an understanding of the current landscape of digital games designed for children with diabetes. We briefly explored the use and impact of well-established learning theories in such games. The most frequently mentioned theoretical frameworks were social cognitive theory and social constructivism. Due to the limitations of the reported evaluation methodologies, little evidence was found to support the strong promise of games for diabetes. Furthermore, we could not establish a relation between design features and the game outcomes. We argue that an in-depth discussion about the extent to which learning theories could and should be manifested in the design decisions is required.

Type 1 diabetes affects approximately 1 in every 500 children in the UK. Although it is a lifelong condition, there are few if any overt manifestations, which can make it more difficult to meet people with the same condition. To avoid the risk of health complications, an emphasis is placed on a routine of selfmanagement behaviours. However, factors such as the desire to 'fit in' with the peer group may impede adherence and thus increase the probability of diminished health later in life. Creating appropriate peer support networks may be valuable in aiding a young person with diabetes to attend to their condition through interactions with otherwise unseen peers. Through a series of design workshops the context of living with type 1 diabetes and the value of peer support are explored from the perspective of an adolescent. Four types of support are reported: informational; emotional; tangible; and belonging/companionship, and design opportunities explored.