Results and analysis of initial experiments
Contents
1. e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 problems Maybe add something about the visibility of the users going out of Kinect vision or other persons interfering Sometimes even though the calibration is done and the person has not moved from that position the stimuli appear outside this range and the subject cannot reach them 7 Menu navigation a Does the users understand how to navigate in the system selecting menu items etc using the defined gestures Since instructions are in English we had to keep explaining instructions to the users during the test It is difficult for older people to understand the menu control system This is also very sensitive so it is complex for them to select the menu topic they want and then select it with the other hand They often select a section different from the desired one b Is it sufficiently intuitive In our opinion it is not intuitive enough And as mentioned before it is hard to make the correct selection on the desired section Maybe you could design each section of the menu as if it were a kind of button you could select with the gesture of press Thus perhaps be more intuitive and does not require the use of both hands 8 The initial prototype provides some basic animations on how to interact with the menus a To what extent is this sufficient for the users In most cases using anim2. AAL Joint Programme game up Game based mobility training and motivation of ae senior citizens AAL 2011 4 090 GAMEUP PROJECT DOCUMENT 6 gameup Results and analysis of initial experiments Category Deliverable Public Reference D4 1 Version 1 1 Date 30 November 2013 Responsible O berri Participants IBERNEX USE KLINIKEN VALENS NORUT CYBERLAB DIAKONI O BERRI Related to WP4 Piloting and Evaluation T4 1 Initial experiments AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 DOCUMENT CHANGES REGISTRY Ver Rev Date Author s Comments 0 01 June Roberto Nu o Carolina First initial version Rodriguez Peter Oesch Ellen Brox 1 30 September Roberto Nufio Carolina Final version Rodriguez Peter Oesch Ellen Brox 1 1 30 November Roberto Nu o Carolina Updated version Some test Rodriguez Peter Oesch performed in November have Ellen Brox been included Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 ii of 55 e AAL Joint Programme gamelp Game based mobility training and motivation of senior citizens AAL 2011 4 090 TABLE OF CONTENTS Results and analysis of initial experiments ccssssceccssssceccssssceccesssseccesssssscecssssesenses i DOCUMENT CHANGES REGISTRY cccsssssecccsssseccnssseccenssssccecssssccacssseccacsssssce
3. cccccsccccsssseeeceesteeeceeseeeeseaaes 24 7 2 4 Notes to be taken by the expert during testing ccccesssceceeeeessessnaees 27 7 3 TROMS YUN D ioen cetee pae aaae e aee AEE E AEREE EEE 29 7 3 1 Test method USCC ccc icsscece coevccceucvcedstenveustesvstedeceutece EANAN EROSSA ARANE NE AKKA 30 7 3 2 Results from the scientists test of the user interface cceseeesseceeeeees 31 7 3 3 Results from the user testing exercises cccececssececsssteeeceeneeeesenaeeeeseaaes 33 Analisys Of the results ccicccccsiccsctcsiccccccvciccsdcaccacsssviccasssntcecscseccccedsnscacssaveccacdantcatss 38 8 1 Participants rece sicccciesacindesentslcasiens techies easar ea re ra Eep N ERRA 38 8 2 THE TOGHiNOlO BY lt occezsssfecaccacecsessnsea0 atecsiezaancegacdoceagiesastaiebact od caseaincegectadecgesaancese 38 8 3 TRG main MENU ieeccaissSecs snsscesavassdedeaYonstcesiisterseassevtacasseeleaseteavalsieceanssersoaasecees 39 8 4 SWIPE sereia e e eee a los Mice aE e e ea aeea a e E R 39 8 5 JASEFUCTI ONS iaaea A EA E A E EEEE EEEa E R 40 8 6 EXETCI SES iieiea gnen aee deiae e aE iaa aa a aE E ean 40 8 7 USEFS O PIMON tiscscics teeces x iienaa inae Eaa eE ER Ea E aE 41 Conclusions regarding the first prototype cccccsssssccccsssececcssssceceesssceseessseees 42 The apple picking BaMewieseccisseecicsisesvccdssssvccescesvesssssavecesssavestecsaveseecoavesssscavessecoxs 43 10L THEU SES curea E AE A SA E T AAE R 43 10 2 First test May 2013ean
4. 7 3 2 Results from the scientists test of the user interface 13264 The screen There is no full screen choice so the application window is too small Elements text progress bar the stick man etc are too small and do not utilize the full screen space Ficiek Swipe You must be able to use either hands for commands The swipe movement is very difficult it sometimes gets harder than the exercises One has to swipe too often All the swipes and the difficulties to make them work make people give up the exercise program 7 3 2 3 The main menu The menu works fine with mouse and keyboard but not with Kinect it is too challenging to hold one arm still while swiping with the other The arm that is supposed to be kept still will frequently move a bit during the swipe movement and a wrong item is chosen The menu items are too close and there are too many options in this preliminary menu 7 3 2 4 Exercises Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 31 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 e There is no red ball one can grab when starting an exercise so the second swipe can be replaced by a pose e There should be an animation or film to show where to stand and how to perform the exercises e We miss a name on the exercises one that the senior users w
5. Evaluates the exercises as helpful USER_5 Navigation is unclear needs everything explained by the Supervisor Step by Step User can t imagine to do these on its own Mentions I m not a computerfreak and adds that after 2 to 3 Months it would maybe work better Evaluates the exercises as helpful USER_7 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 13 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 User has some difficulties to understand the task doesn t know something like that Navigation unclear Exhausting because of concentration more than exercising 7 1 2 4 Transition user USER_6 Navigation is difficult needs additional instructions of the supervisor Not at all interested in computers Can t imagine to do something like this at home Exhausting to the user also because of concentration Cannot read the letters on the screen USER_12 Doesn t like computers Navigation unclear for the user Cannot imagine to do something like this at home Hard for the body but also for concentration 7 1 2 5 Frail user USER_4 Standing is unsafe patient is too weak therefore all exercises including strength and range of motion are performed in sitting but the exercises look a little bit different Navigation is possible from t
6. C2 Sit to stand C3 Standing reaching exercise C4 Standing walking This release will include a basic menu system for interaction with the system and selection of exercises All exercises will include examples of how increased difficulty motoric level can be implemented There will be no games in this release Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 3 of 55 e AAL Joint Programme game up Game based mobility training and motivation of tees senior citizens AAL 2011 4 090 3 Elderly users 3 1 Inclusion and exclusion criteria The following inclusion criteria were established see also D2 1 Inclusion criteria e Age 65 years e One or more of the following Previous history of falls or in risk of falling Recent illness or surgery e Impaired strength or balance Exclusion criteria e Cognitive impairment defined as a Mini Mental State Examination score lt 26 e Other disease illness or limiting condition that would make inclusion and beneficial use of the system difficult e g complete blindness or deafness or severe disabilities 3 2 Numbers of tests needed Most major problems can be uncovered in a test with 4 to 6 participants and additional participants are less and less likely to produce new information Dumas amp Redish 1999 Nielsen 2000 There might be different problems within Spain Norw
7. 2013 D4 1 1 1 51 of 55
8. E a 43 10 3 Second test September 2013 00 cccscccccssscecsesnececsecneeecseqeeecseqeeeesseqaeeeeseeaes 45 10 4 Later trials sccccevssscccuvacescessasncecevsnccecevatscccussviac inaina cevuusie cersiac ccuunliacess icde 46 The Walking BaMe wscscicssscsciscecesescsstsvvesestesvassccesedaseceuvicesdeveeaescosvesseseueseseceavinsecoxs 47 11 1 ThE USPS i esccccavccsccduvensscdvasnccecavsuncccusavccccuaveccdeussvscecensvaddcusuacecesvbsscdessnccccesshebee 47 11 2 The trial csvssecccavecscccuvsecectuastecectvsnccc cas avec cunsecscdussbiceGessecccasuecce cesvviecduavaccccdassiiee 47 11 2 1 NOPWAY iiss ncssacbsccsvanseces ssdesacevadecucs saduiees vanestes raa aE aai aia iraia 47 11 2 2 Switzerland eecdecsesecsccceasiaecdessadecedensdecodessacedevsaiecdeass cccevatt raa 48 113 RESULTS ve enoni E ANEN AAEE 49 T1232 Tr oT 1 A A A TA EE T AE EAE EEA T AE N AEN ee 49 1L 2 GWe eo A AA AO EEEE AORA 49 11 4 Discussion and conclusion ccceceessececeesneeeceenaeeeeseaueceeseueeeeseaeeecsenaeeeeseaaes 50 a a a a RER 0 1 A Aa AEE en ee ee 50 ILA SWITZED ANG ee e E E O T AA E E OERE 50 Referenc s ccesssiscessisccssesssiscsssssicesssssiacessssicnsssssiacsesastensssssiacenssseceenssssaesedsssensesses 51 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 iv of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizen
9. any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 7 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 6 Questions during initial testing of prototype 1 Specific questions to be addressed during this first initial test period 6 1 Technical issues e Any specific issues or problems during installation of the exergame sw This could be related to download operations during installation specific issues related to local PC etc e Any specific problems related to the location and conditions where the system is used This could e g be lighting conditions interference type colour of clothes worn by the users etc e Any specific problems related to the location height above the floor of the Kinect sensor Some exercises are probably better recognized when the Kinect sensor is not located too high e g for exercise B3 Hip extension We expect that in most cases the sensor should be located just below the TV monitor e Any specific problems related to the distance from the Kinect sensor to the user e Any specific problems related to the performance that could e g be due to limitation of the computer CPU graphics card etc 6 2 Operation of the system user interaction e The user must be located within a specific area in front of the Kinect in order to operate the system To what extent does this cause a
10. detect and the user should preferably sit straight towards the camera e To what extend does this cause problems for the users e Suggested ways of avoiding potential problems e The first prototype has implemented various motoric level difficulty levels for the individual exercises e How would you consider each of the levels for each individual exercise Too easy hard Too fast slow progress e Were there any interventions of the supervisor to prevent a fall required If so describe when it happened 6 4 Notes to be taken by the expert during testing In order to get as much valuable feedback as possible the expert supervisor takes note of the following during the testing An overview picture of the test location indicating location of monitor Kinect and user Location of the Kinect Approx height above the floor of the Kinect sensor Distance from Kinect to the user Specification of PC running the system Type of chair support used for the strength exercise B3 Hip extensions and B4 standing leg abduction preferably also include a picture of the chair support Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 10 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 7 RESULTS 7 1 VALENS One physiotherapist tested initially all exercises twice with a spec
11. explaining how it worked and how we planned to perform the experiment They were also shown the applications for showing results and we discussed common goals for our group We only had three Fitbits and even if many users have a PC at home we would have to visit all at home to install the program to enable them to read results daily Reading results also requires to be connected to internet since the server currently is in Spain It was decided that three and three users would take a Fitbit and a charger home and then the results from the whole periode would be read after Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 47 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 two weeks Each participant received an individual oral information and demonstration of the Fitbit and charger as well as an instructive user manual in Norwegian particularly designed for the users A total of ten persons tried the Fitbit but one is too young to have the results included The first three had the step counter from 22 03 05 04 2013 the next three from 04 04 19 04 and then three from 19 04 03 05 The last person had it from 03 05 and for four weeks since the Friday after two weeks was the Norwegian national day After two weeks at the next meeting the three who had had the step counters wer
12. need to move the chair backwards to get the last apple Strength Leg Abduction LEVEL 1 Avatar is not exactly mirroring the user Difficult to reach the apple with left leg Easier with right leg Avatar is not exactly mirroring the user Difficult to reach the apple with left leg Easier with right leg LEVEL 2 Ditto LEVEL 3 Ditto LEVEL 4 Ditto C1 Sitting Reaching LEVEL 1 OK LEVEL 2 OK LEVEL 3 OK LEVEL 4 OK C2 Sitting Standing LEVEL 1 More a strength than a balance exercise Unclear what the task is Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 18 of 55 AAL Joint Programme game up Game based mobility training and motivation of ati senior citizens AAL 2011 4 090 red square on the screen appears without previous explanation LEVEL 2 Ditto LEVEL 3 Ditto LEVEL 4 Ditto C3 Standing Reaching LEVEL 1 Too easy LEVEL 2 User cannot feel a difference compared to Level 1 LEVEL 3 Too many apples on the ground much more difficult compared to L1 and L2 Difficulties to get the apples from the ground but possible LEVEL 4 Pick red and green apple after each other difficult to face the camera and pick the apples C4 Standing Walking LEVEL 1 Introduction in relation to the target area unclear Exercises with a chair unclear where to put the chair Unclear if need to put two feet on the Platform LEVEL 2 Somet
13. see when one stands sideways to the camera The figures get strange Difficult to perform the exercises Technical problems Ending up in menu otherwise not Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 36 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 Proposal to improvements Have to find something to replace the swipe that is what they spent most time doing Must be able to choose which arm to use in all commands Need text in Norwegian written and spoken Difficult to see the figures when standing sideways possible to do something about it Would be nice with info about where to stand on the floor Some of the commercial games have this There is plenty of room in the room so it is easy to end up too far away or to the side It should be marked where people have to stand The exercises should not be too accurate it gets too difficult and frustrating The application is too sensitive on distance we had to move the audience quite a bit further back compared to the commercial games about 1 5 meters further back Unnecessary with two swipes The users say that they wish to be able to walk too stand on the legs and use them They like games from the Kinect adventure because they can use the entire body hands out u
14. what extend does this cause problems for the users This exercise has generated difficulties very often Many times although the person lifts the leg the object is not selected other times however it is We have not been able to find a way to solve the problem therefore some users have been able to do the exercise and in other cases we had to skip it b Suggested ways of avoiding potential problems Maybe you could design the exercise in order to be performed while the person is in a lateral position that is to say not facing the camera but turned to the side 16 The first prototype has implemented various motoric levels difficulty levels for the individual exercises a How would you consider each of the levels for each individual exercise Too easy hard Too fast slow progress The different ways to adjust the exercises to each person are sufficient allowing adaptation to individual needs Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 26 of 55 AAL Joint Programme AL gt L 8 cae game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 17 Were any interventions of the supervisor to prevent a fall required If so describe when it happened No 7 2 4 Notes to be taken by the expert during testing In order to get as much valuable feedback as possible the expert supervisor ta
15. 11 4 2 Switzerland The majority of the patients referred for rehabilitation to the clinic Valens perceived at least some benefit and no relevant barriers by using a step counter The additions of a step counter to the conventional rehabilitation regime may lead to increased daily walking distances Further research is needed to assess effectiveness of a step counter in decreased long term mobility disability Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 50 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 12 References Berg K O Wood Dauphinee S L Williams J l amp Maki B 1992 Measuring balance in the elderly validation of an instrument Can J Public Health 83 Suppl 2 S7 11 Dumas JS amp Redish JC 1999 A Practical Guide to Usability Testing Exeter Intellect Books Nielsen J 2000 Why You Only Need to Test with 5 Users Retrieved 20 12 2012 from http www useit com alertbox 20000319 html Tinetti M E Inouye S K Gill T M amp Doucette J T 1995 Shared risk factors for falls incontinence and functional dependence Unifying the approach to geriatric syndromes JAMA 273 17 1348 1353 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP
16. Berg Balance Score User groups Balance exercises prototype 1 0 38 Frail C1 Sitting reaching 39 44 Transition C2 Sit to stand 45 55 Active c3 Standing reaching gt 56 Very active C4 Standing walking Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 6 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 5 Ethical issues 5 1 Informed consent Before commencement of the testing all participants will be asked to give informed consent The format of the informed consent will depend on local requirements A written informed consent is preferred 5 2 Safety The most obvious risk of GameUp used in elderly persons is that a fall occurs A fall is defined as an event which results in a person coming to rest unintentionally on the ground or lower level not as a result of a major intrinsic event such as a stroke or overwhelming hazard Tinetti Inouye Gill amp Doucette 1995 To minimise the risk of falling balance exercises must be chosen according to the User group the elderly person belongs to In addition supervisors will observe elderly user during the whole user trial to prevent any falls Every intervention of the supervisor within the user trials to prevent a fall will be recorded Confidential document It s forbidden to make
17. and the testing became boring because more time was spent on trying to continue swipe than to play e Some seniors feel exhausting because of concentration more than exercising e Users were complained about the small letters e Some users say that they wish to be able to walk too stand on the legs and use them They like games from the Kinect adventure because they can use the entire body hands out use the legs etc Kick bubbles seal holes in an aquarium etc Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 41 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 9 Conclusions regarding the first prototype e GameUp idea and Exercises are appreciated e Considerable navigation and calibration problems e Instructions on screen are difficult to read and difficult to understand e Difficult to select menu and to swipe e Frequent problems with use of chair during standing exercises e Sitting Standing exercises more strength then balance demands e Holding times during strength exercises are too long e Spawn interval is too long Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 42 of 55 AAL Joint Programme game up Game based mobility training and motivatio
18. ations is not enough and the professional has to make a demonstration of how to work with the menu 9 The initial prototype provides an initial calibration mode for automatically measuring the height and other critical body measurements of the users In the final version these data will be stored for each individual user For the time being this process must be repeated each session a To what extent is this process intuitive It is intuitive enough Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 23 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 b To what extent does it seems like this automated procedure provides the necessary results for the individual tailoring of the exercises 7 2 3 Exercises from a specialist point of view 10 Kinect implementation of exercises a Overall to what extent is the Kinect system suitable for implementing exergames based on the proposed exercises in area A B and C The Kinect seems appropriate to implement the exercises however there are some difficulties such as the fact that in some cases the movement of the person gets outside the range of the Kinect making it impossible to perform the task e g standing walking exercise sometimes apples appear out of range that is when the person moves in order to reach t
19. ay and Switzerland as well as within the four different user groups frail transient active and very active elderly It is therefore planned to have 4 6 tests per user group adding to 16 20 tests within each country Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 4 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 4 Procedure of the initial experiments 4 1 1 Test flow The initial experiments with prototype 1 should proceed according to the below provided flow chart 1000 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 5 of 55 gameup 4 1 2 AAL Joint Programme senior citizens Game based mobility training and motivation of Selection of appropriate exercises AAL 2011 4 090 Balance exercises C1 C4 available in prototype 1 should be chosen according to the user groups see table 1 The user group is defined by the Berg Balance Test Berg et al 1992 Rational is explained in D2 1 The strength and range of movement exercises may be used in all user groups It is recommended to begin testing on level 1 If the elderly user is competent on a level he she may progress to the next level Table 1 User groups and balance exercises
20. by green either a tree or grass This leaves little room for users to see the apples while they fall The crown of the tree must be moved up and the grass must take less space from the bottom Most players found that the apples fell too fast it was too hard to catch 1 Results from a younger participant has been left out of the results Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 43 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 them When this is combined with a small area where the apples are visible the game gets too hard to play for most of our users The gameplay took so long that players exchanged in the middle of a game The red apple on the sign beside the red apple basket is impossible to see for most the contrast must be bigger Also the sign should not be in front of the stem since it is very hard to see and some complained about a too massive stem on the tree The apples themselves are also very small Figure 8 The first version of the apple picking game There were also some clouds that moved across the sky Some interpreted this as birds and asked us to remove the disturbing animals they just took the attention away from the task The baskets where the apples must be dropped were on the ground It is not necessary to bend down to get rid of the app
21. calibrate for sitting positions couldn t recognize a difference 7 1 2 2 Very active user USER_1 Introduction difficult to read small letters Difficult to start user needs additional information of the supervisor Body measurement user doesn t realize that he can do the movements directly User thinks introduction is already the exercise Swiping doesn t work at the beginning Difficult to the user to select items User thinks GameUp is doable Size and color of the letters maybe better black than white The avatar seems restless to the user Unclear where the chair needs to be placed USER_2 The user doesn t understand how to navigate the system without extra explanations of the supervisor it doesn t seem sufficiently intuitive to the user The basic animations for the exercises are sufficient for the user At the beginning unclear that he has to swipe two times until the exercise starts Calibration can only be done with explanations of the supervisor User believes that this project could be very helpful for selftraining The letters on the screen should be bigger are not readable Red square which is getting white unclear to the user what that means User doesn t notice the informations in the right corner of the screen Difficult to exercise and watch the screen especially with torso rotation and apple picking on the floor USER_10 User thinks navigation is clear good Idea Hip extension H
22. cases the sensor should be located just below the TV monitor No problem with this It was not possible to use the TV monitor since this had no input to connect the computer The tests were performed with a computer screen 4 Any specific problems related to the distance from the Kinect sensor to the user The required distance from the sensor to the user is quite large When testing this is not a problem since the room is large enough to do so However it could be a problem when using the program in different homes or centers 5 Any specific problems related to the performance that could e g be due to limitation of the computer CPU graphics card etc As commented in the Exergame manual for initial experiments sometimes there were problems when it came to execute the exercises the program would lock down and close We couldn t identify a specific cause or situations in which happen repeatedly Sometimes the figure that appeared on the screen was shaking or appeared without legs or with crooked arms etc We don t know whether these are due to a limitation in the system features 7 2 2 Operation of the system user interaction 6 The user must be located within a specific area in front of the Kinect in order to operate the system To what extent does this cause any Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 22 of 55
23. cond user trial e The spawn interval even if this is set to O on all exercises it takes too long to wait for the next exercise e Red square which is getting white unclear to the user what that means e It is not easy to understand when to change from left to right arm and that a new swipe is required to continue Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 40 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 e Frequent problems with use of chair during standing ROM amp strength exercises e Difficult to exercise and watch the screen especially with torso rotation and apple picking on the floor e Weare not warned when we are too close or too far away e Some exercise movement lead out to the main menu 8 7 Users opinion e Most participants enjoyed doing the exercises and think that this program can be beneficial for them e Some users likes the idea of this game could imagine to practice something like this at home but others think it s too difficult to do at home by himself e The seniors liked the exercises that they managed to perform but not those that they did not manage e They liked the red apple it is very visible and easy to understand that they shall reach for it e The swipe movement to start exercises was very difficult
24. csssseeeees ii TABLE OF CONTENTS iecessccccssssccdesssecsasestaccecsasecesudassvsceasshesnusssaccowastsssouassd S ESIN S Aesi iii 1 IMTFOGUCTION wisccsccicerecccsssendens ceseccbssexnccoad secc onde IETA I AOO E 1 1 1 Aim initial experiments prototype 1 cccccccccccssssssseceeececessssssseeeeeessessesssaeens 1 1 2 The apple picking game trials in a user centric game deSIgN c0cee 1 1 3 The Walkie Sainte sinisiin aeaee canes sete aae a aeaea E 2 2 Content Of prototype 1 c65 cccsessscccsesteccswessaccouesseccctedseccdvessasssceasaccouessassoveseecsouas 3 3 Elderly USCIS siscciisssccccesscsccccessacsccsssscccsessncicesssscccesssscccasssscccasssscccasssscccasesscdeassssccss 4 3 1 InclUSION ANd EXCIUSION Criteria cccccccesssssssecececeeessesseaeceeeceseesesteaeeeeeeeseeses 4 3 2 Numbers of tests NEG arseenin esenee leibouseeeie adelesveeszes castes sass oGeeeets 4 4 Procedure of the initial experiments cccccssscccecssssececcssseceecesseeessesseeeseesseeees 5 ArI TESTOW Sie scchbeceeet ssc EE E EE eaves 5 4 1 2 Selection of appropriate CxerciSes scissioni ierse nainn 6 5 Ethical iSSUCS citcssscsticessssicccesscactcetscscccsssscecessssaccccessaszsesssasecssssassessssascesessacacessesdees 7 5 1 informed CONSENT issezccsseckacdessaestasccececteasaertasteatachesvadatastcstecteastancadeestechessaentese 7 5 2 Safety eea eE e a e e a e a E S 7 6 Questions during initial testing of prototype 1 ssssessssssssesse
25. d there is a sound for apples falling in the basked to notify the players that they have managed to get rid of an apple There is also a positive feedback when the game is over The start menu is changed so now there are four big buttons The final colour scheme will be decided after we have finalised the colours tests Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 46 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 11 The walking game 11 1 The users 11 1 1 Norway Ten Norwegian users participated in first trials of the walking game application using the fitbit step counter without having seen this during the development phase 11 1 2 Switzerland A primary rehabilitation goal in older people with mobility problems is to expand their walking distance Previous studies have shown that the motivation to walk can be increased through the use of a step counter Compared to Japan and the United States the pedometer is in Switzerland an underused motivational device A pilot study was performed with the objective to investigate whether elderly patients with mobility problems perceive a personal benefit in the use of a step counter 11 2 The trial 11 2 1 Norway The users were introduced to the walking app in March 2013 They first got a common introduction to the system
26. e taken aside First the results were imported and then users could use the walking game application early version running on computer to look at the results and also remember what they had done on certain days particularly those days with either much or little activity and then they were interviewed about the usage of the step counter At last they filled in a System Usability questionnaire about the application Three new users were given instructions and took over the step counters When all participants were gathered in front of the screen to play exergames the common achievements towards the goal where shown to all also those who had not had a step counter The common goals in Norway were to walk to a village 70 km away as well as climbing a 1238 m high mountain just behind the church The total achievements where increased for every person It was not possible to see the individual achievements in the common results but everybody knew that they contributed with whatever they had managed of steps and stairs 11 2 2 Switzerland Persons older than 65 years with mobility problems due to various causes referred between July and September 2013 for rehabilitation to the clinic Valens with a minim mental status gt 24 were equipped for three full days with a fitbit step counter Daily steps were counted and a questionnaire based on the technology acceptance model TAM 3a was used inferring patients opinion about the perceived benefit a
27. en using the program in different homes or centers e Sometimes the figure that appeared on the screen was shaking or appeared without legs or with crooked arms etc This happened frequently when lightning conditions changed i e sun came up or other people came into view of Kinect e Very often the program locked down and closed So the person had to start it again e Interferences during the exercises when someone stands behind 8 3 The main menu e Letters on the screen are hardly readable e In some cases the professional has to make a demonstration of how to work with the menu e The menu works fine with mouse and keyboard but not with Kinect it is too challenging to hold one arm still while swiping with the other e The arm that is supposed to be kept still will frequently move a bit during the swipe movement and a wrong item is chosen e The menu items are too close and there are too many options in this preliminary menu 8 4 Swipe e You must be able to use either hands for commands Several of the users can only use one arm and one who cannot use the left could not swipe at all e The swipe movement is very difficult it sometimes gets harder than the exercises e One has to swipe too often e All the swipes and the difficulties to make them work make people give up the exercise program Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP co
28. essoosssssssessoosssssssese 8 6 1 Technical ISSUES ernis nares anake aain ee aeee aidaa ENa Ee aiea R eiS 8 6 2 Operation of the system user interaction cccccecsecsecstecsseceecseceeeseeees 8 6 3 Exercises from a specialist point of view cccccccessssssceceeeceseesenseaeeeeeessessees 9 6 4 Notes to be taken by the expert during testing c c ccccccsssssssseceseeeseesees 10 7 RESULTS sis ssscsscccsssseciissssscccsssevedcassevsccedesv cdsesssscceesives ca ssavceassssdessasssscccsassves sassends 11 7 1 VALEN Ser a EAAS EAA REA EAA AET EANA 11 7 11 Technical iSSUESee senenn reee E eae e aeea Eeee EN ERENER EA 11 7 1 2 Operation of the system user interaction cccscccsseceseeesteeeesseeesseeees 11 7 1 3 Exercises from a supervisior point Of ViOW c cccccccssssssssceeeessessessaeees 15 7 1 4 Notes to be taken by the expert during testing c csesssceceeeeesssssaeees 20 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 iii of 55 10 11 12 e AAL Joint Programme gamelp Game based mobility training and motivation of senior citizens AAL 2011 4 090 7 2 OFBERR I carior desta cavecst EE E A 21 laal Technical ISSUES russii sii ressa EARRA EEA RANES 21 7 2 2 Operation of the system user interaction cccscsecsseceseeesseeeessecesseeees 22 7 2 3 Exercises from a specialist point Of ViCW
29. est 7 3 TROMS YUND The tests in Norway are organised in a different manner than in Switzerland and Spain since the recruitment is very different The user partner is a congregation that has regular arrangements for seniors They have two well established bi weekly gatherings for seniors and created a new one for this project called the exercise gathering This group meets every second Friday 11 00 14 00 They normally first have a light lunch together and then they play commercial Kinect games or participate in GameUp trials if there is anything to test All the participants know that they are participating in a research project and have signed an informed consent They are eager to try out whatever is developed in the project and give feedback The users are now experienced Kinect players so they can give valuable feedback on for instance the user interface They all enjoy the gatherings because it both is a social event and it gives an opportunity to exercise There are no health care personnel present and the seniors are considered to be users visitors and not patients Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 29 05 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 Figure 6 At the exercise gathering the users are making ready to test the GameUp exercise p
30. ey confused the viewing application with using the step counter at home without access to the application and we think it would have been better not to fill out the two forms in the same session 11 3 2 Switzerland Fourteen consecutive patients 9m 6f with a mean age of 72 4 years 6 years fulfilled the inclusion criteria One patient was unable to use the step counter The median number of steps per day was 15931 min 6106 max 16396 Of the thirteen remaining patients 9 found at least some benefit and 4 found no benefit walking more steps per day 2 patients felt very capable 6 capable 4 partly capable and 1 restricted to use the step counter Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 49 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 11 4 Discussion and conclusion 11 4 1 Norway Most of the users in Norway enjoy walking but are not able to walk outdoors for large parts of the year due to snow and ice Use of a step counter was considered motivational and our impression was that it was particularly motivational that others knew that they were walking Setting group goals and comparing with other groups was perceived as fun How this will work in the long run is another question since some found it a bit stressful to remember the step counter every morning
31. fidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 32 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 All exercises were tested several times also using the user manual on how to perform the exercises We also tried to make the system crash by performing mistakes on purpose The conclusion is that all exercises are playable and that there are not many bugs All exercises are in fact fun to do and with some improvements they can function as exergames Details about some of the exercises Exercise A3 here one can take the ball aslant but get less points then A spawn interval of 0 does not work on this exercise There is not much effect in changing the exercise parameters We tried to fine tune A2 and B3 but did not see any effects A2 and B3 are too difficult on level 1 one has to lift too high 7 3 4 Results from the user testing exercises The seniors liked the exercises that they managed to perform but not those that they did not manage They liked the red apple it is very visible and easy to understand that they shall reach for it The swipe movement to start exercises was very difficult and the testing became boring because more time was spent on trying to continue swipe than to play The fact that we only had 4 repetitions of each exercise contributed to this The
32. give problems although the employed chair has an open back Some users are placed behind the chair and exercises are not done correctly so you have to explain them to stand on the side b Suggested ways of avoiding potential problems Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 25 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 First instructions show the image of a person standing at the front and on one side that is why so many users do not know whether they should be placed in one or another position There should be more specific and clear instructions explaining that they should be standing at one side of the chair and also as discussed above there should be a demo with the stimuli so that users understand clearly how they should be placed in order to do the exercise correctly 14 The range of movement exercise A2 Standing leg raises should also be done while standing beside the chair a To what extend does this cause problems for the users Ditto b Suggested ways of avoiding potential problems Ditto 15 The range of movement exercise A1 knee extension exercise works a little better if you are sitting slightly rotated compared to the camera But this is difficult to detect and the user should preferably sit straight towards the camera a To
33. he very beginning The letters on the screen are not readable Calibration can only be done with explanations of the supervisor Every exercise is possible out of the chair USER_8 User has no problems to navigate Most of the exercises are clear with animation of avatar some additional instructions of the supervisor are needed Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 14 of 55 e AAL Joint Programme game up Game based mobility training and motivation of atl senior citizens AAL 2011 4 090 Believes this is a good thing if it is further developed especially for younger people USER_13 Navigation is quite clear needs some verbal instructions from the supervisor Thinks that the Game is too sensitive to disturbing factors somebody walking into the camera lightning conditions moving a chair User likes the idea of this game could imagine to practice something like this at home USER_14 Difficulties to navigate needs verbal instructions from the supervisior Thinks the exercises are good could imagine to do exercises like these at home 7 1 3 Exercises from a supervisior point of view Overall Kinect seems suitable for performing the recommended exercises During testing of 14 elderly users the following observations were made ROM Knee Extension LEVEL 1 OK LEVEL2 Difficult to reach the apple with left leg easier with
34. hem the Kinect cannot capture this movement and a red coloured stripe appears on the side and top of the screen which indicates that the movement is left out b Any general operational problems or issues Very often the program locked down and closed So the person had to start it again Sometimes the sensor is not sensitive enough to detect the movement of hands that make the screen change so they had to repeat it many times Interferences during the exercises when someone stands behind 11 The individual exercises a For each of the individual exercises to what extent does the system make the users perform the exercise in the way intended by the professionals and described in the specification in D2 1 e A1 Often the exercise cannot be done properly since the stimuli appear as if they were very close to the person making the person bend the knee to do so e A2 is done correctly e A3 and A4 were done successfully although often the program locked down and the person had to get out of the exercises Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 24 of 55 game up Game based mobility training and motivation of AAL Joint Programme senior citizens AAL 2011 4 090 e B1 and B2 is done correctly e B3 and B4 much difficulty when placed correctly and perform the exercises with the right movement e C balance e
35. ial focus on technical issues as well as on the exercises from the professional perspective Following this usability tests were performed with 14 elderly users 4 Frail age median 71 2 Transition age median 70 4 Active age median 77 4 Very active age median 73 7 1 1 Technical issues The system is very sensitive to lighting conditions If these change the Avatar starts to do fast uncoordinated movements often followed by a crash Bright clothes are difficult to see in bright conditions When other people come into view of Kinect the Avatar starts to do fast uncoordinated movements sometimes followed by a crash 7 1 2 Operation of the system user interaction 7 14 2 1 Therapist Letters on the screen are hardly readable Menu navigation is easy to understand but requires practice It happened several times that did choose options instead of exercising the lines are very close assume that elderly users with shoulder problems or tremor will have difficulties with navigation Basic animations are sufficient It would be nice to have a starting picture saying hello Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 11 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 Calibration did work fine was not sure whether do have to re
36. ill understand e It is not easy to understand when to change from left to right arm and that a new swipe is required to continue e f you don t succeed in an exercise it would be nice with a feedback about how it should be done e It should be possible to skip exercises e One should have to go back to the initial pose every time a red ball has been caught otherwise one can catch three in one stretch e Itis possible to perform the sideways exercises facing the camera so the instructions should not show it sideways or at least make it clear that the user should face the camera e The spawn interval even if this is set to O on all exercises it takes too long to wait for the next exercise e The strength exercises often get stuck so that it is impossible to get to the next this happens if the users make a small error or take too long Need feedback to tell what to do e Some bugs missing features e Weare not warned when we are too close or too far away e Some exercise movement lead out to the main menu 7 3 3 Results from scientists test of the exercises We performed several tests on how changes in the configuration file affects the exergame play Many of the parameters are hardcoded in the initial version making the test less successful It is difficult to perform many of the exercises by just following the instructions For many of the exercises it was still difficult to understand what to do and when to do it Con
37. imes are the whole arms of Avatar not visible LEVEL 3 Needs a lot of Space Radius LEVEL 4 Not clear what to do with the green apple Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 19 of 55 AAL Joint Programme AL gt game up Game based mobility training and motivation of main senior citizens AAL 2011 4 090 7 1 4 Notes to be taken by the expert during testing An overview picture of the test location indicating location of monitor Kinect and user Figure1 Location of the Kinect Height approx 100cm Distance from Kinect has to be at least 2 5m and the radius around the user at least 1 5m The space should be free from objects Type of chair support used for the strength exercise B3 Hip extensions and B4 standing leg abduction preferably also include a picture of the chair support Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 20 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 Figure 2 A user trying an exercise in the exercise program 7 2 O BERRI The prototype was tested with 17 users Fragile 5 users Transition 4 users Active 4 users Very active 4 users Users of Fragile and Transition group are people that are in a rehabilitation centre af
38. ip abduction and Squat too hard It is a pity that you can t swipe backwards User could imagine to do a program like this at home Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 12 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 USER_11 Navigation seems clear and practicable to the user The user notices to many defects prefers to have a 1 1 instruction with a supervisor and no computer 7 1 2 3 Active user USER_9 Navigation is almost clear Problems with waving It would be helpful to have a German version and a bigger screen Letters not readable Avatar restless too many moves Strength exercises too long Thinks GameUp is a good idea also to exercise at home USER_3 The letters on the screen should be bigger The user has problems with coordination left right As soon as she takes her left hand for swiping the right hand starts to move as well The basic animations are insufficient for the user She doesn t understand what to do She needs help and verbal instruction from the supervisior doesn t know any english Calibration can only be done with explanations of the supervisior Requires many repetitions until she is capable to navigate The user prefers doing something else than playing computer games Couldn t imagine to do something like this at home
39. kes note of the following during the testing An overview picture of the test location indicating location of monitor Kinect and user Figure3 Location of the Kinect Location of the Kinect Approx height above the floor of the Kinect sensor e The Kinect is placed at the same height as the display approximately five feet from the ground Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 27 of 55 AAL Joint Programme AALO game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 Figure 4 A user trying an exercise in the exercise program Distance from Kinect to the user e 2 3 meters aprox Specification of PC running the system e HP ProBook 6560b Core i5 2450M 2 5 GHz Windows 7 Professional 64 bit 4 GB RAM 320 GB HDD DVD SuperMulti DL 15 6 HD 1366 x 768 HD Intel HD Graphics 3000 3G Type of chair support used for the strength exercise B3 Hip extensions and B4 standing leg abduction preferably also include a picture of the chair support Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 28 of 55 LT AAL Joint Programme pa AL gt game up Game based mobility training and motivation of Lira senior citizens AAL 2011 4 090 Figure 5 Type of chair using during the t
40. les just hold the arm out with the apple over the basket centre but everybody who have tried the game tend to bend down no matter the age The baskets should be higher up to avoid our users from falling Some apples also fall too far away from the users they are impossible to reach Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 44 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 Also the stick person is without head The users do not mind the stick person it is easy to see but they would like it to have a head The users also want the text and voice to be Norwegian and the sound to be so high that they can hear it It was considered positive that new apples do not fall while the users strive to get rid of the last apple picked 10 3 Second test September 2013 In this new version the tree was lifted and the grass took up much less space Also the apples were a bit bigger and they take a bit longer to fall The clouds are removed and the baskets are put on stools to get higher The contrast between the red apple and the sign has also been enhanced with a much lighter sign Apples caught 0 Time 5 s Apples missed 0 Figure 9 The second version of the apple picking game The text is now in Norwegian and most can hear the sound when an apple is caught The
41. les paused reason unclear on the screen User swipes to resume and keeps on exercising Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 16 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens Strength Standing Heel amp Toe Raises LEVEL 1 User has to remain for too long in a position the actual position LEVEL 2 Ditto LEVEL 3 Ditto LEVEL 4 Ditto Strength Semi Squat LEVEL 1 Chair does not fit with the actual position LEVEL 2 Ditto LEVEL 3 Ditto LEVEL 4 Ditto Strength Hip Extension AAL 2011 4 090 Chair does not fit with LEVEL 1 Avatar is not exactly mirroring the user Difficult to reach the apple with left leg Easier with right leg Chair does not fit with the actual position Avatar is moving a lot compared to the user who is quiet LEVEL 2 Avatar is not exactly mirroring the user Difficult to reach the apple with left leg Easier with right leg LEVEL 3 Difficult to reach an apple Direction of the movement seems unclear to the user Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 17 of 55 AAL Joint Programme game up Game based mobility training and motivation of lt a senior citizens AAL 2011 4 090 LEVEL 4 After 9 Apples paused
42. mpossible Time is shown in red line suddenly Foot backwards realised Person 2 Not so easy Too difficult to hit Foot backwards Foot sideways Not so easy Difficult Even if the person reaches the red ball it does not work Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 35 of 55 e AAL Joint Programme gamelp Game based mobility training and motivation of PIPER senior citizens oe Broom up Yes Easy went well Even the 95 year old managed this they liked this exercise Twist the body No Ended up returning to with brook the menu managed after some twisting and trials Knee bend Not sure since Took too long for a Wrong or bad there were too new apple to instruction many problems appear Error Bt they Helped when one took many knee bends of the researchers while waiting came into the camera focus Table 2 This table sums up the results from the user testing How difficult was it to perform the instructions The swiping was considered as very difficult almost impossible Almost nobody managed this and then only after a lot of trials and others showing One of the researchers normally had to step in and do it Several of the users can only use one arm and one who cannot use the left could not swipe at all One has to swipe twice a source of irritation Difficult to
43. n of senior citizens AAL 2011 4 090 10 The apple picking game 10 1 The users The group testing the apple picking game has consisted of approximately 8 10 seniors The number is approximate since there are people who for different reasons discontinue the participation and then new ones are recruited and we have had several trials of new iterations of the game During the first year of the project September 2012 November 2013 a total of 14 persons have signed an informed consent The average age is 81 5 years old ranging from 64 to 951 of these there are 10 women and 4 men Out of these 13 have a mobile phone and 9 have a PC 10 2 First test May 2013 The users were introduced to the first version of the apple picking game on 03 05 2013 All users present tried the first version of the apple picking game This session was a part of user centred design and the methods used was to observe the players as well as have open discussions about the design colours etc We wanted to know whether they found the concept of the game fun and we wanted input on the layout colours etc The main findings were reported back to the developers A part of the session was filmed so that we later could study the results The users found the game fun they wanted to play more and they said that they found it useful for flexibility and reaction speed Still the trial uncovered several issues that had to be changed Most of the screen is taken up
44. nd barriers using a fitbit step counter Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 48 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 11 3 Results 11 3 1 Norway Eight out of nine found it easy to use the step counter they either had it in a pocket or they clipped it onto the bra or waistline of the trousers or skirt The one who found it difficult has a lame arm Two strategies were used for charging Most charged every or almost every night but a couple only charged once during the period Most also found it motivational they liked to have a step counter One person who could not go outside this period due to slippery roads told that instead of using a tray to transport things for the kitchen to the living room she would walk back and forwards many times In the same period one person had the most steps on a day he she was shovelling snow One found it demanding to remember it though and would not like to have it on a daily bases The group goals were very well perceived we could observe that they enjoyed watching new results and they managed to walk the distance several times They also enjoyed looking at the results from a group in Spain consisting of researchers The results from the SUS system usability scale are more uncertain It seems like th
45. nsortium GAMEUP 2013 D4 1 1 1 39 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 8 5 Instructions e Instructions on screen are difficult to read e It is difficult to perform many of the exercises by just following the instructions For many of the exercises it was still difficult to understand what to do and when to do it e Instructions are useful but not enough for most users nor are the exercises Further instructions have to be given to the elderly so that they can understand the exercises e Instructions show the image of a person standing at the front and on one side and that is why so many users do not know whether they should be placed in one or another position 8 6 Exercises e C2 Sitting Standing exercises are more a strength then a balance exercise and was therefore decided to remove on the Valens meeting e Strength exercises B3 hip extension and B4 standing leg abduction were too difficult for the frail group and presented always technical problems because the chair was between the user and the camera These two exergames are therefore removed from the frail exercise program in the next version of the games e Repetition holding times and distance of the targeted apple needs in some exercises adaptations e Holding times during B1 B4 strength exercises are too long especially for frail group this will be investigated further in the se
46. ny problems Maybe add something about the visibility of the users going out of Kinect vision or other persons interfering e Menu navigation e Does the users understand how to navigate in the system selecting menu items etc using the defined gestures e ls it sufficiently intuitive Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 8 of 55 6 3 game up Game based mobility training and motivation of AAL Joint Programme senior citizens AAL 2011 4 090 The initial prototype provides some basic animations on how to interact with the menus To what extent is this sufficient for the users The initial prototype provides an initial calibration mode for automatically measuring the height and other critical body measurements of the users In the final version these data will be stored for each individual user For the time being this process must be repeated each session To what extent is this process intuitive To what extent does it seems like this automated procedure provides the necessary results for the individual tailoring of the exercises Exercises from a specialist point of view Kinect implementation of exercises Overall to what extent is the Kinect system suitable for implementing exergames based on the proposed exercises in area A B and C Any general operational problems or issues The individual exe
47. rcises For each of the individual exercises to what extent does the system make the users perform the exercise in the way intended by the professionals and described in the specification in D2 1 Suggested modifications to the implementation of the exercises The initial prototype provides some basic animations on how to perform the individual exercises To what extent are these helpful and sufficient for the users Are the instructions sufficiently detailed The strength exercise B3 Hip extensions and B4 standing leg abduction should be done while standing beside the chair and not behind it should however possible to stand behind the chair if you have an open type back of chair To what extend does this cause problems for the users Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 9 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 e Suggested ways of avoiding potential problems e The range of movement exercise A2 Standing leg raises should also be done while standing beside the chair e To what extend does this cause problems for the users e Suggested ways of avoiding potential problems e The range of movement exercise A1 knee extension exercise works a little better if you are sitting slightly rotated compared to the camera But this is difficult to
48. right leg LEVEL3 Right OK left long waiting time until an apple appears After 21 apples no more new apples appear LEVEL4 Only with trunk movements possible putting the trunk backwards and swinging the leg up apple is too far up Easier with right then left leg ROM Standing Leg Raises LEVEL 1 Right OK left bad synchronisation Avatar is nervous no more apples Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 15 of 55 game up Game based mobility training and motivation of LEVEL 2 LEVEL 3 LEVEL 4 AAL Joint Programme senior citizens AAL 2011 4 090 appear Chair and Avatar don t fit exactly User touches backrest of chair with hands but screen shows arm in the air Ditto Ditto ROM Arm Extension LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 OK Chair and Avatar don t fit together Avatar doesn t lift the arms symmetrically while user does As soon as the user is lifting his arms it switches to paused confusion with waving ROM Trunk rotation LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 OK When the animation came the user tried to simulate the movement to the computer it felt like swiping Torso rotation possible without broom Right hand is assisting the left hand During exercising 3x paused reason unclear on the screen User swipes to resume and keeps on exercising After two app
49. rogram 7 3 1 Test method used Two ICT researchers at Norut first did a technical testing of the user interface and exercises Feedback was given to Cyberlab since we experienced many crashes and problems We received a new version from Cyberlab with some of the bugs fixed Next two researchers from Norut and one from USE tried both the user interface and the exercises and the feedback is given on this version One of the researchers at Norut also tried all the exercises on all levels to see if they were playable and how it was to go through the entire program After this we were ready to try the exercises at the exercise gathering Ten seniors were present at this gathering and 7 of them tried at least one of the exercises before we were running out of time One user would start on one exercise and then another would take over on the same exercise and start on the next We only tried level one with 4 repetitions of each exercise with the users to be able to test more in a limited time Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 30 of 55 gameup AAL Joint Programme Game based mobility training and motivation of senior citizens AAL 2011 4 090 We did not calibrate the program for each user since they changed so often It was calibrated for one of the female scientist This might have caused some of the problems we had
50. s AAL 2011 4 090 1 Introduction The main part of this document describes the tests and analyses of the intial prototypes of the exercise program and its user interface This covers chapters 2 9 Chapter 10 describes the user centric approach of the development of an apple picking game performed in Norway and chapter 11 describes the test of the first version of the walking app that is utilising a step counter 1 1 Aim initial experiments prototype 1 e The initial testing should address and give advice and preferably conclusive feedback on the following issues e Technical issues installation operation lighting conditions etc e Operation of the system User interaction menu navigation and selection etc e The implementation of the exercises from a specialist point of view movements motoric levels etc e The purpose is to provide as much valuable feedback as possible from this initial testing The feedback will be used by the development team for the further development of the exercises and the games during the development period of GameUp and thus increasing the likelihood of developing successful exergames tailored for the targeted users 1 2 The apple picking game trials in a user centric game design Based on the results from the first user trials of the first prototype an apple picking game was developed The game was developed by deploying a user centric design method and in this document we describe not onl
51. same sound is however heard if new apples appear on the tree and this was confusing The stick man has now got a head Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 45 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 10 persons tried the game this time 2 men and 8 women Two of the persons were new they did not participate in the first trial At first the game was set to catch 10 apples but this took too long for most so we reduced this to 5 after three players Many of the players struggle to get rid of the apples particularly the yellow ones on the left side This can be due to light coming in through big windows One person does not like that new apples appear if the player has not caught enough The users like that the avatar has a head and they do not think that it needs more meat on the bones They find it possible to read the text on top of the screen but not while they are playing Since the play does not go on while they have an apple in the hand they were told that this is when they could look at the text When the game is over the score screen is there immediately without any fanfare or feedback 10 4 Later trials There have been several trials where we have tested small changes in the game For instance the sound when new apples appear has been removed an
52. se the legs etc Kick bubbles seal holes in an aquarium etc Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 37 of 55 AAL Joint Programme game up Game based mobility training and motivation of tees senior citizens AAL 2011 4 090 8 Analisys of the results 8 1 Participants Frail Transition Active Very active TOTAL N N N N N VALENS 4 2 4 4 14 45 O BERRI 5 4 4 4 17 55 TOTAL 9 6 8 8 31 29 19 26 26 100 In Norway 10 people participated in the test but they were not recruited by levels The total number of participants in the test of the prototype 1 was 41 elderly people 8 2 The Technology e The Kinect seems appropriate to implement the exercises however there are some difficulties such as the fact that in some cases the movement of the person gets outside the range of the Kinect making it impossible to perform the task e The required distance from the sensor to the user is quite large When testing this is not a problem since the room is large enough to do so Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 38 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 However it could be a problem wh
53. swipe also led to most exercise for the left swipe arm There were also several exercises that the seniors had problems performing One reason could be the placement on the floor since the camera expects that the users are in a specific position and there was no hint from the program as to where to stand That the program was not calibrated for each user can also have caused problems Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 33 of 55 AAL Joint Programme bere AAL 2011 4 090 Figure 7 Two of the users are trying different exercises in the exercise program Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 gameup AAL Joint Programme Game based mobility training and motivation of senior citizens AAL 2011 4 090 Table 1 The following table sums up the results from the user testing Exercise Ease of Ease of performance Comments understanding Take apple Easy Impossible Apple too far away out to the left Get up and get Suitable Difficult and easy Nice with the read apple balls Stand walk Difficult to Difficult Got outside the understand that scope of the you are supposed camera to stand in the red spot Tip toe hit with Difficult Difficult the head Person 1 Not difficult I
54. ter suffering falls or surgery Users of Active and Very active groups are in the network of integrated social services All tests were conducted at the same location in the rehabilitation center s living room Only 3 of the participants have experience in the use of these kind of technologies 7 2 1 Technical issues 1 Any specific issues or problems during installation of the exergame sw This could be related to download operations during installation specific issues related to local PC etc No Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 21 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 2 Any specific problems related to the location and conditions where the system is used This could e g be lighting conditions interference type colour of clothes worn by the users etc If someone else interferes in the sensor field area problems arise When the sun comes through the window and illuminates the room too much the sensor has some problems to detect movements therefore it is necessary to close the curtains 3 Any specific problems related to the location height above the floor of the Kinect sensor Some exercises are probably better recognized when the Kinect sensor is not located too high e g for exercise B3 Hip extension We expect that in most
55. xercises can be performed correctly b Suggested modifications to the implementation of the exercises 12 The initial prototype provides some basic animations on how to perform the individual exercises a To what extent are these helpful and sufficient for the users Instructions are useful but not enough for most users nor are the exercises Further instructions have to be given to the elderly so that they can understand the exercises b Are the instructions sufficiently detailed In some exercises with current instructions is enough but not in most of them We think that all exercise instructions should have a complete demo on how to perform the exercise the position the subject to be placed should appear as well as the stimuli and how to catch them In some cases like in exercise C1 there is a complete demonstration exercise this should be similar for all exercises It would be great if in addition the instructions were adapted to each level For example one demo when you have to take a stimuli with the hand and one demo when you have to take one stimuli with the hand and other with the foot 13 The strength exercise B3 Hip extensions and B4 standing leg abduction should be done while standing beside the chair and not behind It should however possible to stand behind the chair if you have an open type back of chair a To what extend does this cause problems for the users In general these exercises
56. y the first but also the consecutive couple of trials These trials are only performed in Norway so far The apple picking game is described in D3 2 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 1 of 55 AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 1 3 The walking game A walking app utilising the Fitbit step counter was developed by USE in Spain and a first version was tested on the users in Norway The walking game is described in D3 3 Confidential document It s forbidden to make any kind of use of it without the explicit consent of GAMEUP consortium GAMEUP 2013 D4 1 1 1 2 of 55 e AAL Joint Programme game up Game based mobility training and motivation of senior citizens AAL 2011 4 090 2 Content of prototype 1 The first prototype has focus on the GameUp exercises and how the Kinect system is able to identify the core movements and poses in these exercises The following exercises are included covering area A B and C see also D2 1 A Range of movement A1 Knee extension A2 Standing leg raises A3 Arm extension with broom A4 Torso rotation with broom B Strength B1 Standing heel and toe rises B2 Half squat holding to a chair B3 Hip extension B4 Standing leg abduction C Balance C1 Sitting reaching exercises
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