video games
Research Papers
An Integrative Model for the Effectiveness of Biofeedback Interventions for Anxiety Regulation: Viewpoint
Biofeedback has shown to be a promising tool for the treatment of anxiety; however, several theoretical as well as practical limitations have prevented widespread adaptation until now. With current technological advances and the increasing interest in the use of self-monitoring technology to improve mental health, we argue that this is an ideal time to launch a new wave of biofeedback training. In this viewpoint paper, we reflect on the current state of biofeedback training, including the more traditional techniques and mechanisms that have been thought to explain the effectiveness of biofeedback such as the integration of operant learning and meditation techniques, and the changes in interoceptive awareness and physiology. Subsequently, we propose an integrative model that includes a set of cognitive appraisals as potential determinants of adaptive trajectories within biofeedback training such as growth mindset, self-efficacy, locus of control, and threat-challenge appraisals. Finally, we present a set of detailed guidelines based on the integration of our model with the mechanics and mechanisms offered by emerging interactive technology to encourage a new phase of research and implementation using biofeedback. There is a great deal of promise for future biofeedback interventions that harness the power of wearables and video games, and that adopt a user-centered approach to help people regulate their anxiety in a way that feels engaging, personal, and meaningful.
View Full Paper →A game-based neurofeedback training system to enhance cognitive performance in healthy elderly subjects and in patients with amnestic mild cognitive impairment
Introduction: This study examines the clinical efficacy of a game-based neurofeedback training (NFT) system to enhance cognitive performance in patients with amnestic mild cognitive impairment (aMCI) and healthy elderly subjects. The NFT system includes five games designed to improve attention span and cognitive performance. The system estimates attention levels by investigating the power spectrum of Beta and Alpha bands. Methods: We recruited 65 women with aMCI and 54 healthy elderly women. All participants were treated with care as usual (CAU); 58 were treated with CAU + NFT (20 sessions of 30 minutes each, 2-3 sessions per week), 36 with CAU + exergame-based training, while 25 patients had only CAU. Cognitive functions were assessed using the Cambridge Neuropsychological Test Automated Battery both before and after treatment. Results: NFT significantly improved rapid visual processing and spatial working memory (SWM), including strategy, when compared with exergame training and no active treatment. aMCI was characterized by impairments in SWM (including strategy), pattern recognition memory, and delayed matching to samples. Conclusion: In conclusion, treatment with NFT improves sustained attention and SWM. Nevertheless, NFT had no significant effect on pattern recognition memory and short-term visual memory, which are the other hallmarks of aMCI. The NFT system used here may selectively improve sustained attention, strategy, and executive functions, but not other cognitive impairments, which characterize aMCI in women.
View Full Paper →Feasibility of Using Tetrax Biofeedback Video Games for Balance Training in Patients With Chronic Hemiplegic Stroke
BACKGROUND: Decreased weight bearing on the affected lower limb and poor weight shifting are common after a stroke occurs. The Tetrax biofeedback system is a center-of-pressure controlled video game system designed for patients with balance deficits. Although it is a commercial product, information about its clinical use for patients affected by stroke is limited. OBJECTIVE: To investigate the feasibility and potential efficacy of the Tetrax biofeedback system for balance training in patients with chronic stroke. DESIGN: Feasibility study. SETTING: Rehabilitation department of a medical center. PARTICIPANTS: Participants who had sustained a hemiplegic stroke at least 6 months prior to enrollment but were still able to stand independently for more than 5 minutes. METHODS: Participants were randomly assigned to an intervention group (IG) or control group (CG). All participants received conventional rehabilitation training. The IG also received 20 minutes of exposure to Tetrax biofeedback games controlled by change in center of pressure 3 times a week for 6 weeks. MAIN OUTCOME MEASUREMENTS: The primary outcome was feasibility, addressed by adherence, safety, and satisfaction. The secondary outcome was efficacy, which was evaluated by the subtests of physiological profile assessment, posturography, Timed Up and Go, and Forward Reach tests. We used percentage change (post-training score - pretraining score/pretraining score) to quantify the intervention effects. Mann-Whitney U tests were used to analyze differences in percentage of change between groups. RESULTS: A total of 14 participants were assigned to the IG, and 13 were assigned to the CG; 12 participants in the IG and 11 in the CG completed the study. In the IG group, those who completed the 6-week intervention attended 89.5% of planned sessions. No major adverse events or falls occurred within the intervention sessions. With use of 5-point Likert scales, participants rated their enjoyment of Tetrax games as 4.33 ± 0.78, their motivation as 4.17 ± 1.03, and perceived helpfulness as 4.25 ± 0.97. The IG demonstrated a significantly greater improvement in reaction time (P = .002), proprioception (P < .001), symmetric weight bearing (P = .027), Timed Up and Go (P < .001), and Forward Reach (P < .001) compared with the CG. CONCLUSIONS: Using Tetrax biofeedback video games for balance training is a feasible adjunctive program that may augment conventional therapy in persons affected by chronic hemiplegic stroke. LEVEL OF EVIDENCE: II.
View Full Paper →Video Games for Neuro-Cognitive Optimization
Sophisticated video games that integrate engaging cognitive training with real-time biosensing and neurostimulation have the potential to optimize cognitive performance in health and disease. We argue that technology development must be paired with rigorous scientific validation and discuss academic and industry opportunities in this field.
View Full Paper →Neurofeedback in adolescents and adults with attention deficit hyperactivity disorder
Abstract Neurofeedback is being utilized more commonly today in treating individuals who have attention deficit hyperactivity disorder (ADHD). Neurofeedback, which is based on theories that recognize the organic basis of ADHD, utilizes biofeedback to guide individuals to regulate their brain activity. Neurofeedback relies on research that has demonstrated that most individuals who have ADHD, as compared to matched peers, have excess slow wave activity and reduced fast wave activity. It provides immediate feedback to the individual about his or her brain wave activity in the form of a video game, whose action is influenced by the individual's meeting predetermined thresholds of brain activity. Over several sessions of using the video and auditory feedback, individuals reduce their slow wave activity and/or increase their fast wave activity. Individuals who complete a course of training sessions often show reduced primary ADHD symptoms. Research has shown that neurofeedback outcomes compare favorably to those of stimulant medication. © 2005 Wiley Periodicals, Inc. J Clin Psychol/In Session 61: 621–625, 2005.
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