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Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation

BACKGROUND: Active video game (AVG) playing, also known as “exergaming,” is increasingly employed to promote physical activity across all age groups. The Wii Fit Balance Board is a popular gaming controller for AVGs and is used in a variety of settings. However, the commercial off-the-shelf (OTS) de...

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Autores principales: Thirumalai, Mohanraj, Kirkland, William B, Misko, Samuel R, Padalabalanarayanan, Sangeetha, Malone, Laurie A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861301/
https://www.ncbi.nlm.nih.gov/pubmed/29510972
http://dx.doi.org/10.2196/rehab.8003
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author Thirumalai, Mohanraj
Kirkland, William B
Misko, Samuel R
Padalabalanarayanan, Sangeetha
Malone, Laurie A
author_facet Thirumalai, Mohanraj
Kirkland, William B
Misko, Samuel R
Padalabalanarayanan, Sangeetha
Malone, Laurie A
author_sort Thirumalai, Mohanraj
collection PubMed
description BACKGROUND: Active video game (AVG) playing, also known as “exergaming,” is increasingly employed to promote physical activity across all age groups. The Wii Fit Balance Board is a popular gaming controller for AVGs and is used in a variety of settings. However, the commercial off-the-shelf (OTS) design poses several limitations. It is inaccessible to wheelchair users, does not support the use of stabilization assistive devices, and requires the ability to shift the center of balance (COB) in all directions to fully engage in game play. OBJECTIVE: The aim of this study was to design an adapted version of the Wii Fit Balance Board to overcome the identified limitations and to evaluate the usability of the newly designed adapted Wii Fit Balance Board in persons with mobility impairments. METHODS: In a previous study, 16 participants tried the OTS version of the Wii Fit Balance Board. On the basis of observed limitations, a team of engineers developed and adapted the design of the Wii Fit Balance Board, which was then subjected to multiple iterations of user feedback and design tweaks. On design completion, we recruited a new pool of participants with mobility impairments for a larger study. During their first visit, we assessed lower-extremity function using selected mobility tasks from the International Classification of Functioning, Disability and Health. During a subsequent session, participants played 2 sets of games on both the OTS and adapted versions of the Wii Fit Balance Board. Order of controller version played first was randomized. After participants played each version, we administered the System Usability Scale (SUS) to examine the participants’ perceived usability. RESULTS: The adapted version of the Wii Fit Balance Board resulting from the user-centered design approach met the needs of a variety of users. The adapted controller (1) allowed manual wheelchair users to engage in game play, which was previously not possible; (2) included Americans with Disabilities Act-compliant handrails as part of the controller, enabling stable and safe game play; and (3) included a sensitivity control feature, allowing users to fine-tune the controller to match the users’ range of COB motion. More than half the sample could not use the OTS version of the Wii Fit Balance Board, while all participants were able to use the adapted version. All participants rated the adapted Wii Fit Balance Board at a minimum as “good,” while those who could not use the OTS Wii Fit Balance Board rated the adapted Wii Fit Balance Board as “excellent.” We found a significant negative correlation between lower-extremity function and differences between OTS and adapted SUS scores, indicating that as lower-extremity function decreased, participants perceived the adapted Wii Fit Balance Board as more usable. CONCLUSIONS: This study demonstrated a successful adaptation of a widely used AVG controller. The adapted controller’s potential to increase physical activity levels among people with mobility impairments will be evaluated in a subsequent trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by WebCite at http://www.webcitation.org/6xWTyiJWf)
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spelling pubmed-58613012018-03-26 Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation Thirumalai, Mohanraj Kirkland, William B Misko, Samuel R Padalabalanarayanan, Sangeetha Malone, Laurie A JMIR Rehabil Assist Technol Original Paper BACKGROUND: Active video game (AVG) playing, also known as “exergaming,” is increasingly employed to promote physical activity across all age groups. The Wii Fit Balance Board is a popular gaming controller for AVGs and is used in a variety of settings. However, the commercial off-the-shelf (OTS) design poses several limitations. It is inaccessible to wheelchair users, does not support the use of stabilization assistive devices, and requires the ability to shift the center of balance (COB) in all directions to fully engage in game play. OBJECTIVE: The aim of this study was to design an adapted version of the Wii Fit Balance Board to overcome the identified limitations and to evaluate the usability of the newly designed adapted Wii Fit Balance Board in persons with mobility impairments. METHODS: In a previous study, 16 participants tried the OTS version of the Wii Fit Balance Board. On the basis of observed limitations, a team of engineers developed and adapted the design of the Wii Fit Balance Board, which was then subjected to multiple iterations of user feedback and design tweaks. On design completion, we recruited a new pool of participants with mobility impairments for a larger study. During their first visit, we assessed lower-extremity function using selected mobility tasks from the International Classification of Functioning, Disability and Health. During a subsequent session, participants played 2 sets of games on both the OTS and adapted versions of the Wii Fit Balance Board. Order of controller version played first was randomized. After participants played each version, we administered the System Usability Scale (SUS) to examine the participants’ perceived usability. RESULTS: The adapted version of the Wii Fit Balance Board resulting from the user-centered design approach met the needs of a variety of users. The adapted controller (1) allowed manual wheelchair users to engage in game play, which was previously not possible; (2) included Americans with Disabilities Act-compliant handrails as part of the controller, enabling stable and safe game play; and (3) included a sensitivity control feature, allowing users to fine-tune the controller to match the users’ range of COB motion. More than half the sample could not use the OTS version of the Wii Fit Balance Board, while all participants were able to use the adapted version. All participants rated the adapted Wii Fit Balance Board at a minimum as “good,” while those who could not use the OTS Wii Fit Balance Board rated the adapted Wii Fit Balance Board as “excellent.” We found a significant negative correlation between lower-extremity function and differences between OTS and adapted SUS scores, indicating that as lower-extremity function decreased, participants perceived the adapted Wii Fit Balance Board as more usable. CONCLUSIONS: This study demonstrated a successful adaptation of a widely used AVG controller. The adapted controller’s potential to increase physical activity levels among people with mobility impairments will be evaluated in a subsequent trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by WebCite at http://www.webcitation.org/6xWTyiJWf) JMIR Publications 2018-03-06 /pmc/articles/PMC5861301/ /pubmed/29510972 http://dx.doi.org/10.2196/rehab.8003 Text en ©Mohanraj Thirumalai, William B Kirkland, Samuel R Misko, Sangeetha Padalabalanarayanan, Laurie A Malone. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 06.03.2018. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on http://rehab.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Thirumalai, Mohanraj
Kirkland, William B
Misko, Samuel R
Padalabalanarayanan, Sangeetha
Malone, Laurie A
Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation
title Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation
title_full Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation
title_fullStr Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation
title_full_unstemmed Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation
title_short Adapting the Wii Fit Balance Board to Enable Active Video Game Play by Wheelchair Users: User-Centered Design and Usability Evaluation
title_sort adapting the wii fit balance board to enable active video game play by wheelchair users: user-centered design and usability evaluation
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861301/
https://www.ncbi.nlm.nih.gov/pubmed/29510972
http://dx.doi.org/10.2196/rehab.8003
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