Escaping through virtual gaming-what is the association with emotional, social, and mental health? A systematic review.

Background: The realm of virtual games, video games, and e-sports has witnessed remarkable and substantial growth, captivating a diverse and global audience. However, some studies indicate that this surge is often linked to a desire to escape from real life, a phenomenon known as escapism. Much like substance abuse, escapism has been identified as a significant motivator, leading to adverse outcomes, including addiction. Therefore, it is crucial to comprehend the existing research on the connection between escapism and engagement in virtual gaming. This understanding can shed light on the reasons behind such practices and their potential impact on mental and public health. Purpose: The objective of this systematic review is investigate the findings pertaining to association between escapism and the practice of virtual games, such as video-games and e-sport. Methods: PUBMED and SCOPUS database were systematically searched. Six independent researchers screened articles for relevance. We extracted data regarding escapism-related measures, emotional/mental health-related measures and demographic information relevant to the review purpose. Results: The search yielded 357 articles, 36 were included. Results showed that: (i) Escapist motivation (EM) is one of the main motives for playing virtual games; (ii) EM is related to negative clinical traits; (iii) EM predicts negative psychological/emotional/mental health outcomes; (iv) EM is associated with impaired/negative perception of the real-world life; (v) EM predicts non-adaptive real social life; and (vi) EM is associated with dysfunctional gaming practices in some cases. However, EM can have beneficial effects, fostering confidence, determination, a sense of belonging in virtual communities, and representation through avatars. Furthermore, the reviewed findings suggest that EM was positively linked to mitigating loneliness in anxious individuals and promoting social activities that preserved mental health among typical individuals during the pandemic. Conclusion: Our review reinforces the evidence linking EM in the context of virtual games to poor mental health and non-adaptive social behavior. The ensuing discussion explores the intricate connection between escapism and mental health, alongside examining the broad implications of virtual gaming practices on underlying motivations for escapism in the realms of social cognition, health promotion, and public health.

Personalisation of a virtual gaming system for children with motor impairments: performance and usability.

PURPOSE: To demonstrate the potential role of virtual game personalisation for use as a therapeutic modality to improve upper extremity function in children with cerebral palsy (CP). METHODS: The study tested a convenience sample of 60 typically developing children (TD) aged 6-10 years and 20 children with CP aged 7-11 years. Children participated in a single 30-min session when they played the game in accuracy mode (virtual targets are hit as they become progressively larger or smaller) or dwell mode (virtual targets are hit when the users remains on them for progressively shorter or longer durations). These two modes can be played in conventional (non-personalised), personalised and with and without arm weights conditions; weights were used for the TD group in order to ensure that game play would be sufficiently challenging as to require personalisation. We measured performance variables (frequency of changes in game level difficulty and accuracy as measured by percent success of hitting the virtual targets) in each condition and usability variables (self-reported perceived effort and enjoyment). RESULTS: Comparisons between the usability of the conventional and personalised conditions among typically developing children showed that although children self-reported significantly more effort while playing the personalised game, the level of enjoyment remained high (no significant differences between conventional and personalised game play conditions). In addition, comparisons between playing the personalised game with and without weights by typically developing children, indicated that percent success was significantly higher for the game played without weights, suggesting that the system is sensitive to dynamic changes in performance. Comparisons between the TD and CP groups showed that when the game was played in personalised dwell mode (hovering over the target for several seconds) children with CP progressed significantly less quickly through different difficulty levels compared to typically developing children. In contrast, no significant differences were found in accuracy mode (immediate response on target hit), between the TD and CP groups in any of the experimental conditions. DISCUSSION: The personalised game approach was shown to be enjoyable for both groups of users and able to change the level of difficulty in real time. The results suggest that this approach to gaming can provide motor challenges while preserving a high level of enjoyment. CONCLUSION: Personalised virtual therapy shows promise as a tool for upper extremity therapy for children with motor impairment.Implications for RehabiliationIn recent years, there has been an increase in the use of assistive technologies including virtual gaming in the general area of health care and clinical practice.Virtual gaming provides an interactive, real-time experiences that are flexible and ecologically valid ways to improve specific cognitive and motor abilities.Personalisation of virtual games entails dynamic adaptation of the parameters in real time according to the user's functional level).The results have demonstrated that personalised virtual gaming is enjoyable and feasible for typically developing children and children with cerebral palsy.The results suggest that this approach to gaming can provide motor challenges while preserving a high level of enjoyment.

Clinical and physical efficiency of virtual reality games in soccer players with low back pain / Eficiencia de los juegos de realidad virtual en jugadores de futbol con dolor de espalda baja / Eficiência clínica e física de jogos de realidade virtual em jogadores de futebol com dor lombar

ABSTRACT Introduction: Virtual reality training (VRT) is an advanced technology that creates virtual games by a computer through specific software. It is a type of rehabilitation training commonly used in balance problems to treat musculoskeletal conditions. Objective: To determine and compare the effects of virtual reality games with those of core stabilization training on physical efficiency in soccer players with chronic low back pain. Methods: A randomized, double-blinded, controlled study was conducted on 60 LBP participants at a university hospital. The first group (n=20) received virtual reality (VR) training; the second group (n=20) received core stabilization (CS) training; and the third group (n=20) received conventional training exercises for four weeks. Scores of clinical and sports performance were measured at baseline, and after 4 weeks, 8 weeks and 6 months. Results: The baseline demographic and clinical characters did not show any significant differences (p>0.05) in the statistical analysis, which shows a homogenous population. Four weeks following the training, the VR training group showed more significant changes in clinical scores than the CS training and control groups (p≤0.001). The scores for sports performance also showed more significant improvement in the VR training group than in the other two groups (p≤0.001). The same improved clinical and sports performance changes were seen at 8 weeks and 6 months of follow-up in the VR training group, when compared to the other two groups (p≤0.001). Conclusion: This study suggests that training through virtual reality games results in long-term improvement in clinical and sports performance compared to other forms of training in soccer players with chronic low back pain.Level of evidence I b; Therapeutic studies - Investigation of treatment results.

RESUMEN Introducción: El entrenamiento de realidad virtual (VRT) es una tecnología avanzada, que crea juegos virtuales por computadora a través de un software específico. Es un tipo de entrenamiento de rehabilitación que se usa comúnmente en problemas de equilibrio para tratar afecciones musculoesqueléticas. Objetivo: Encontrar y comparar los efectos de los juegos de realidad virtual sobre el entrenamiento de estabilización central sobre la eficiencia física en jugadores de fútbol con dolor lumbar crónico. Métodos: Se realizó un estudio controlado, aleatorizado, doble ciego en 60 participantes con dolor lumbar en un hospital universitario. El primer grupo (n = 20) recibió entrenamiento de realidad virtual (VR), el segundo grupo (n = 20) recibió entrenamiento de estabilización central (CS) y el tercer grupo (n = 20) recibió ejercicios de entrenamiento convencionales durante cuatro semanas. Los puntajes de rendimiento clínico y deportivo se midieron al inicio del estudio, después de 4 semanas, 8 semanas y 6 meses. Resultados: Los caracteres demográficos y clínicos basales no mostraron ninguna diferencia significativa (p. 0,05) en el análisis estadístico lo que indica una población homogénea. Cuatro semanas después del entrenamiento, el grupo de entrenamiento de RV mostró cambios más significativos en las puntuaciones clínicas que los de entrenamiento de CS y los grupos de control (p≤0,001). Las puntuaciones de rendimiento deportivo también mostraron una mejora significativa en el grupo de entrenamiento de RV comparadas con los otros dos grupos (p≤0,001). Hubo los mismos cambios clínicos y de rendimiento deportivo a las 8 semanas y 6 meses de seguimiento en el grupo de entrenamiento de RV y en los otros dos grupos (p≤0,001). Conclusión: Nuestro estudio sugirió que el entrenamiento a través de juegos de realidad virtual mejoró el rendimiento clínico y deportivo más que otros entrenamientos en jugadores de fútbol con dolor lumbar crónico a largo plazo. Nivel de evidencia Ib; Estudios terapéuticos, investigación de los resultados del tratamiento.

RESUMO Introdução: O treinamento com realidade virtual (TRV) é uma tecnologia avançada que cria jogos virtuais para computador por meio de software específico. É um tipo de treinamento de reabilitação comumente usado em problemas de equilíbrio no tratamento de doenças musculoesqueléticas. Objetivo: Determinar e comparar os efeitos dos jogos de realidade virtual com o treinamento de estabilização central na eficiência física de jogadores de futebol com dor lombar crônica. Métodos: Estudo randomizado, duplo-cego e controlado realizado com 60 participantes com lombalgia em um hospital universitário. O primeiro grupo (n = 20) recebeu treinamento de realidade virtual (RV), o segundo grupo (n = 20) recebeu treinamento de estabilização central (EC) e o terceiro grupo (n = 20) recebeu exercícios de treinamento convencional por quatro semanas. Os escores de desempenho clínico e esportivo foram medidos no início do estudo e depois de 4 semanas, 8 semanas e 6 meses. Resultados: As características demográficas e clínicas basais não mostraram diferença significativa (p > 0,05) na análise estatística, o que indica população homogênea. Quatro semanas depois do treinamento, o grupo RV mostrou mudanças mais significativas nos escores clínicos do que os grupos EC e controle (p ≤ 0,001). Os escores de desempenho esportivo também mostraram melhora significativa no grupo RV do que nos outros dois grupos (p ≤ 0,001). As mesmas mudanças benéficas de desempenho clínico e esportivo foram observadas em 8 semanas e 6 meses de acompanhamento no grupo RV em comparação com os outros dois grupos (p ≤ 0,001). Conclusão: Este estudo sugere que o treinamento com jogos de realidade virtual resulta em melhora do desempenho clínico e esportivo a longo prazo do que outras formas de treinamento em jogadores de futebol com dor lombar crônica. Nível de evidência Ib; Estudos terapêuticos, Investigação dos resultados de tratamentos.

Exergames como conteúdo estratégico na educação física escolar / Exergames as strategic content in school physical education

O objetivo do trabalho foi analisar a influência da utilização dos exergames como parte integrante no conteúdo da Educação Física Escolar na coordenação motora dos estudantes. Três grupos experimentais (GE) participaram das 18 intervenções com exergames, jogos em quadra, ou aulas alternadas, respectivamente, enquanto o grupo controle (GC) seguiu com as aulas regulares de Educação Física. Testes de coordenação motora foram aplicados antes e após as intervenções. Os dados foram analisados através de medidas de tendências centrais, com comparações entre grupos (Kruskal-Wallis) e, para cada grupo, comparações entre momentos (Wilcoxon para amostras pareadas) e cálculo do tamanho do efeito. Não houve diferença significativa entre GC e GE, mas houve grande efeito para todos os grupos experimentais, principalmente no de exergames, em quase todas as habilidades. O uso dos exergames no contexto escolar pode promover uma ampliação do repertório motor da criança e o aperfeiçoamento de algumas habilidades de maneira lúdica, o que geralmente não ocorre em aulas de educação física sem organização do conteúdo.

The aim of this study was to analyze the influence of the use of exergames as part of scholar physical education on the student's motor coordination. Three experimental groups (GE) took part in 18 intervention classes either with exergames only, general games in the court only, or alternating exergames and games in the court, while the control group (GC) kept attending the regular physical education classes. Motor coordination tests were conducted before and after the period of the interventions. Data were analyzed by means of central trend measures, with comparisons between groups (Kruskal-Wallis) and, for each group, between moments (pair-wise Wilcoxon) and effect size. No difference was found between GC and GE, but the intervention led to large effects in the three experimental groups, mainly in the exergames group, in which the effect was large in almost all skills assessed. The use of exergames in a school context can promote an expansion of the child's motor repertoire and the improvement of some skills in a playful way, what usually does not occur in physical education classes without content organization.

Serious Games Are Not Serious Enough for Myoelectric Prosthetics.

Serious games show a lot of potential for use in movement rehabilitation (eg, after a stroke, injury to the spinal cord, or limb loss). However, the nature of this research leads to diversity both in the background of the researchers and in the approaches of their investigation. Our close examination and categorization of virtual training software for upper limb prosthetic rehabilitation found that researchers typically followed one of two broad approaches: (1) focusing on the game design aspects to increase engagement and muscle training and (2) concentrating on an accurate representation of prosthetic training tasks, to induce task-specific skill transfer. Previous studies indicate muscle training alone does not lead to improved prosthetic control without a transfer-enabling task structure. However, the literature shows a recent surge in the number of game-based prosthetic training tools, which focus on engagement without heeding the importance of skill transfer. This influx appears to have been strongly influenced by the availability of both software and hardware, specifically the launch of a commercially available acquisition device and freely available high-profile game development engines. In this Viewpoint, we share our perspective on the current trends and progress of serious games for prosthetic training.

The role of smartphone game applications in improving laparoscopic skills.

BACKGROUND: Virtual games (VGs) have a positive impact on laparoscopic skills. Time spent playing, the console and the type of game used correlate with the speed of acquisition of laparoscopic skills and their preservation. METHODS: A total of 45 university medical students with no previous surgical experience were divided into three groups: gamers (n=20), control (n=10) and intervention (n=15). They passed the laparoscopic skills testing and training model, developed by the European Academy of Gynecological Surgery, over two sessions. Every 5 intervention participants were asked to play a different smartphone application game daily for 2 months between the two sessions. Scores were calculated at both sessions and used to calculate the evolution ratio between sessions. RESULTS: Significant advantage was found at session 1 of gamers over non-gamers (p=0.002). No significant difference existed between the two non-gamer groups (p=0.96), or between the three intervention sub-groups (p>0.05). All participants' performances improved between sessions. No significant difference existed in evolution between control and gamers (p=0.121), nor between intervention and gamers (p=0.189). Significant advantage was found in evolutions of the intervention group over control group (p=0.035). CONCLUSION: Previous VG experience is a significant factor in showing better laparoscopic skills when virtual reality simulator is used for the first time. Recent and regular smartphone gaming practice significantly improves laparoscopic skills in non-gamers independently of the type of game practiced. Smartphone gaming practice appears to influence positively some specific laparoscopic skills more than others.

Relationship between perceived competence and performance during real and virtual motor tasks by children with developmental coordination disorder.

PURPOSE: (i) To compare children with DCD and typically developing participants via standard motor assessments, two interactive virtual games, measures of physical, social and cognitive self-competence and feedback while playing the virtual games and (ii) To examine the contribution of age and each motor assessment to predict self-competence. METHODS: Participants were 25 boys with DCD and 25 typically developing boys, aged 5-9 years. They completed the M-ABC-2, the Pictorial Scale of Perceived Competence, the 6-Minute Walk Test, and then played the two Kinect games and completed the Short Feedback Questionnaire for Children. RESULTS: Children with DCD showed lower physical competence and lower performance than the typical controls in all standard motor assessments. This performance significantly correlated with the children achievements in part of virtual games and with their self-perceived experience while performing within virtual environments. Among the DCD group, Kinect Running game significantly predicted physical and social competence. CONCLUSIONS: The significant correlations between the virtual games and standard motor assessments support the feasibility of using these games when evaluating children with DCD for the richer profile they provide. Implications for rehabilitation Clinicians should refer to the impacts of DCD on child's self-competence and daily life. Technological rehabilitation and the use of VR games have the potential to improve self-competence of children with DCD. By including VR games that simulate real life in the intervention for DCD, clinicians may raise child's enjoyment, self-competence and involvement in therapy.

Effects of lower limb motion control training combined with core stability training on the lower limb motor function of hemiplegic patients after stroke / 中华物理医学与康复杂志

Objective To observe the effects of lower limb motion control training using virtual games combined with core stability training (CST) on the lower limb motor function of hemiplegic patients after stroke.Methods Sixty hemiplegic stroke patients were divided into an observation group and a control group (n =30 in each) using a random number table.The control group was given conventional treatment and CST,while the observation group received lower limb motion control training using virtual games in addition to conventional treatment and CST.All of the patients were assessed using the Fugl-Meyer lower limb assessment (FMA),the Berg balance scale (BBS),the modified Barthel index (MBI),10 metre maximum walking speed (MWS) and functional ambulation categorization (FAC)before and after 8 weeks of treatment.Results Before the intervention there was no significant difference between the two groups in any of the measurements.After the treatment,however,the average FMA,BBS,MBI,MWS and FAC in the observation group were significantly better than those before treatment and those in the control group.Conclusions Lower limb motion control training using virtual games combined with core stability training can improve effectively the lower limb motor function of hemiplegic patients after stroke.Such a combination is worth applying in clinical practice.

A comparison of the upper limb movement kinematics utilized by children playing virtual and real table tennis.

Active virtual games (AVG) may facilitate gross motor skill development, depending on their fidelity. This study compared the movement patterns of nineteen 10-12 yr old children, while playing table tennis on three AVG consoles (Nintendo Wii, Xbox Kinect, Sony Move) and as a real world task. Wrist and elbow joint angles and hand path distance and speed were captured. Children playing real table tennis had significantly smaller (e.g. Wrist Angle Forehand Real-Kinect: Mean Difference (MD): -18.2°, 95% Confidence Interval (CI): -26.15 to -10.26) and slower (e.g. Average Speed Forehand Real-Kinect: MD: -1.98 ms(-1), 95% CI: -2.35 to -1.61) movements than when using all three AVGs. Hand path distance was smaller in forehand and backhand strokes (e.g. Kinect-Wii: MD: 0.46 m, 95% CI: 0.13-0.79) during playing with Kinect than Move and Wii. The movement patterns when playing real and virtual table tennis were different and this may impede the development of real world gross motor skills. Several elements, including display, input and task characteristics, may have contributed to the differences in movement patterns observed. Understanding the interface components for AVGs may help development of higher fidelity games to potentially enhance the development of gross motor skill and thus participation in PA.