With the continuous development of extended reality (XR), encompassing augmented reality (AR), virtual reality (VR), and mixed reality (MR), the increasing application of VR, especially combined with game technology in the health area, is trending. Due to this development, academia and industry have rising research and practices focusing on VR exercise game applications and their evaluation. This paper presented a pilot study addressing the comparison of user preferences in using VR exercise games. Eight volunteering participants with VR or rowing experience were involved in the pilot study. Their responses on using different postures (standing or sitting), display devices (VR or a large screen), and game tasks (collect coins vs distance travelled) were explored, as well as feedback suggestions for the study and VR games. The pilot study revealed the opportunities and challenges to enhance the VR exercise games, user experience, and performance. It tested the feasibility and duration of each session and potential improvements that could be made for the main experiment, including the instructions, game environments, process, devices, data gathering, and analysis methods. © 2024 Copyright held by the owner/author(s).

Since the term ’human-computer interaction’ was first used in the 1970s, the way humans interact with computers has become diverse. Immersive technologies provide an interactive way to merge the physical and digital worlds. Among immersive technologies collectively referred to as extended reality (XR), virtual reality (VR) is one of the main types. In the industrial market, most of the investment in immersive technology was concentrated in the gaming industry, and healthcare-related applications were also at the forefront. Lack of consumer demand and user experience issues were among the main challenges of popularisation. With this background, this dissertation used the literature review and survey to understand the development status, opportunities, challenges, and evaluation of XR games in healthcare from academic and consumer perspectives. Based on these results, this dissertation designed and implemented an indoor VR rowing game for physical exercise aimed at the elderly and conducted a questionnaire-based test on this game. This small-scale test is a pilot study to test the experimental environment, equipment and methods, as well as collect feedback on the game and research. Based on this feedback and the problems found in the pilot study, this dissertation improved the experimental design and the game settings and conducted a large-scale formal experiment. This experiment tested the subjective evaluation method based on standardised scales and the objective evaluation based on biosensors in VR rowing games. This dissertation explored user preferences on real devices, postures, and game tasks and studied the impact of age on them. This dissertation provides a reference value for researchers and developers in related work: 1) the current status and trends of XR game applications and evaluation in the health fields from academic and industrial perspectives, 2) attempting to provide solutions to the lack of VR games for elderly users, and 3) trying to provide subjective and objective evaluation methods for user experience evaluation as well as exploration of user preferences.

In recent years, with the rise of the ageing population worldwide, the health of the elderly has attracted increasing attention. This study explored existing extended reality (XR) game applications aiming at physical exercise for the elderly. Through the review of 1847 papers from the Scopus database, 17 articles were included. Based on these papers, we explored the existing contributions of exercise XR games for the elderly, the development opportunities and challenges of such games, and their special considerations in adapting to the characteristics and requirements of the target user. The results were organized into several perspectives: publication information and keywords, immersive technologies and game concepts, teamwork and social games, evaluation, opportunities and challenges, and adapting designs. We found the elderly interested in and accepted using XR games. The reported research results proved positive effects on such games’ physical and mental health. XR exercise games for the elderly should considerately adapt to the elder’s cognition, behaviour, and demand. Although problems existed, such as simulator sickness, safety risks, device problems, and cost, there were opportunities and space for research and future developments. Researchers and developers could refer to this paper for XR exercise games for the elderly and create or enhance future XR applications by learning from existing work. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Virtual reality, augmented reality, and mixed reality (VR/AR/MR) as information and communication technologies have been recognised and implemented in healthcare in recent years. One of the popular application ways is games, due to the potential benefits of providing an engaging and immersive experience in a virtual environment. This study presents a systematic literature review that evaluates the state-of-the-art on VR/AR/MR game applications in healthcare by collecting and analysing related journal and conference papers published from 2014 through to the first half of 2020. After retrieving more than 3,000 papers from six databases, 88 articles, from both computer science and medicine, were selected and analysed in the review. The articles are classified and summarised based on their (1) publication information, (2) design, implementation, and evaluation, and (3) application. The presented review is beneficial for both researchers and developers interested in exploring current research and future trends in VR/AR/MR in healthcare. © 2022 Association for Computing Machinery.

Facing the increasingly serious ageing problem, IT technology is being applied more and more to alleviate the increasing health demands of the elderly. Virtual reality (VR) games, in particular, have been shown to benefit the physical and mental health of the elderly. However, almost all consumer-level VR games address the general user, not considering the characteristics of the elderly, such as their particular needs regarding cognitive aspects and safety. In addition, the existing VR rowing games’ research typically focuses on athlete training or is based on a rowing machine. Extending on previous research, this paper proposes a conceptual design of a VR rowing game, VRrowing to provide a home exercise game for the elderly which benefits both physical and mental health. This research first analysed the relevant literature and existing VR exercise games for the elderly to find characteristics and their particular needs. Then, following design principles (in exercise games, human–computer interaction, and user interfaces (UIs)) for the elderly, this study proposed a conceptual design of VRrowing through the MDA framework (standing for mechanics, dynamics, and aesthetics). The results cover the system architecture, activities and tasks, patterns and roles, mechanics and structures, and UI examples. Based on comprehensive consideration of the results from relevant research and fostering strengths and circumventing weaknesses, VRrowing was designed as a sports game, aimed at the elderly according to their characteristics and needs, which fills the void of home VR rowing games for seniors’ exercise. This research has reference value for scientific research or development personnel in VR game applications and evaluations, especially for such games targeting the elderly. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

With the increasing of ageing all over the world, elderly health attracts more and more attention. This paper aims to study existing extended reality (XR) game applications for physical exercise through a literature review with 14 papers as an outcome. Based on these papers, we explored the contributions, opportunities, and challenges of exercise XR games for the elderly. The papers were analysed based on several perspectives, including publication information, design and implementation, game information, teamwork and social games, evaluation, and advantages and disadvantages. We found that the elderly were interested in and accepted the use of XR games. The positive effect of such games was common in the research results. Even if there were problems, such as simulator sickness, safety risks. device problems, and cost, there are still opportunities and space for research and development in the future. The overall positive attitudes toward XR exercise games for the elderly could be seen by both researchers, developers, and users. However, these game applications also presented some problems and future improvements are needed. The presented review is beneficial for researchers and developers to create or enhance future XR applications by learning from existing work.

Software and applications of augmented reality (AR), virtual reality (VR), and mixed reality (MR) technology combined with game/gamification techniques in healthcare have increasingly been studied in academia. However, there is a need to explore the usage, challenges and opportunities of AR/VR/MR game/gamification software/applications in the healthcare system. To explore this, we present an online survey conducted in the healthcare-relevant system (including hospital-based system, homecare-based system, institute and university, and industry). Based on the answers, we found examples of digital games and AR/VR/MR applications used in healthcare, as well as some general information (name and feature, purpose, target user, and use occasion), usage situation, and user experience. This presented survey is beneficial for both researchers and developers in computer science and medical science. It can familiarise them with existing products and their current use, advantages and potential issues of AR/VR/MR and game applications in healthcare. In future work, the survey would be extended to obtain other user experiences and feedback of AR/VR/MR techniques and game/gamification technology applied to healthcare, as well as to study how to overcome the challenges, and develop the opportunities further.

The use of augmented and virtual reality (AR/VR) has recently been increased in various people’s work and life. The combination of technology with digital games have recently received much attention. The 2020 Augmented and Virtual Reality Survey Results report by Perkins Coie, XR Association, and Boost VC, pointed out that immersive techniques are leaving from laboratory research and theoretical applications and growing upas fully mature and income-generating marketplaces. Except forgames and entertainment, the most common area reported was healthcare and medical devices from immersive technologies, followed by education. The survey presented in this paper explores the usage, perceived benefits and problems of AR/VR games for mental or physical health. It also highlights future features that users would see as relevant in these applications. Through an online questionnaire, we found examples of used AR/VR games and their usage frequency, the user’s perception of their mental or physical health benefits and problems, and the prospects to physical and mental health for AR/VR games. This study is helpful for researchers and developers both in computer science and medical science. It provides people with examples of existing consumer-level products, their advantages and disadvantages, and AR/VR games’ requirements relevant to mental and physical health. In future work, the survey sample size would be extended to collect additional user experience data and further explore the challenges and opportunities of such techniques for public health.