JMIR Publications

ABSTRACT

Background:

Exergames have emerged as effective interventions for promoting physical activity and preventing type 2 diabetes (T2D). Kinect-based exergames have demonstrated improvements in exercise adherence and health outcomes, but their high cost and reliance on specialized hardware hinder widespread home-based adoption. Recent advances in computer vision now enable monocular-camera-based systems, offering a potentially cost-effective and scalable alternative for promoting physical activity at home.

Objective:

This study aimed to evaluate the feasibility and user experience of monocular-camera-based exergames as a home-based intervention for individuals at risk for T2D.

Methods:

Forty-five community-dwelling individuals at high risk for T2D (mean age = 47.12, SD = 6.92) were recruited and randomized into three groups (n = 15 each): (1) Control group (traditional offline exercise), (2) Kinect group (Kinect-based exergame), and (3) Monocular group (Monocular-camera-based exergame). Participants engaged in a 10-minute intervention once per week for 7 weeks. Data were collected at three time points: baseline (exercise performance: heart rate and perceived fatigue), post-intervention (exercise performance and user experience, including game experience and intrinsic motivation), and follow-up (user engagement and qualitative feedback). One-way ANOVA was used for data analysis.

Results:

Exercise performance was comparable across all groups, with no significant differences in heart rate (p = 0.757) or fatigue levels (p = 0.248). However, participants in the monocular group reported significantly lower fatigue compared to the control group (p = 0.035). Intrinsic motivation was significantly higher in both the Kinect (M = 35.13, SD = 3.20) and monocular (M = 34.00, SD = 4.41) groups compared to the control group (M = 26.06, SD = 1.87; p < 0.001), with no significant difference between the two exergame groups (p = 0.443). While most user experience measures showed no significant differences, the monocular group reported a higher perceived challenge (M = 3.45) compared to the Kinect group (M = 2.96; p = 0.092). Additionally, the monocular group exhibited higher engagement, as evidenced by more frequent use, fewer challenges, and a greater intention to continue using the system.

Conclusions:

Monocular-camera-based exergame is a feasible and effective solution for promoting physical activity in individuals at risk for T2D. It offers motivational and experiential benefits similar to Kinect-based systems but require less costly and more accessible equipment. These findings suggest that monocular systems have strong potential as scalable tools for home-based chronic disease prevention. Clinical Trial: The trial was registered in ClinicalTrials.gov (NCT06950528).