Biofeedback Methodology: a Narrative Review

Vasilyev, V. S.; Borisov, Vasilii I.; Syskov, Alexey

doi:10.1109/sibircon48586.2019.8958019

Cited by 11 publications

(4 citation statements)

References 54 publications

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“…An exergame should be able to adapt to the individual patient at a physical and cognitive level to meet the heterogeneous and individual requirements of patients with MS and to allow for an optimal training zone [51,95]. For this reason, the design integrated individual levels for physical and cognitive functions into the exergames, allowing for an individually challenging game for patients with MS. To extend the playfulness and effectiveness of the exergames in the future, the assessment of certain motor and cognitive parameters (objective) or rating scales (subjective) could help to define an individual training area [99][100][101][102]. The integration of in-exergame, real-time adaptation could help to maintain a predefined optimal training zone in a training session and over a longer period (progression) [51,102,103].…”

Section: Training Intensity and Progressmentioning

confidence: 99%

Design and Evaluation of User-Centered Exergames for Patients With Multiple Sclerosis: Multilevel Usability and Feasibility Studies

Schättin¹,

Häfliger²,

Meyer³

et al. 2021

JMIR Serious Games

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Background Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Patients with MS experience a wide range of physical and cognitive dysfunctions that affect their quality of life. A promising training approach that concurrently trains physical and cognitive functions is video game–based physical exercising (ie, exergaming). Previous studies have indicated that exergames have positive effects on balance and cognitive functions in patients with MS. However, there is still a need for specific, user-centered exergames that function as a motivating and effective therapy tool for patients with MS and studies investigating their usability and feasibility. Objective The aim of this interdisciplinary research project is to develop usable and feasible user-centered exergames for the pressure-sensitive plate Dividat Senso by incorporating theoretical backgrounds from movement sciences, neuropsychology, and game research as well as participatory design processes. Methods Focus groups (patients and therapists) were set up to define the user-centered design process. This was followed by the field testing of newly developed exergame concepts. Two sequential usability and feasibility studies were conducted on patients with MS. The first study included a single exergaming session followed by measurements. Between the first and second studies, prototypes were iterated based on the findings. The second study ran for 4 weeks (1-2 trainings per week), and measurements were taken before and after the intervention. For each study, participants answered the System Usability Scale (SUS; 10 items; 5-point Likert Scale; score range 0-100) and interview questions. In the second study, participants answered game experience–related questionnaires (Flow Short Scale [FSS]: 13 items; 7-point Likert Scale; score range 1-7; Game Flow questionnaire: 17 items; 6-point Likert Scale; score range 1-6). Mixed methods were used to analyze the quantitative and qualitative data. Results In the first study (N=16), usability was acceptable, with a median SUS score of 71.3 (IQR 58.8-80.0). In the second study (N=25), the median SUS scores were 89.7 (IQR 78.8-95.0; before) and 82.5 (IQR 77.5-90.0; after), and thus, a significant decrease was observed after training (z=−2.077; P=.04; r=0.42). Moreover, high values were observed for the overall FSS (pre: median 5.9, IQR 4.6-6.4; post: median 5.8, IQR 5.4-6.2) and overall Game Flow Questionnaire (pre: median 5.0, IQR 4.7-5.3; post: median 5.1, IQR 4.9-5.3). A significant decrease was observed in the item perceived importance (FSS: z=−2.118; P=.03; r=0.42). Interviews revealed that user-centered exergames were usable, well accepted, and enjoyable. Points of reference were identified for future research and development. Conclusions The project revealed that the newly developed, user-centered exergames were usable and feasible for patients with MS. Furthermore, exergame elements should be considered in the development phase of user-centered exergames (for patients with MS). Future studies are needed to provide indications about the efficacy of user-centered exergames for patients with MS.

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Section: Training Intensity and Progressmentioning

confidence: 99%

Design and Evaluation of User-Centered Exergames for Patients With Multiple Sclerosis: Multilevel Usability and Feasibility Studies

Schättin¹,

Häfliger²,

Meyer³

et al. 2021

JMIR Serious Games

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show abstract

“…Knowledge from different research fields and disciplines (e.g., sport science and HCI) should be used to examine different parameters assessing physical ( Wallace et al, 2014 ; Burgess, 2017 ; Coyne et al, 2018 ; McLaren et al, 2018 ), cognitive ( Solovey et al, 2014 ; Grassmann et al, 2016 ; Oschlies-Strobel et al, 2017 ; He et al, 2019 ; Hughes et al, 2019 ; Zhou et al, 2020 ), and mental ( Schrader et al, 2017 ; Mostefai et al, 2019 ) load. Objective parameters could be defined by physiological and performance-related factors ( Vasilyev et al, 2019 ). Physiological parameters could be measurements, outcomes, and variables related to HR (e.g., heart rate variability), respiration, eye tracking, facial expression, skin conductance, and brain (e.g., functional near-infrared spectroscopy and electroencephalogram) and muscle (e.g., electromyography) activity.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Impact of Heart Rate-Based In-Game Adaptations in an Exergame-Based Functional High-Intensity Interval Training on Training Intensity and Experience in Healthy Young Adults

2021

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Physical inactivity remains one of the biggest societal challenges of the 21st century. The gaming industry and the fitness sector have responded to this alarming fact with game-based or gamified training scenarios and thus established the promising trend of exergaming. Exergames—games played with the (whole) body as physical input—have been extolled as potential attractive and effective training tools. Simultaneously, researchers and designers are still exploring new approaches to exploit the full potential of this innovative and enjoyable training method. One way to boost the attractiveness and effectiveness of an exergame is to individualize it with game adaptations. A physiological parameter that is often used to balance the physical challenge and intensity of exergames to the player’s fitness skills is the heart rate (HR). Therefore, researchers and designers often rely on age-based, maximum HR (HRmax) formulas originating from performance diagnostics. In combination with the player’s assessed real-time HR during an exergame session, the pre-determined HRmax is used to adapt the game’s challenge to reach a pre-defined HR and physical intensity level (in-exergame adaptations), respectively. Although the validity and reliability of these age-based HRmax formulas were proven in heterogeneous target populations, their use is still often criticized as HR is an individual parameter that is affected by various internal and external factors. So far, no study has investigated whether the formula-based pre-calculated HRmax compared to a standardized individually pre-assessed HRmax elicits different training intensities, training experiences, and flow feelings in an exergame. Therefore, we compared both variants for in-exergame adaptation with the ExerCube – a functional high-intensity interval training exergame – in healthy young adults. Comparing the results of the two conditions, no significant differences were found for HR parameters and perceived physical and cognitive exertion, nor for overall flow feelings and physical activity enjoyment. Thus, the formula-based in-exergame adaptation approach was suitable in the presented study population, and the ExerCube provided an equally reliable in-exergame adaptation and comparable exergame play experiences. We discuss our findings in the context of related work on exergame adaptation approaches and draw out some implications for future adaptive exergame design and research topics.

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“…This physiological and psychological control effect has been applied in the area of video games [ 37 ], also in physical training, training people to improve breathing, and even self-control of HRV in physical activities [ 15 , 38 , 39 , 40 ]. In the area of medicine, applications are being studied in anorectal recovery therapies, integrating the IoMT (Internet of Medical Things) concept [ 41 , 42 ].…”

Section: Related Workmentioning

confidence: 99%

Heart Rate Variability Control Using a Biofeedback and Wearable System

Viera

Kaschel

Valencia

2022

Sensors

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Heart rate variability is an important physiological parameter in medicine. This parameter is used as an indicator of physiological and psychological well-being and even of certain pathologies. Research on biofeedback integrates the fields of biological application (physiological behavior), system modeling, and automated control. This study proposes a new method for modeling and controlling heart rate variability as heart rate acceleration, a model expressed in the frequency domain. The model is obtained from excitation and response signals from heart rate variability, which through the instrumental variables method and the minimization of a cost function delivers a transfer function that represents the physiological phenomenon. This study also proposes the design of an adaptive controller using the reference model. The controller controls heart rate variability based on the light actuators designed here, generating a conditioned reflex that allows individuals to self-regulate their state through biofeedback, synchronizing this action to homeostasis. Modeling is conducted in a target population of middle-aged men who work as firefighters and forest firefighters. This study validates the proposed model, as well as the design of the controllers and actuators, through a simple experiment based on indoor cycling. This experiment has different segments, namely leaving inertia, non-controlled segment, and actively controlled segment.

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Biofeedback Methodology: a Narrative Review

Cited by 11 publications

References 54 publications

Design and Evaluation of User-Centered Exergames for Patients With Multiple Sclerosis: Multilevel Usability and Feasibility Studies

Design and Evaluation of User-Centered Exergames for Patients With Multiple Sclerosis: Multilevel Usability and Feasibility Studies

Comparing the Impact of Heart Rate-Based In-Game Adaptations in an Exergame-Based Functional High-Intensity Interval Training on Training Intensity and Experience in Healthy Young Adults

Heart Rate Variability Control Using a Biofeedback and Wearable System

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