Insights from Japanese Seniors After Playing Brain-Training Games and Using a Brain-Activity Wearable Device: An Exploratory Pilot in a Living-Lab

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The paper presents a comparative analysis of two brain-training games after being used by 6 old Japanese adults. The discussion is focussed on key UI/UX preferences including large or high-contrast text, intuitive navigation, a relaxed pace or using touch-based controls.

This should be seen more as an exercise for software design engineers than as a scientific publication. I don’t see the relevance of this study with respect to the state of the art in terms of software design of with respect to requirements of older adults for brain training. Even if trying to understand the UI/UX design as a key aspect when designing brain-training games, the results of the paper cannot be extrapolated. Analysing only two games from the large spectrum of commercial proposals available nowadays is ridiculous. The same occurs with respect to the size of the sample, three participants are not enough for evaluating UI/UX design in a broad general concern.

Author Response

Comment: The paper presents a comparative analysis of two brain-training games after being used by 6 old Japanese adults. The discussion is focussed on key UI/UX preferences including large or high-contrast text, intuitive navigation, a relaxed pace or using touch-based controls.

This should be seen more as an exercise for software design engineers than as a scientific publication. I don’t see the relevance of this study with respect to the state of the art in terms of software design of with respect to requirements of older adults for brain training. Even if trying to understand the UI/UX design as a key aspect when designing brain-training games, the results of the paper cannot be extrapolated. Analysing only two games from the large spectrum of commercial proposals available nowadays is ridiculous. The same occurs with respect to the size of the sample, three participants are not enough for evaluating UI/UX design in a broad general concern.

 

Response:

Thank you for your review of the paper. We have substantially reformatted the paper to address how the game design features and interaction with the devices can influence older adults' adherence to sustained cognitive interventions (i.e. factors that are likely important in sustaining play of the games). We have clarified the aim of the study, study methodology, and presentation of the results within the UTAUT2 framework. 
While numerous brain training games do exist, our selected games are exemplary of a tablet-based and console-based game, and originate from reputable publishers (NeU Corporation, led by a neuroscientist; and Nintendo), which serve as models for the many mobile-based developers. To reduce the burden on older adults both on time involvement in our study, and also cognitive load in playing the games (where joining our study involves both travel to and from our institute (~1 hour), study methodology and ethical document explanation, informed consent (~30minutes), completing short skills assessment (~10 minutes), completing surveys (~10 minutes) focus group discussion (~30 minutes)), we decided to limit the game-playing session to 30 minutes per game (~1 hour), for a total involvement of 3 hours and 20 minutes. 30 minutes was decided by researchers as enough time to experience many of the features of the game, such that appropriate feedback could be given. 
We have made it clear that our study is an exploratory pilot with 6 persons, and explain the requirements for future studies. 

Reviewer 2 Report

Comments and Suggestions for Authors

The topic of this paper holds significant practical relevance, closely aligning with the developmental needs of cognitive health technologies in an aging society. It focuses on the user experience of Japanese older adults in using brain-training games integrated with wearable neurotechnology, filling an empirical research gap in this field. The study innovatively combines the commercial EEG device EX-Brain with an off-the-shelf brain-training game, conducting real-scenario evaluations in a living lab environment. This provides a novel perspective and practical foundation for human-computer interaction design in gerontechnology.

The research methodology is overall sound, employing a mixed approach of focus groups, standardized questionnaires (SUS, UEQ), and qualitative interviews. Data sources are diverse, and the analysis is grounded in the UTAUT2 theoretical framework, enhancing the interpretability of the findings. The results reveal that older adults are highly motivated to prevent dementia and prefer design features such as large fonts, high contrast, and intuitive navigation—insights that offer valuable guidance for age-friendly interface design.

Overall, the paper provides meaningful user insights for the design of cognitive health technologies targeting older adults, demonstrating strong practical potential and room for further development.

Author Response

Comment:

The topic of this paper holds significant practical relevance, closely aligning with the developmental needs of cognitive health technologies in an aging society. It focuses on the user experience of Japanese older adults in using brain-training games integrated with wearable neurotechnology, filling an empirical research gap in this field. The study innovatively combines the commercial EEG device EX-Brain with an off-the-shelf brain-training game, conducting real-scenario evaluations in a living lab environment. This provides a novel perspective and practical foundation for human-computer interaction design in gerontechnology.

The research methodology is overall sound, employing a mixed approach of focus groups, standardized questionnaires (SUS, UEQ), and qualitative interviews. Data sources are diverse, and the analysis is grounded in the UTAUT2 theoretical framework, enhancing the interpretability of the findings. The results reveal that older adults are highly motivated to prevent dementia and prefer design features such as large fonts, high contrast, and intuitive navigation—insights that offer valuable guidance for age-friendly interface design.

Overall, the paper provides meaningful user insights for the design of cognitive health technologies targeting older adults, demonstrating strong practical potential and room for further development.

 

Response: 

Thank you for your review of the paper. We appreciate your feedback, and have incorporated the comments from other reviewers to substantially improve the content and presentation of our work. We have reformatted the abstract, results, discussion and conclusions to present the work more clearly within the UTAUT2 framework, as well as most importantly, establish how our findings will be important in enabling the sustained usage of brain training games by older adults to achieve a sufficient dosage during interventions. We look forward to your continued review of our work. 

Reviewer 3 Report

Comments and Suggestions for Authors

Reviewer Comment
The article addresses an important and original topic regarding the use of cognitive technology in older adults, game-based learning, and wearable brain activity devices. While the study's purpose is valuable, the overall structure is not sufficiently clear according to scientific reporting standards. A lack of content integrity and clarity is particularly noticeable in the abstract, method, discussion, and conclusion sections. Literature links are superficial, the sources used are largely outdated, and the analysis process is limited. Insufficient quantitative data in the presentation and interpretation of findings, the failure to enrich qualitative findings with supporting citations, and the lack of detailed discussion of limitations reduce the scientific strength of the study. Overall, the article should be improved by more clearly defining the research structure, strengthening data analysis, completing ethical and methodological explanations, integrating current sources, and linking the results to practice. Specific recommendations are as follows.

Revisions
1. While the abstract section reflects the general content of the study, it needs more fluid and clear formatting in terms of structure and expression. The purpose, method, findings, and conclusion sections are not sufficiently separated. It was not stated that the findings are not generalizable due to the small number of participants. The research purpose should be clearly stated at the beginning of the abstract with the phrase "The aim of this study was to...". Furthermore, the methodology section should be presented more clearly and clearly, and the analysis approach used should be briefly described. More quantitative data (e.g., mean scores, percentage distributions) should be included in the findings; this will enrich the abstract in terms of both content and scientific strength.
2. Although the introduction section of the article is based on current sources, the differences and uniqueness of this study compared to previous studies are not clearly stated. The literature section is information-based; the existing gap is not clearly identified. Furthermore, the purpose of the study is not directly stated in the introduction, but only indirectly in the method section. Therefore, the justification, unique contribution, and purpose statement of the study should be structured in a clear and integrative manner in the introduction section.
3. The type of research (e.g., qualitative, quantitative, or mixed-method) is not clearly stated. The method section mostly consists of an introduction of the games and the device. This makes the scientific approach of the study unclear. The type of research should be clearly defined and should be stated as "This exploratory mixed-method study was conducted to...".
4. Six elderly individuals were included in the study, and demographic information is presented in a table. However, the participant selection method, inclusion, and exclusion criteria were not specified. Furthermore, the participants' cognitive and physical abilities were not assessed. This section should clarify how the sample was selected, whether it was voluntary or based on specific criteria.

5. The System Usability Scale (SUS) and User Experience Questionnaire (UEQ) were used. However, the number of items, sub-dimensions, scoring system, and validity information for these scales were not provided. Furthermore, it was not stated whether the scales were translated into Japanese or culturally adapted. This information is important for demonstrating the reliability of the data collection tools.

6. Focus group interviews and observation notes were collected. However, the qualitative analysis process was not described. The phrase "Notes were reorganized into major topics" is rather superficial. The analysis approach used (e.g., thematic analysis, content analysis) should be clearly stated, and brief information about the coding process should be provided.

7. Information regarding the ethical process is quite limited in the method section of the article. Ethics committee approval is stated in only a single sentence, but a declaration of compliance with the Declaration of Helsinki is not included in the text. The ethics committee approval date and decision number are not provided. It is not stated whether written or verbal informed consent was obtained from the participants. Furthermore, the dates during which the data collection process was conducted are not specified. Although the study used focus group interviews and observation methods, there is no information indicating whether the COREQ or a similar checklist was used. An additional explanation section should be added to the methodology to address these deficiencies. It should be clearly stated that the study was conducted in accordance with the principles of the Declaration of Helsinki, and the date and number of the ethics committee approval should be included. Written informed consent should be obtained from the participants, and the date range for the data collection period should be included. Furthermore, a declaration of compliance with an internationally recognized checklist such as the COREQ or STROBE should be included in the study's reporting.
8. The data collection period was not dated. A date statement should be added to the Methods section.
9. The study mentions the participation of six elderly individuals. 

However, no information is provided regarding how this number was chosen, the rationale for limiting the sample size, or whether any sampling calculation methods (e.g., power analysis, data saturation, or purposive sampling) were used. This demonstrates the lack of an explanation based on the principle of "data saturation," which is frequently used in qualitative research. Furthermore, despite the small sample size of older individuals, it is not stated why this number was deemed sufficient to meet the research objective. The rationale for determining the number of participants and the sampling method are not explained. Furthermore, if a sufficient justification cannot be provided for this study, it would be more appropriate to present it as a pilot study.

10. System Usability Scale (SUS) and User Experience Questionnaire (UEQ) scores are presented in tabular form. However, mean, standard deviation, median, or range values ​​are not provided. This makes statistical evaluation of the data difficult. Furthermore, no comparative analysis was conducted to determine whether there were any differences between the two games. Even though the number of participants is small, providing simple descriptive statistics (e.g., mean ± SD or median [IQR]), which are appropriate for a small sample, would make the findings more understandable.

11. The findings section of the article summarizes the data but is not sufficiently clear and systematic. The SUS and UEQ results are presented in tables, but statistical information such as mean, standard deviation, or score range is not included. This makes the findings difficult to interpret. Furthermore, the differences between the two games were not evaluated. Even though the number of participants was small, the inclusion of descriptive statistics and simple comparison tests is necessary. In the qualitative findings section, participant statements are not directly quoted but merely summarized with researcher comments. This weakens the reliability of the qualitative data. Short direct participant quotes should be included for each theme.

12. The discussion section is supported by very few sources, leaving a weak link to the literature. The findings are only explained in general terms and are not sufficiently linked to previous studies. The study's results should be discussed by comparing them with existing literature, and similar and different aspects should be clearly stated. More current and topic-specific sources should be used, and the findings should be interpreted in depth by relating them to the theoretical framework. Furthermore, inferences should be drawn from the results, and how these findings can contribute to practice or future research should be clearly emphasized. These revisions will make the discussion section more comprehensive, scientifically sound, and meaningful.

13. Most of the sources used in the discussion section are outdated and outdated. This weakens the study's relevance to the literature and hinders the evaluation of the findings within a contemporary scientific context. The discussion section should be supported by current research published within the last five years and should be linked to new studies, particularly in the areas of cognitive technology use in older individuals, user experience (UX/UI), and wearable neurotechnology. Including current sources will both strengthen the study's place in the literature and increase the validity of the results.

14. The limitations of the article are discussed very briefly and superficially in the discussion section. The text only cites the small number of participants as a limitation. However, this is not the only limitation of this study. The short data collection period, the limited sample size to a single country, the collection of qualitative data with a small group, and the lack of a control group are also significant limitations. Furthermore, how these factors affect the generalizability of the results is not explained. The limitations section should be expanded to clearly state these factors and emphasize that the study's findings are only applicable to a specific context. This revision will increase the scientific transparency and credibility of the research.

15. The conclusion section of the article summarizes the general findings but is not sufficiently clear and structured. General conclusions are superficially presented, and the unique contribution of the study is not emphasized. Clinical or practical recommendations are not clearly stated, and the practical implications of the findings are not explained. Furthermore, recommendations for future research are very brief and lack direction. The conclusion section should be reorganized into three parts: general conclusion, clinical-practical contributions, and future research recommendations. The significance of the findings, their practical implications, and necessary future work should be clearly presented.

Comments on the Quality of English Language

Language should be simplified throughout the text, favoring short, direct sentences. Spelling errors, syntax errors, and inconsistent terminology should be corrected through academic proofreading or language editing.

Author Response

Comment: Overall, the article should be improved by more clearly defining the research structure, strengthening data analysis, completing ethical and methodological explanations, integrating current sources, and linking the results to practice. Specific recommendations are as follows.

Response: Thank you very much for your detailed review, it has greatly helped us to work on improving the quality of the paper. 

Revisions
1. While the abstract section reflects the general content of the study, it needs more fluid and clear formatting in terms of structure and expression. The purpose, method, findings, and conclusion sections are not sufficiently separated. It was not stated that the findings are not generalizable due to the small number of participants. The research purpose should be clearly stated at the beginning of the abstract with the phrase "The aim of this study was to...". Furthermore, the methodology section should be presented more clearly and clearly, and the analysis approach used should be briefly described. More quantitative data (e.g., mean scores, percentage distributions) should be included in the findings; this will enrich the abstract in terms of both content and scientific strength.

Response: We have updated the abstract and methodology to include several sections for clearer presentation, and clarified the aim and purpose of the study, and existing literature gap. 

2. Although the introduction section of the article is based on current sources, the differences and uniqueness of this study compared to previous studies are not clearly stated. The literature section is information-based; the existing gap is not clearly identified. Furthermore, the purpose of the study is not directly stated in the introduction, but only indirectly in the method section. Therefore, the justification, unique contribution, and purpose statement of the study should be structured in a clear and integrative manner in the introduction section.

Response: We have added a section on the literature gap, and included recent research. 

3. The type of research (e.g., qualitative, quantitative, or mixed-method) is not clearly stated. The method section mostly consists of an introduction of the games and the device. This makes the scientific approach of the study unclear. The type of research should be clearly defined and should be stated as "This exploratory mixed-method study was conducted to...".

Response: We have included the research type.

4. Six elderly individuals were included in the study, and demographic information is presented in a table. However, the participant selection method, inclusion, and exclusion criteria were not specified. Furthermore, the participants' cognitive and physical abilities were not assessed. This section should clarify how the sample was selected, whether it was voluntary or based on specific criteria.

Response: We have added details following the COREQ checklist. 

5. The System Usability Scale (SUS) and User Experience Questionnaire (UEQ) were used. However, the number of items, sub-dimensions, scoring system, and validity information for these scales were not provided. Furthermore, it was not stated whether the scales were translated into Japanese or culturally adapted. This information is important for demonstrating the reliability of the data collection tools.

Response: This information has been added. 

6. Focus group interviews and observation notes were collected. However, the qualitative analysis process was not described. The phrase "Notes were reorganized into major topics" is rather superficial. The analysis approach used (e.g., thematic analysis, content analysis) should be clearly stated, and brief information about the coding process should be provided.

Response: We have described the method (content analysis)

7. Information regarding the ethical process is quite limited in the method section of the article. Ethics committee approval is stated in only a single sentence, but a declaration of compliance with the Declaration of Helsinki is not included in the text. The ethics committee approval date and decision number are not provided. It is not stated whether written or verbal informed consent was obtained from the participants. Furthermore, the dates during which the data collection process was conducted are not specified. Although the study used focus group interviews and observation methods, there is no information indicating whether the COREQ or a similar checklist was used. An additional explanation section should be added to the methodology to address these deficiencies. It should be clearly stated that the study was conducted in accordance with the principles of the Declaration of Helsinki, and the date and number of the ethics committee approval should be included. Written informed consent should be obtained from the participants, and the date range for the data collection period should be included. Furthermore, a declaration of compliance with an internationally recognized checklist such as the COREQ or STROBE should be included in the study's reporting.

Response: As noted, we have included reference to COREQ. For the ethical information, this is described in two sections at the end of the paper, so we have not included it in the Methodology. We have added dates. 

8. The data collection period was not dated. A date statement should be added to the Methods section.

Response: Added. 
9. The study mentions the participation of six elderly individuals. 

However, no information is provided regarding how this number was chosen, the rationale for limiting the sample size, or whether any sampling calculation methods (e.g., power analysis, data saturation, or purposive sampling) were used. This demonstrates the lack of an explanation based on the principle of "data saturation," which is frequently used in qualitative research. Furthermore, despite the small sample size of older individuals, it is not stated why this number was deemed sufficient to meet the research objective. The rationale for determining the number of participants and the sampling method are not explained. Furthermore, if a sufficient justification cannot be provided for this study, it would be more appropriate to present it as a pilot study.

Response: We have reframed the paper as an exploratory pilot study. 

10. System Usability Scale (SUS) and User Experience Questionnaire (UEQ) scores are presented in tabular form. However, mean, standard deviation, median, or range values ​​are not provided. This makes statistical evaluation of the data difficult. Furthermore, no comparative analysis was conducted to determine whether there were any differences between the two games. Even though the number of participants is small, providing simple descriptive statistics (e.g., mean ± SD or median [IQR]), which are appropriate for a small sample, would make the findings more understandable.

Response: Thank you for your comment. Despite the small sample size, we have now included statistical descriptions. 

11. The findings section of the article summarizes the data but is not sufficiently clear and systematic. The SUS and UEQ results are presented in tables, but statistical information such as mean, standard deviation, or score range is not included. This makes the findings difficult to interpret. Furthermore, the differences between the two games were not evaluated. Even though the number of participants was small, the inclusion of descriptive statistics and simple comparison tests is necessary. In the qualitative findings section, participant statements are not directly quoted but merely summarized with researcher comments. This weakens the reliability of the qualitative data. Short direct participant quotes should be included for each theme.

Response: As above. Regarding the participant quotes, as participants were split into two focus groups, we found it more appropriate to summarise the themes across both sessions. In Japanese language, it also common to omit a lot of context when making a statement, so we felt the findings were better presented as a summary. However, some participant quotes could be added where it would substantially improve the understanding of the results. 

12. The discussion section is supported by very few sources, leaving a weak link to the literature. The findings are only explained in general terms and are not sufficiently linked to previous studies. The study's results should be discussed by comparing them with existing literature, and similar and different aspects should be clearly stated. More current and topic-specific sources should be used, and the findings should be interpreted in depth by relating them to the theoretical framework. Furthermore, inferences should be drawn from the results, and how these findings can contribute to practice or future research should be clearly emphasized. These revisions will make the discussion section more comprehensive, scientifically sound, and meaningful.

Response: We have included more sources and links to literature (recent papers) in the Discussion. We have added "Implications" to the Results section.

13. Most of the sources used in the discussion section are outdated and outdated. This weakens the study's relevance to the literature and hinders the evaluation of the findings within a contemporary scientific context. The discussion section should be supported by current research published within the last five years and should be linked to new studies, particularly in the areas of cognitive technology use in older individuals, user experience (UX/UI), and wearable neurotechnology. Including current sources will both strengthen the study's place in the literature and increase the validity of the results.

Response: We have added recent references where possible. 

14. The limitations of the article are discussed very briefly and superficially in the discussion section. The text only cites the small number of participants as a limitation. However, this is not the only limitation of this study. The short data collection period, the limited sample size to a single country, the collection of qualitative data with a small group, and the lack of a control group are also significant limitations. Furthermore, how these factors affect the generalizability of the results is not explained. The limitations section should be expanded to clearly state these factors and emphasize that the study's findings are only applicable to a specific context. This revision will increase the scientific transparency and credibility of the research.

Response: We have expanded the limitations discussion to incorporate these points. 

15. The conclusion section of the article summarizes the general findings but is not sufficiently clear and structured. General conclusions are superficially presented, and the unique contribution of the study is not emphasized. Clinical or practical recommendations are not clearly stated, and the practical implications of the findings are not explained. Furthermore, recommendations for future research are very brief and lack direction. The conclusion section should be reorganized into three parts: general conclusion, clinical-practical contributions, and future research recommendations. The significance of the findings, their practical implications, and necessary future work should be clearly presented.

Response: We have clarified the conclusions from our study and split the section into three parts as suggested. 

Reviewer 4 Report

Comments and Suggestions for Authors

The authors explore the perception and experience of older Japanese people when interacting with two cognitive games, Active Brain Club and Big Brain Academy. The topic of cognitive games for the prevention of cognitive diseases in the elderly is really relevant.
After reading it, I would like to note that methodologically the article does not present new techniques or approaches, but is based on existing approaches, and is descriptive in nature of an experiment on a fairly small sample of 6 people.  In addition, there is no analysis of the use of these games over a long period of time, as indicated by the authors. 
Currently, it is difficult to understand what the contribution of this study is, except for testing these two games on a small sample, as well as collecting feedback from it. In addition, the findings have some contradictions, which may be due to a very small sample. If an experiment had been conducted on at least 20-30 participants, it would have been possible to calculate the average values and standard deviations.
Thus, I see the following areas for improvement: 
- it is necessary to clearly formulate what exactly was analyzed - the convenience of the interface, motivation, the acceptability of technology, the impact on cognitive engagement, or all of them together.
- expand the sample and describe the participants. At least 20-30 participants are needed for minimum validity.
- add quantitative data, provide averages and standard deviations for SUS/UEQ, and not just descriptive statements
- it is necessary to show how the components of UTAUT2 were evaluated (for example, behavioral intention, technology acquisition effort, social impact).
- distinguish between subjective impressions and analytical conclusions, indicate what is based on quotes from participants (qualitative analysis), and what is based on statistics (quantitative result).
- focus on UX analysis and practical conclusions, for example, which interface features were convenient or, conversely, caused difficulties for older participants.
The study is potentially interesting and has practical significance, but in its current form it is perceived as a descriptive report.

 

Author Response

Comment: In addition, there is no analysis of the use of these games over a long period of time, as indicated by the authors. 

Response: We conducted a single-session study, and highlight this in the Limitations. In our revision of the paper, we have emphasised how factors of the game design and interaction with devices will be important in sustaining continued usage of cognitive training. 

Comment: Currently, it is difficult to understand what the contribution of this study is, except for testing these two games on a small sample, as well as collecting feedback from it. In addition, the findings have some contradictions, which may be due to a very small sample. If an experiment had been conducted on at least 20-30 participants, it would have been possible to calculate the average values and standard deviations.

Response: We state this in the Limitations of our study, and have reframed the paper as an exploratory pilot.

Thus, I see the following areas for improvement: 
- it is necessary to clearly formulate what exactly was analyzed - the convenience of the interface, motivation, the acceptability of technology, the impact on cognitive engagement, or all of them together.

Response: 

- expand the sample and describe the participants. At least 20-30 participants are needed for minimum validity.

Response: Unfortunately it is not possible at this time to expand the current study, however, we describe the requirements for a potential future study. 

- add quantitative data, provide averages and standard deviations for SUS/UEQ, and not just descriptive statements

Response: Added. 

- it is necessary to show how the components of UTAUT2 were evaluated (for example, behavioral intention, technology acquisition effort, social impact).

Response: We have made reference to adherence to use the technologies. 

- distinguish between subjective impressions and analytical conclusions, indicate what is based on quotes from participants (qualitative analysis), and what is based on statistics (quantitative result).

Response: We have broken the results section into two parts, quantitative and qualitative, and make reference in the discussion to the particular scale used (either SUS/UEQ) when discussing quantitative results. 

- focus on UX analysis and practical conclusions, for example, which interface features were convenient or, conversely, caused difficulties for older participants.

Response: We have added Implications in the Results, and included a Practical implications section to the Conclusion. 

The study is potentially interesting and has practical significance, but in its current form it is perceived as a descriptive report.
Response: Thank you for your detailed comments and we look forward to your further review. 

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for making significant revisions to your study. However, it appears that some points in the text still need improvement. The following points should be noted in this context:

Revisions
1. Page 3, line 107; We have used a COREQ checklist to report our methodology. The source must be cited.
2. The meanings of M and F in Table 1 should be explained in a footnote.
3. The method section does not include a description of quantitative data analysis. Although statistical procedures such as mean, standard deviation, and two-sample t-tests are presented in the results section of the study based on SUS and UEQ scores, the methodology section does not describe how these analyses were conducted. The statistical approach used, the tests used, the software used for the analyses, and the significance level should be clearly stated.
4. Although the list of abbreviations in the manuscript is included at the end, they should be clearly stated at their first mention in the text. All abbreviations should be checked.

Comments on the Quality of English Language

The language of the article has improved significantly compared to the previous version; the fluency, terminology, and structure are more appropriate. However, some small phrases and longer sentences still require improvement for full academic compliance. While the overall language has improved, a final check would be beneficial.

Author Response

Thank you for making significant revisions to your study. However, it appears that some points in the text still need improvement. The following points should be noted in this context:
 >> Thank you very much for your review of our major revision. Your comments have greatly helped us to improve the manuscript. Please find below responses to the suggested revisions in this round.

Revisions
1. Page 3, line 107; We have used a COREQ checklist to report our methodology. The source must be cited.
 >> Added a rationale for usage and source.

2. The meanings of M and F in Table 1 should be explained in a footnote.
>> Added an explanation in the Table description.

3. The method section does not include a description of quantitative data analysis. Although statistical procedures such as mean, standard deviation, and two-sample t-tests are presented in the results section of the study based on SUS and UEQ scores, the methodology section does not describe how these analyses were conducted. The statistical approach used, the tests used, the software used for the analyses, and the significance level should be clearly stated.
>> Added a new section to the Methods, 2.7 Data Analysis that describes this.

4. Although the list of abbreviations in the manuscript is included at the end, they should be clearly stated at their first mention in the text. All abbreviations should be checked.
>> Checked the abbreviations and re-worded several that only appeared once or could be explained without using an acronym. All first instances of an acronym are stated in full.

Comments on the Quality of English Language
The language of the article has improved significantly compared to the previous version; the fluency, terminology, and structure are more appropriate. However, some small phrases and longer sentences still require improvement for full academic compliance. While the overall language has improved, a final check would be beneficial.
>> We have made a detailed check of the language, removing any typos, improving the clarity of sentences and the logical flow of paragraphs through re-positioning sentences. Longer sentences have been shortened where possible. Track changes has been enabled for this edit.

Reviewer 4 Report

Comments and Suggestions for Authors

The authors have completely or partially eliminated all the submitted comments.

I ask the authors to pay attention to typos in the text.

COREQ is also mentioned, but no explanation is given for this approach.

In general, I can recommend the work for publication.

Author Response

The authors have completely or partially eliminated all the submitted comments.
I ask the authors to pay attention to typos in the text.
COREQ is also mentioned, but no explanation is given for this approach.
In general, I can recommend the work for publication.

 >> Thank you very much for your review of our major revision. Your comments have greatly helped us to improve the manuscript. We have added a rationale and reference for COREQ, and have made a detailed check of the language, removing any typos, improving the clarity of sentences and the logical flow of paragraphs through re-positioning sentences. Longer sentences have been shortened where possible. Track changes has been enabled for this edit.