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Applied Sciences
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Serious Games and Extended Reality in Healthcare
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Serious Games and Extended Reality in Healthcare

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Computing and Artificial Intelligence".

Deadline for manuscript submissions: closed (20 February 2025) | Viewed by 6011

Special Issue Editors

Dr. Chen Huei Leo

E-Mail Website
Guest Editor
Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore 117576, Singapore
Interests: serious games; extended reality; education; healthcare
Special Issues, Collections and Topics in MDPI journals
Dr. Bina Rai

E-Mail Website
Guest Editor Assistant
Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore 117576, Singapore
Interests: serious games; extended reality; education; healthcare
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to announce a forthcoming Special Issue in Applied Sciences, focusing on the transformative applications of serious games and extended reality (XR) within the realms of healthcare. In an era characterized by rapid technological advancements, these immersive technologies have shown remarkable potential to revolutionize the way we approach health wellness.

Scope and Focus

In recent years, the landscape of healthcare has been revolutionized by the integration of innovative technologies. Serious games and XR have become pivotal tools that transcend traditional boundaries in healthcare. This Special Issue aims to showcase the latest research, advancements, and innovative implementations of these technologies in addressing various challenges in this sector.

Specifically, these technologies have the potential to engage users, simulate real-world scenarios, and facilitate immersive environments that foster skill development, decision-making, and critical thinking. We welcome original research articles, reviews, case studies, and evaluation studies that shed light on the latest advancements, challenges, and potential solutions within this exciting domain.

This Special Issue provides a unique platform for researchers, healthcare professionals, and technologists to exchange ideas, share their expertise, and shape the future of healthcare through the integration of cutting-edge technologies.

Topics of interest include (but are not limited to) the following:

  1. Applications of serious games: present studies demonstrating the efficacy or validation of serious games for healthcare applications.
  2. Extended reality: examine the integration of XR in healthcare settings, including (but not limited to) its role in patient rehabilitation or medical visualization.
  3. Innovative healthcare: investigate the design, implementation, and assessment of immersive learning experiences through serious games and XR in formal and informal healthcare settings. Some examples include (but are not limited to) the sharing of novel approaches to develop simulations that bridge the gap between theory and practice, fostering experiential learning and clinical training.
  4. Gamification of healthcare: examine the integration of game elements and mechanics in healthcare contexts to enhance engagement, motivation, and knowledge retention. Discuss user interfaces, interaction techniques, and usability aspects within serious games and immersive environments.

We look forward to receiving your contributions that will undoubtedly contribute to the advancement of knowledge at the intersection of serious games and extended reality in healthcare.

Dr. Chen Huei Leo
Guest Editor

Dr. Bina Rai
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • serious games
  • extended reality
  • healthcare

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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22 pages, 6786 KiB  
Article
Development of RelaxQuest: A Serious EEG-Controlled Game Designed to Promote Relaxation and Self-Regulation with a Potential Focus on ADHD Intervention
by Alan F. Pérez Vidal, José-Antonio Cervantes, Jesse Y. Rumbo-Morales, Felipe D. J. Sorcia-Vázquez, Gerardo Ortiz-Torres, Christian A. Castro Moncada and Ignacio de la Torre Arias
Appl. Sci. 2024, 14(23), 11173; https://doi.org/10.3390/app142311173 - 29 Nov 2024
Cited by 1 | Viewed by 1081
Abstract
This article presents the development of a serious game designed to help individuals improve their ability to relax and self-regulate, with a particular focus on children. Additionally, the game has the potential to become an effective tool for intervention in individuals with Attention [...] Read more.
This article presents the development of a serious game designed to help individuals improve their ability to relax and self-regulate, with a particular focus on children. Additionally, the game has the potential to become an effective tool for intervention in individuals with Attention Deficit Hyperactivity Disorder (ADHD) due to its integration of critical elements for measuring attention levels. These include omission errors, commission errors, response times, standard deviations of response times, and other relevant variables. The game allows control through electroencephalographic (EEG) signals, using alpha wave modulation and blinking as interaction methods. The amplification of alpha wave amplitude is associated with states of relaxation and mental tranquility, indicating that their modulation could potentially mitigate anxiety and enhance emotional self-regulation. The game’s primary objective is to encourage participants to attain relaxing mental states by overcoming challenges as they progress. In order to achieve this, the game’s development necessitated a comprehensive understanding of EEG signal processing, a crucial aspect meticulously explored in this article. In addition, this paper presents the results of alpha wave and flicker detection, along with a performance analysis that demonstrates satisfactory results. Subsequently, the game was assessed with children to evaluate its effectiveness, facilitating a comprehensive analysis of various performance parameters. The findings indicate that the game facilitates the gradual improvement of participants’ skills with each iteration, notably enhancing their capacity to achieve a state of relaxation. Full article
(This article belongs to the Special Issue Serious Games and Extended Reality in Healthcare)
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28 pages, 6881 KiB  
Article
Engagement Analysis Using Electroencephalography Signals in Games for Hand Rehabilitation with Dynamic and Random Difficulty Adjustments
by Raúl Daniel García-Ramón, Ericka Janet Rechy-Ramirez, Luz María Alonso-Valerdi and Antonio Marin-Hernandez
Appl. Sci. 2024, 14(18), 8464; https://doi.org/10.3390/app14188464 - 20 Sep 2024
Cited by 1 | Viewed by 1963
Abstract
Background: Traditional physical rehabilitation involves participants performing repetitive body movements with the assistance of physiotherapists. Owing to the exercises’ monotonous nature and lack of reward, participants may become disinterested and cease their recovery. Games could be used as tools to engage participants in [...] Read more.
Background: Traditional physical rehabilitation involves participants performing repetitive body movements with the assistance of physiotherapists. Owing to the exercises’ monotonous nature and lack of reward, participants may become disinterested and cease their recovery. Games could be used as tools to engage participants in the rehabilitation process. Consequently, participants could perform rehabilitation exercises while playing the game, receiving rewards from the experience. Maintaining the players’ engagement requires regularly adjusting the game difficulty. The players’ engagement can be measured using questionnaires and biosignals (e.g., electroencephalography signals—EEG). This study aims to determine whether there is a significant difference in players’ engagement between two game modes with different game difficulty adjustments: non-tailored and tailored modes. Methods: We implemented two game modes which were controlled using hand movements. The features of the game rewards (position and size) were changed in the game scene; hence, the game difficulty could be modified. The non-tailored mode set the features of rewards in the game scene randomly. Conversely, the tailored mode set the features of rewards in the game scene based on the participants’ range of motion using fuzzy logic. Consequently, the game difficulty was adjusted dynamically. Additionally, engagement was computed from 53 healthy participants in both game modes using two EEG sensors: Bitalino Revolution and Unicorn. Specifically, the theta (θ) and alpha (α) bands from the frontal and parietal lobes were computed from the EEG data. A questionnaire was applied to participants after finishing playing both game modes to collect their impressions on the following: their favorite game mode, the game mode that was the easiest to play, the game mode that was the least frustrating to play, the game mode that was the least boring to play, the game mode that was the most entertaining to play, and the game mode that had the fastest game response time. Results: The non-tailored game mode reported the following means of engagement: 6.297 ± 11.274 using the Unicorn sensor, and 3.616 ± 0.771 using the Bitalino sensor. The tailored game mode reported the following means of engagement: 4.408 ± 6.243 using the Unicorn sensor, and 3.619 ± 0.551 using Bitalino. The non-tailored mode reported the highest mean engagement (6.297) when the Unicorn sensor was used to collect EEG signals. Most participants selected the non-tailored game mode as their favorite, and the most entertaining mode, irrespective of the EEG sensor. Conversely, most participants chose the tailored game mode as the easiest, and the least frustrating mode to play, irrespective of the EEG sensor. Conclusions: A Wilcoxon-Signed-Rank test revealed that there was only a significant difference in engagement between game modes when the EEG signal was collected via the Unicorn sensor (p value = 0.04054). Fisher’s exact tests showed significant associations between the game modes (non-tailored, tailored) and the following players’ variables: ease of play using the Unicorn sensor (p value = 0.009341), and frustration using Unicorn sensor (p value = 0.0466). Full article
(This article belongs to the Special Issue Serious Games and Extended Reality in Healthcare)
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Review

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17 pages, 1239 KiB  
Review
Video Games in Rehabilitation Programs for People with Parkinson’s Disease: A Systematic Review
by Isabel Quirosa-Galán, Sara García-Bravo, Anthia Cristina Fabara-Rodríguez, Mª Pilar Rodríguez-Pérez, Elisabet Huertas-Hoyas, Jorge Pérez-Corrales, Gemma Fernández-Gómez, Madeleine Donovan and Cristina García-Bravo
Appl. Sci. 2025, 15(1), 311; https://doi.org/10.3390/app15010311 - 31 Dec 2024
Viewed by 1439
Abstract
Background: Parkinson’s disease is a neurodegenerative disorder affecting the central and peripheral nervous systems. Its treatment combines pharmacological and rehabilitative approaches, aimed at improving motor symptoms and preventing cognitive decline. Virtual reality emerges as a complementary rehabilitative option, showing efficacy in enhancing motor [...] Read more.
Background: Parkinson’s disease is a neurodegenerative disorder affecting the central and peripheral nervous systems. Its treatment combines pharmacological and rehabilitative approaches, aimed at improving motor symptoms and preventing cognitive decline. Virtual reality emerges as a complementary rehabilitative option, showing efficacy in enhancing motor and cognitive aspects. This study systematically reviews the effectiveness of virtual reality in the rehabilitation of individuals with Parkinson’s disease. Methods: A systematic review was carried out. The Jadad scale was used to assess the methodological quality of the included studies, and the Oxford Center for Evidence-Based Medicine criteria were applied to determine the level of evidence and recommendation. The review followed PRISMA guidelines, with a literature search conducted in databases such as Cochrane and PubMed. Results: The studies indicate improvements in gait, balance, and overall motor function in Parkinson’s patients using virtual reality, though limitations such as small sample sizes and the lack of control groups in some studies are noted. Conclusions: Virtual reality proves to be an effective tool in Parkinson’s rehabilitation, enhancing balance and motor function. However, more studies with adequate methodological quality and larger sample sizes are needed to validate these findings. Full article
(This article belongs to the Special Issue Serious Games and Extended Reality in Healthcare)
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Other

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16 pages, 572 KiB  
Systematic Review
Integration Between Serious Games and EEG Signals: A Systematic Review
by Julian Patiño, Isabel Vega, Miguel A. Becerra, Eduardo Duque-Grisales and Lina Jimenez
Appl. Sci. 2025, 15(4), 1946; https://doi.org/10.3390/app15041946 - 13 Feb 2025
Viewed by 1109
Abstract
A serious game combines concepts, principles, and methods of game design with information and communication technologies for the achievement of a given goal beyond entertainment. Serious game studies have been reported under a brain–computer interface (BCI) approach, with the specific use of electroencephalographic [...] Read more.
A serious game combines concepts, principles, and methods of game design with information and communication technologies for the achievement of a given goal beyond entertainment. Serious game studies have been reported under a brain–computer interface (BCI) approach, with the specific use of electroencephalographic (EEG) signals. This study presents a review of the technological solutions from existing works related to serious games and EEG signals. A taxonomy is proposed for the classification of the research literature in three different categories according to the experimental strategy for the integration of the game and EEG: (1) evoked signals, (2) spontaneous signals, and (3) hybrid signals. Some details and additional aspects of the studies are also reviewed. The analysis involves factors such as platforms and development languages (serious game), software tools (integration between serious game and EEG signals), and the number of test subjects. The findings indicate that 50% of the identified studies use spontaneous signals as the experimental strategy. Based on the definition, categorization, and state of the art, the main research challenges and future directions for this class of technological solutions are discussed. Full article
(This article belongs to the Special Issue Serious Games and Extended Reality in Healthcare)
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