A Serious Game to Self-Regulate Heart Rate Variability as a Technique to Manage Arousal Level Through Cardiorespiratory Biofeedback : Development and Pilot Evaluation Study
Estrella, Tony (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Alfonso, Carla (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Ramos-Castro, Juan (Universitat Politècnica de Catalunya. Departament d'Enginyeria Electrònica)
Alsina, Aitor (Universitat Autònoma de Barcelona. Departament de Microelectrònica i Sistemes Electrònics)
Capdevila Ortís, Lluís (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)

Data:	2023
Resum:	Background: Heart rate variability biofeedback (HRVB) is an established intervention for increasing heart rate variability (HRV) in the clinical context. Using this technique, participants become aware of their HRV through real-time feedback and can self-regulate it. Objective: The aim of this study was 2-fold: first, to develop a serious game that applies the HRVB technique to teach participants to self-regulate HRV and, second, to test the app with participants in a pilot study. Methods: An HRVB app called the FitLab Game was developed for this study. To play the game, users must move the main character up and down the screen, avoiding collisions with obstacles. The wavelength that users must follow to avoid these obstacles is based on the user's basal heart rate and changes in instantaneous heart rate. To test the FitLab Game, a total of 16 participants (mean age 23, SD 0. 69 years) were divided into a control group (n=8) and an experimental group (n=8). A 2 × 2 factorial design was used in each session. Participants in the experimental condition were trained in breathing techniques. Results: Changes in the frequency and time domain parameters of HRV and the game's performance features were evaluated. Significant changes in the average RR intervals and root mean square of differences between adjacent RR intervals (RMSSD) were found between the groups (P=. 02 and P=. 04, respectively). Regarding performance, both groups showed a tendency to increase the evaluated outcomes from baseline to the test condition. Conclusions: The results may indicate that playing different levels leads to an improvement in the game's final score by repeated training. The tendency of changes in HRV may reflect a higher activation of the mental system of attention and control in the experimental group versus the control group. In this context, learning simple, voluntary strategies through a serious game can aid the improvement of self-control and arousal management. The FitLab Game appears to be a promising serious game owing to its ease of use, high engagement, and enjoyability provided by the instantaneous feedback.
Ajuts:	Agencia Estatal de Investigación PID2019-107473RB-C21 Agencia Estatal de Investigación PID2019-107473RB-C22 Agència de Gestió d'Ajuts Universitaris i de Recerca 2021SGR-00806
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Serious game ; Heart rate variability ; Biofeedback ; Mobile health ; Mhealth ; App ; Mobile phone
Publicat a:	JMIR Serious Games, Vol. 11 (2023) , p. e46351-17, ISSN 2291-9279

DOI: 10.2196/46351
PMID: 37616033

17 p, 2.1 MB

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