JMIR Publications

ABSTRACT

Reducing inactivity in patients with chronic disease is vital since it can decrease the risk of disease progression and mortality. Exergames are an innovative approach to becoome more physically active and positively affecting physical health outcomes. However, current commercial exergames might not optimally meet the needs of patients with chronic heart failure, who are often elderly. In this article we describe the process of designing and developing a mobile exergame app for patients with heart failure involving end-users. The player-centered, iterative, interdisciplinary and integrated (P-III) framework for designing and developing serious games has been modified and used for designing and developing an exergame. The exergame was developed iteratively in seven iterations: iteration 1: physical activity and physical interaction design; iteration 2: concept design; and iteration 3-7: exergame design and development. The last four iterations contained three phases: (1) exergame design prototype (iteration 3), (2) working prototype (iteration 4), and (3) exergame development (iterations 5 – 7). The exergame was about taking care of a farm and to do activities on the farm the patient has to walk in the physical world. An exergame designed to encourage patients with heart failure to walk for 10 minutes was successfully developed using the P-III framework for serious games. This framework can be applied to the development of exergames by including the design of the physical activity and physical interaction as well as early and integrated deployment of the exergame. Furthermore, involving stakeholders with different roles is a successful approach for developing exergames.