Section: New Results

Serious exergames for Cognitive Stimulation

Participants : Guillaume Sacco, Monique Thonnat.

A serious exergame is a video game combining cognitive and physical stimulation with a positive impact on patients affect. We have worked to develop and assess X-Torp, a serious exergame which is played with a Kinect™ (see Figure 31).

This naval battle serious exergame contains two game modes: a scenario mode and a therapist mode. The scenario mode is the core of the game. It combines exploration of an open world and mini-games. Moving in the open world (ocean with islands) corresponds to the physical exercise phase. The mini games (missions proposed on the islands) correspond to the phases of stimulation / cognitive evaluation. The game includes a system of experience points, which reflects the progression of the player in the scenario mode. The therapist mode contains direct access to the virtual versions of the neuropsychological tests proposed in the scenario mode. Therapist mode also contains a physical test that can be performed in a virtual environment.

The integration of serious exergames as a tool to manage patients with neurocognitive disorders could have a major interest in the evaluation of cognitive abilities for two reasons: the design of tests and their more ecological character. Indeed, if the serious game is regularly used by the patient (in autonomy possibly guided by an avatar but not by a therapist), we think that it can allow a much more fine and relevant evaluation of the residual cognitive functions. The first reason for this is that in patients with mild or moderate cognitive impairment, there is a variation in test performance that may be related to anxiety, but also to the variability of observable performance over the day and day to day for some patients.

The innovative aspect of our approach is both a combination of physical and cognitive activity within the same game and the use of goal-directed motor skills for physical stimulation. Indeed, the use of virtual support to guide physical activity allows a longer duration of activity and therefore a better training.

If we consider the continuum of care of patients with neurocognitive disorders at prodromal or mild stages, we find that contacts with the health care system are limited. In addition, the availability of health professionals who can offer stimulation activities remains limited compared to the massive demand generated by the large number of patients with neurocognitive disorders. The interest of our approach is that it makes it possible to free oneself largely from the healthcare professional (which intervenes only for consultations of synthesis and reassessment) and thus allows many more patient follow-up for one healthcare professional.

Thus the development of playful serious exergames, with adequate design and in sufficient numbers, available for example via online gaming platforms, would allow regular use by patients in their homes. The serious exergame would then be a tool for training cognitive functions and physical abilities. It would also be a tool for regular and objective assessment and monitoring of the cognitive and physical performance of patients. It could even be envisaged the creation of game allowing the early detection of cognitive dysfunctions directly from the home of the subjects and inviting them if necessary to consult their physician.