A group discussion of individuals with expertise working in the field of exergaming and rehabilitation focused on the issue of designing exergames for persons with disabilities as well as appropriate interventions using exergames. The purpose of these discussions was to develop recommendations for the design, evaluation, and application of exergames in therapy serving as potential guidelines for researchers, developers, and therapists. The following key issues were addressed: (1) Challenges in exergame design for persons with disabilities, (2) adaptation of exergames for persons with disabilities, (3) exergame interventions, and (4) future research directions. It is the hope of the group that the results of these recommendations will help improve the quality of exergame design and interventions and thereby increase opportunities for persons with disabilities to engage sustainably in exergaming.
World Health Organization. How to Use the ICF: A Practical Manual for Using the International Classification of Functioning, Disability and Health (ICF). Exposure Draft for Comment. Geneva: World Health Organization; 2013. http://www.who.int/classifications/drafticfpracticalmanual.pdf (accessed May18, 2014).
LohseKR, HildermanCG, CheungKL, et al.Virtual reality therapy for adults post-stroke: A systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PloS One, 2014; 9:e93318.
6.
AnnemaJH, VerstraeteM, AbeeleVV, et al.Video games in therapy: A therapist's perspective. Int J Arts Technol, 2013; 6:106–122.
7.
HunickeR, LeBlancM, ZubekR. MDA: A formal approach to game design and game research. In: Proceedings of the AAAI Workshop on Challenges in Game AI. Palo Alto, CA: AAAI; 2004, Workshop 04-04. http://www.aaai.org/Papers/Workshops/2004/WS-04-04/WS04-04-001.pdf (accessed May23, 2014).
8.
MelleckerR, LyonsEJ, BaranowskiT. Disentangling fun and enjoyment in exergames using an expanded design, play, experience framework: A narrative review. Games Health J, 2013; 2:142–149.
9.
GohDH, AngRP, TanHC. Strategies for designing effective psychotherapeutic gaming interventions for children and adolescents. Comput Hum Behav, 2008; 24:2217–2235.
10.
World Health Organization. ICF checklist. Version 2.1a, Clinician Form. For International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2003. http://www.who.int/classifications/icf/training/icfchecklist.pdf (accessed May18, 2014).
11.
MuellerF, EdgeD, VetereF, et al.Designing Sports: A framework for exertion games. In CHI '11: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. New York: ACM; 2011:2651–;2660.
12.
MuellerF, IsbisterK. Movement-based game guidelines. In: Proceedings of the 32nd Annual ACM Conference on Human Factors in computing Systems. New York: ACM; 2014: 2191–2200.
HardyS, GöbelS, GutjahrM, et al.Adaptation model for indoor exergames. Int J Comput Sci Sport, 2012; 11:73–85.
15.
HardyS, DutzT, WiemeyerJ, et al.Framework for personalized and adaptive game-based training programs in health sport. Multimed Tools Appl, 2014; 1–23. (Published online May21, 2014); DOI 10.1007/s11042-014-2009-z
16.
SinclairJ. Feedback Control for Exergames [PhD dissertation]. Mount Lawley, WA, Australia: Edith Cowan University; 2011.
17.
PhillipsCJ, JohnsonDM, WyethP. Videogame reward types. In: Proceedings of the First International Conference on Gameful Design, Research and Applications. Waterloo, ON, Canada: University of Waterloo; 2013:103–106.
18.
PlowMA, McDanielC, LinderS, AlbertsJL. A scoping review of exergaming for adults with systemic disabling conditions. J Bioeng Biomed Sci, 2011; S1:002.
19.
BarryG, GalnaB, RochesterL. The role of exergaming in Parkinson's disease rehabilitation: A systematic review of the evidence. J Neuroeng Rehabil, 2014; 11:33.
20.
KafriM, MyslinskiMJ, GadeVK, DeutschJE. Energy expenditure and exercise intensity of interactive video gaming in individuals poststroke. Neurorehabil Neural Repair, 2014; 28:56–65.
21.
RobertM, BallazL, HartR, LemayM. Exercise intensity levels in children with cerebral palsy while playing with an active video game console. Phys Ther, 2013; 93:1084–1091.
22.
DeutschJE, Guarrera-BowlbyP, MyslinskiMJ, KafriM. Is there evidence that active videogames increase energy expenditure and exercise intensity for people poststroke and with cerebral palsy?. Games Health J, 2015; 4:31–37.
23.
AbrahamC, MichieS. A taxonomy of behavior change techniques used in interventions. Health Psychol, 2008; 27:379–387.
24.
DobkinBH. Progressive staging of pilot studies to improve phase III trials for motor interventions. Neurorehabil Neural Repair, 2009; 23:197–206.
25.
GalnaB, JacksonD, SchofieldG, et al.Retraining function in people with Parkinson's disease using the Microsoft Kinect: Game design and pilot testing. J Neuroeng Rehabil, 2014; 11:60.
26.
GoebelS. Exergames: The European Perspective. Presentation at Games for Increasing Physical Activity: Mechanisms for Change, Houston, TX, May 19, 2014.
