Design and Evaluation of AR-Based Serious Games with
Clinical Knowledge for Promoting Health Fitness
Chien-Lung Hsu1.3*, and Min-Wen Liao1.2
1
Department of Information Management, Chang Gung University
2
Department of Nursing, Chang Gung University
3
Chang Gung Memorial Hospital
*Email: [email protected]
Abstract
Serious Games can be applied in various fields such as military, health care,
aviation, and education. In evidence-base study, serious games based on clinical
knowledge can be designed to enhance holistic care, elderly patient’s safety, and
health care delivery. This study uses augmented reality (AR) technology and
considers clinical knowledge to design AR-based serious games with motion sensing
controller for promoting health fitness. Users can not only paly the proposed serious
grames enjoyly, but also imporve their health. Moreover, we consider “quality of
game” and “perceived enjoymentand”
constructs to design a new research model
based on information system success model to evaluate user acceptance and
statisfication of the proposed games. The results show that (i) “quality of game”
construct could positively affect “perceived enjoymentand” one, (ii) “perceived
enjoymentand” construct could positively affect “intention to use” and “satisfaction”
one, and (iii) “satisfaction” construct could positively affect " intention to use " one.
Keywords: Serious Game, Fitness, Information System Success Model, Clinical
Knowledge
Introduction
With changing lifestyle, the daily activity of people also change with it. Many
studies have indicated that lack of physical activity will easily lead to chronic diseases
(Frank, Christian, & Matthew, 2012). In order to prevent lacing of physical activity,
the fitness training is the best way. Through augmented reality technology to design a
somatosensory game for fitness training, the users will enjoy the game and intention
to use. We base on clinical knowledge to design game action. When the user plays the
game, they can train their fitness at the same time. We hope to promote the user's
health fitness in the future.
Literature Review
Serious Games
Serious Games (SGs) was defined “games that are designed to entertain players
as they educate, train, or change behavior (Benjamin, 2005)” and may have useful
outcome or model real – life situations (Prudy, 2007). To create personal health
promotion games, the supporting from community, knowledge and business may be
required “Games for Health” (Marin, Navarro & Lawrence, 2011).
Augmented Reality
Augmented Reality (AR) technology can help the SGs more close to life.
Klopfer and Sheldon defined AR as a “technology” that blends real and virtual world
experience (Klopfer & Sheldon, 2010). Research showed that AR system could help
learners to develop skill and knowledge (Wu, Lee, Chang, & Liang, 2013). Therefore
when the fitness game is developed on the basis of clinical knowledge and AR
technology, the users would be more satisfied with the game and intention to use.
Physical fitness
Physical fitness as “The ability to carry out daily tasks with vigor and alertness,
without undue fatigue, and with ample energy to enjoy leisure-time pursuits and
respond to emergencies (Frank et al., 2012 ).” Physical fitness is major to improve
cardiorespiratory
endurance,
muscular
endurance,
muscular
strength,
body
composition, and flexibility (Caspersen, Powell, & Christenson, 1985). Physical
inactivity as a primary and actual cause of most chronic diseases (Frank et al., 2012 ).
When exercise becomes interesting, users may be interested and keep exercise.
Finally they will improve their physical fitness.
Information Systems Success Model (ISSM)
Information Systems Success Model (ISSM) Fig.1 was undertaken by William H.
DeLone and Ephraim R. McLean in 1992 (DeLone & McLean, 1992). In this model,
system quality directly affect user satisfaction and satisfaction directly usage
intentions. At the same time, user satisfaction affect usage intentions.
Information quality
Usage
intentions
System use
Net system benefits
System quality
User satisfaction
Service quality
Fig1. Information System Success Model
Methodology
In evidence-base study, serious games based on clinical knowledge can be
designed to enhance holistic care, elderly patient’s safety, and health care delivery
(Olufuwa, 2015). The healthy fitness platform was created on the basis of clinical
knowledge and developed fitness games base on AR technology. Our operating
environment is Microsoft Windows7 and development tools: Vizard、Python、 Unity
3D、 Kinect for Windows SDK、 XAMPP、 ASP.NET、 FAAST.
Using AR technology would lead the games into the user’s life. This healthy
fitness platform includes two major systems. First one is fitness detection system, this
system can detect the user’s level of fitness and provide detect result to show training
enhancement. Second one is the training system, this system will provide training
recommendation according to the test results of fitness detection system. When users
start the game, they will do the warm–up game then enter the fitness detection system.
The system will test user’s balance force, muscle strength, softness and reaction force.
After the test games, the system will develop personalized training courses.
We based on ISSM to propose a new model to explore the relationship between
game quality and satisfaction. Thus, we formulated the following hypotheses and the
Figure 2 was shown the research model.
H1: The quality of game will have a positive impact on the perceived enjoymentand.
H2: The perceived enjoymentand will have a positive impact on satisfaction.
H3: The satisfaction will have a positive impact on intention to use.
H4: The perceived enjoymentand will have a positive impact on intention to use.
Fig. 2 Research model
Results
40 participants were completed the game and fill in the questionnaire. The
demographic results are listed in Table 1.
Table 1 Participants basic information
Description
Gender
Male
Female
Eduction
Bachelor
Master
Frequency of sports per week
<5
5-10
>10
Every sport time (min)
0-30
31-60
61-90
91-120
>120
Number of valid questionnaires
Percentage(%)
16
40.0
24
60.0
4
36
10.0
90.0
37
2
1
92.5
5.0
2.5
22
7
4
4
3
55.0
17.5
10.0
10.0
7.5
Totel 16 males, 24 females were in this study. 92.5% of participants do exercise
less than five times per week. In the meantime there are 55% of participants do
exercise less 30 minutes once time.
The validity of study hypotheses were tested by structural equation modeling.
The testing showed that “quality of game” could affect “perceived enjoymentand”,
“perceived enjoymentand” could affect “intention to use” “Satisfaction”, and the
“Satisfaction” could affect “ intention to use “. The model testing shoeed in Figure 3,
all of research hypotheses in this study had been supported.
Fig. 3 The research structure result
Conclusion
The result show that “quality of game” construct could positively affect
“perceived enjoymentand” one, “perceived enjoymentand” construct could positively
affect “intention to use” and “satisfaction” one, and “satisfaction” construct could
positively affect " intention to use " one. In this study “quality of game” is the key
dimension. Our games designed with clinical knowledge and used AR technology to
improve games quality. Most of the users enjoy in this game. Perceived enjoymentand
is very important, this dimension affects user “satisfaction” and “intention to use”. So
when we creat a serious game need to pay more attention in “the quality of game.”
Acknowledgments
We would like to thank anonymous referees for their valuable suggestions. This
work was supported
in part by the Chang Gung Memorial Hospital Grant
CMRPD3D0061、CMRPD3D0062, and in part by the National Science Council of
Republic of China under the contract numbers MOST 104-2221-E-182-028.
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