JMIR Publications

ABSTRACT

Background:

Traditional rehabilitation programs for children with cerebral palsy and acquired brain injuries aim to enhance motor and cognitive abilities through repetitive exercises, which are often perceived as tedious and demotivating. Extended Reality (XR) technologies, including Augmented Reality (AR) and virtual reality, offer more engaging methods through exergames. However, to date, no AR exergames simultaneously integrate cognitive and motor aspects within navigational tasks. Developing these exergames necessitates rigorous methodological steps, especially when using emerging technologies such as AR. The MIDE framework advocates a participatory design approach, involving users from the outset, the objective being to optimize the interface and to validate game mechanics through user experience assessment. Some researchers initially test these mechanisms on healthy children before applying them to clinical populations.

Objective:

This study aims to evaluate user experience of our AR exergames, consisting of two games (AR Corsi and AR Zoo), in typically developing children.

Methods:

Typically developing children participated in two 1.5-hour sessions. During each session, they played one of two AR games using the Microsoft HoloLens 2 headset: AR Corsi and AR Zoo, both of which are designed to engage executive functions and motor skills through navigational capabilities. User experience was assessed after each session using the following measures: System Usability Scores (SUS) for usability, Attrakdiff for attractiveness and game quality, MeCue for emotional experience, and RPE-C for pre- and post-session mental and physical fatigue.

Results:

Twenty-seven participants (11.9 ± 1.2 years) were included in the study. Mean SUS scores were 79.9 ± 11.4 for AR Corsi and 76.3 ± 12.1 for AR Zoo, indicating good usability. The Attrakdiff questionnaire yielded favorable results, with scores between 1 and 3 for overall attractiveness, pragmatic quality, and stimulation for both AR games. However, the hedonic quality "identity" received neutral scores (0.6 ± 0.5 for AR Corsi and 0.7 ± 0.8 for AR Zoo). The MeCue emotions module yielded average scores of 5.2 ± 0.7 for AR Corsi and 5.3 ± 0.8 for AR Zoo, significantly exceeding the theoretical mean of 4 (P < .001). We observed a significant effect of physical fatigue (P < .023) and mental fatigue (P < .002) after exposure for both games. A comparative analysis of user experience between the two games showed no significant differences.

Conclusions:

This study demonstrates that our exergame, comprising two AR games, is user-friendly and well-received by typically developing children, eliciting positive emotions and overall appeal. Although some children reported fatigue, favorable user experience evaluation confirms the validity of the game's content and mechanisms, suggesting its suitability for use among children with cerebral palsy and acquired brain injuries.