Exergaming System for Exercise-Based Cardiac Rehabilitation in Patients With Heart Failure: Development and Usability...

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Human-Computer Interaction

Background:

• Heart failure (HF) presents a growing global health challenge with suboptimal adherence to early cardiac rehabilitation (CR).
• Exergaming offers a potential alternative to traditional exercise programs for HF patients, but current systems lack tailoring and long-term adherence strategies.
• Integrating exergaming into clinical practice is hindered by limitations in existing research, particularly concerning early-phase CR and patient-specific needs.

Purpose of the Study:

• To design, develop, and assess the usability of a novel exergaming prototype, HEFMOB, for early-phase, exercise-based CR in patients with HF.
• HEFMOB integrates immersive virtual reality (VR), real-time biometric monitoring, and autonomous session management.
• The goal is to support tailored and engaging exercise interventions for HF patients during their initial rehabilitation phases.

Main Methods:

• HEFMOB was developed iteratively by a multidisciplinary team, featuring a VR cycling game and an upper-limb minigame with integrated biometric monitoring (heart rate, blood pressure, oxygen saturation).
• Usability was evaluated in two phases: expert review and a single-session study with 10 HF patients.
• Data collection included researcher evaluations using the Serious Game Usability Evaluator, System Usability Scale (SUS), and Intrinsic Motivation Inventory (IMI) for enjoyment.

Main Results:

• The study involved 10 HF patients (mean age 64.8 years) who completed sessions without adverse events.
• The HEFMOB prototype achieved a good average SUS score of 71.5 and very high enjoyment ratings (mean IMI score 25.1).
• The most frequent gameplay-related events were interface issues (n=61), followed by design (n=52) and hardware (n=23).

Conclusions:

• HEFMOB shows promise as an engaging, well-tolerated exergaming tool for tailored CR in HF patients.
• High usability and enjoyment ratings indicate strong patient acceptability.
• This research is a significant step towards integrating personalized, gamified exercise in inpatient settings, particularly for early mobilization, with future trials planned to assess long-term impact.