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BACKGROUND: The prevalence of overweight and obesity in schoolchildren is increasing in Peru. Given the increased use of digital media, there is potential to develop effective digital health interventions to promote healthy eating practices at schools. This study investigates the needs of schoolchildren in relation to healthy eating and the potential role of digital media to inform the design of game-based nutritional interventions. OBJECTIVE: This study aims to explore schoolchildren's knowledge about healthy eating and use of and preferences for digital media to inform the future development of a serious game to promote healthy eating. METHODS: A survey was conducted in 17 schools in metropolitan Lima, Peru. The information was collected virtually with specific questions for the schoolchild and their caregiver during October 2021 and November 2021 and following the COVID-19 public health restrictions. Questions on nutritional knowledge and preferences for and use of digital media were included. In the descriptive analysis, the percentages of the variables of interest were calculated. RESULTS: We received 3937 validated responses from caregivers and schoolchildren. The schoolchildren were aged between 8 years and 15 years (2030/3937, 55.8% girls). Of the caregivers, 83% (3267/3937) were mothers, and 56.5% (2223/3937) had a secondary education. Only 5.2% (203/3937) of schoolchildren's homes did not have internet access; such access was through WiFi (2151/3937, 54.6%) and mobile internet (1314/3937, 33.4%). In addition, 95.3% (3753/3937) of schoolchildren's homes had a mobile phone; 31.3% (1233/3937) had computers. In relation to children's knowledge on healthy eating, 42.2% (1663/3937) of schoolchildren did not know the recommendation to consume at least 5 servings of fruits and vegetables daily, 46.7% (1837/3937) of schoolchildren did not identify front-of-package warning labels (FOPWLs), and 63.9% (2514/3937) did not relate the presence of an FOPWL with dietary risk. Most schoolchildren (3100/3937, 78.7%) preferred to use a mobile phone. Only 38.3% (1509/3937) indicated they preferred a computer. In addition, 47.9% (1885/3937) of caregivers considered that the internet helps in the education of schoolchildren, 82.7% (3254/3937) of caregivers gave permission for schoolchildren to play games with digital devices, and 38% (1495/3937) of caregivers considered that traditional digital games for children are inadequate. CONCLUSIONS: The results suggest that knowledge about nutrition in Peruvian schoolchildren has limitations. Most schoolchildren have access to the internet, with mobile phones being the device type with the greatest availability and preference for use. Caregivers' perspectives on games and schoolchildren, including a greater interest in using digital games, provide opportunities for the design and development of serious games to improve schoolchildren's nutritional knowledge in Peru. Future research is needed to explore the potential of serious games that are tailored to the needs and preferences of both schoolchildren and their caregivers in Peru in order to promote healthy eating.

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Purpose: The objective of this research was to develop a musical digital game for rehabilitation of upper limb and to verify its usability and user experience with professionals in the field (physical therapists). Materials and Methods: Thirty working professionals were recruited to evaluate the system. The usability was evaluated with the System Usability Scale (SUS) and the user experience was verified with the Game Flow scale. Results: The overall score of the SUS scale was 88.67 (±9.129); this score is interpreted as "Best Imaginable" (86-100). The user experience rating had most of its domains equal or higher than 4, which indicates that all the requirements for a good user experience were present in the game. Conclusions: The Moniz Game proved to be a game with good usability and can be a tool for application in clinical practice regarding motor coordination. However, further studies are needed to evaluate the effect of the Moniz Game on motor coordination in patients with neurological dysfunctions.

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Introduction: Cerebral palsy (CP) is a nonprogressive neuropathological condition that requires lifelong neurocognitive-motor rehabilitation. Evidences indicate that the use of new technologies to assist in rehabilitation processes, such as serious games in virtual reality (VR), have served as adjuncts to therapy and capable of promoting engagement, motivation, and motor activation for these patients. Objective: To investigate the usability of a serious game in VR to help with the stability and balance of the head and trunk of children with CP, focusing on the perception and experience of health professionals. Methods: The collection was carried out with health professionals, and the results were comprehensively evaluated through viability by means of the total score, number of correct answers, number of errors, and level of difficulty during the execution of the game, which were collected from the performance report generated by the application. System satisfaction was also verified by the System Usability Scale (SUS). Results: The mean obtained from the total score of the SUS was 82.10 ± 12.66 points, being considered of high usability for the suggested purpose. The professionals' opinion about the usability of the system did not change due to the performance during the game. Conclusion: The study demonstrated that the developed rehabilitation program has successfully delivered the experience to exercise the head control and trunk balance of subjects with CP.

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Objective: To create and evaluate a digital educational game (DEG) for preschool children for the prevention of iron deficiency and iron deficiency anemia. Methodology: The DEG software was developed by a multidisciplinary team, according to Chandler's methodology, in Engine Unity. The game is a 2D platformer, for Android, with three different phases. A quiz was developed for parents/caregivers about iron absorption and anemia. The quiz content was evaluated by experts. The evaluation of the game was carried out through a questionnaire applied in the school for children from 4 to 6 years of age. Results: For the construction of the game, programming, team planning, art, and soundtrack were necessary. The game was registered at the National Institute of Industrial Property. The quiz was evaluated by 14 experts and all questions had more than 80% agreement. The questionnaire was answered by 32 children with a mean age of 5.0 ± 0.7 years, and ∼70% evaluated the game positively. Thus, the acceptability of the software was favored by most players. Conclusion: The "O Jardim do Ferro" software, from its conception to evaluation, proved to be a promising tool to contribute to food and nutrition education actions, providing opportunities for the construction of knowledge about iron-rich foods for the prevention of iron deficiency and iron deficiency anemia in childhood.

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This research letter presents the co-design process for RG4Face, a mime therapy-based serious game that uses computer vision for human facial movement recognition and estimation to help health care professionals and patients in the facial rehabilitation process.

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BACKGROUND: Insufficient levels of treatment adherence can have adverse effects on the outcomes of physical rehabilitation. To address this issue, alternative approaches to traditional therapies, such as serious games, have been designed to enhance adherence. Nevertheless, there remain gaps in the development of serious games concerning the effective implementation of motivation, engagement, and the enhancement of treatment adherence. OBJECTIVE: This study aims to design a conceptual framework for the development of serious games that incorporate essential adherence factors to enhance patient compliance with physical rehabilitation programs. METHODS: We formulated a conceptual framework using iterative techniques inspired by a conceptual framework analysis. Initially, we conducted a comprehensive literature review, concentrating on the critical adherence factors in physical rehabilitation. Subsequently, we identified, categorized, integrated, and synthesized the concepts derived from the literature review to construct the conceptual framework. RESULTS: The framework resembles a road map, comprising 3 distinct phases. In the initial phase, the patient's characteristics are identified through an initial exploration. The second phase involves the development of a serious game, with a focus on enhancing treatment adherence by integrating the key adherence factors identified. The third phase revolves around the evaluation of the serious game. These phases are underpinned by 2 overarching themes, namely, a user-centered design and the GameFlow model. CONCLUSIONS: The conceptual framework offers a detailed, step-by-step guide for creating serious games that incorporate essential adherence factors, thereby contributing to improved adherence in the physical rehabilitation process. To establish its validity, further evaluations of this framework across various physical rehabilitation programs and user groups are necessary.

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BACKGROUND: Games have been a part of human life since ancient times and are taught to children and adults who want to simultaneously have fun and learn. Nevertheless, in the third decade of this century, technology invites us to consider using video games to learn topics such as entrepreneurship. However, developing a serious game (SG) is difficult because everyone who forms part of the game development team requires adequate learning resources to acquire the necessary information and improve their game development skills. OBJECTIVE: This work aimed to detail the experience gained in developing ATIC (Aprende, Trabaja, Innova, Conquista [learn, work, innovate, conquer]), an SG proposed for teaching and learning entrepreneurship. METHODS: To develop a videogame, first, we established a game development team formed by professors, professionals, and students who have different roles in this project. Scrum was adopted as a project management method. To create concept art for the video game, designers collected ideas from various games, known as "getting references." In contrast, narratology considers the life of a recent university graduate immersed in real life, considering locations, characteristics, and representative characters from an essential city of Ecuador. RESULTS: In a Unity 3D video game in ATIC, the life of a university student who graduates and ventures into a world full of opportunities, barriers, and risks, where the player needs to make decisions, is simulated. The art of this video game, including sounds and music, is based on the landscape and characteristics of and characters from Cuenca, Ecuador. The game aims to teach entrepreneurs the mechanisms and processes to form their businesses. Thus, we developed the following elements of an SG: (1) world, (2) objects, (3) agents, and (4) events. CONCLUSIONS: The narrative, mechanics, and art of video games are relevant. However, project management tools such as leaderboards and appointments are crucial to influencing individuals' decision to continue to play, or not play, an SG. Developing a serious video game is not an easy task. It was essential to consider many factors, such as the video game audience, needs of learning, context, similarities with the real world, narrative, game mechanics, game art, and game sounds. However, overall, the primary purpose of a serious video game is to transmit knowledge in a fun way and to give adequate and timely feedback to the gamer. Finally, nothing is possible if the members of game development team are not satisfied with the project and not clear about their roles.

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BACKGROUND: Epileptic encephalopathy (EE) is defined as the presence of frequent epileptiform activity that adversely impacts development, typically causing the slowing or regression of developmental skills, and is usually associated with frequent seizures. One of the main disturbances in EE is in the coordination of the upper extremities and hands. Traditional rehabilitation for this type of pathology focuses on the alleviation of gross or fine motor disability. In the last few years, the use of low-cost devices together with customized serious games has shown improvements in motor disorders and enrichments in activities of daily living. OBJECTIVE: This study aims to explore the feasibility of a new serious game for improving fine motor control in children with EE. METHODS: The participants were 4 children with EE (male: n=2, 50%; female: n=2, 50%) who were classified as belonging to level 1 in the Gross Motor Classification System. The children were tested over 10 sessions during the intervention period (before and after treatment). The clinical tests performed were the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition and Pittsburgh Rehabilitation Participation Scale. The subscales of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition were fine motor precision, fine motor integration, manual dexterity, and upper-limb coordination. At the end of the first session, we used the User Satisfaction Evaluation Questionnaire to analyze user satisfaction. RESULTS: The significance outcomes for a Student t test (1-tailed) were as follows: P=.009 for fine motor precision, P=.002 for fine motor integration, P=.56 for manual dexterity, and P=.99 for upper-limb coordination. The participation rate as measured using the Pittsburgh Rehabilitation Participation Scale was between good and very good, which means that, based on the therapist's evaluation, interest, independence, and motivation were achieved by each participant. The mean User Satisfaction Evaluation Questionnaire score was close to 30, which is the maximum value. CONCLUSIONS: The results support the use of the proposed serious game as a complement in therapeutic sessions during the rehabilitation processes for children with EE. Significant improvements in fine motor control and activities of daily living revealed that the proposed serious game is beneficial for fine motor disorders of this pathology.

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Background: The use of serious games (SG) has received increasing attention in health care, and can be applied for both rehabilitation and evaluation of motor signs of several diseases, such as Parkinson's disease (PD). However, the use of these instruments in clinical practice is poorly observed, since there is a scarcity of games that, during their development process, simultaneously address issues of usability and architectural design, contributing to the non-satisfaction of the actual needs of professionals and patients. Thus, this study aimed to present the architecture and usability evaluation at the design stage of a serious game, so-called RehaBEElitation, and assess the accessibility of the game. Methods: The game was created by a multidisciplinary team with experience in game development and PD, taking into consideration design guidelines for the development of SG. The user must control the movements of a bee in a 3D environment. The game tasks were designed to mimic the following movements found in the gold-standard method tool-Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS)-for the assessment of individuals with PD: hand opening and closing, hand extension and flexion, hand adduction and abduction, finger tapping, and forearm supination and pronation. The user interacts with the game using a wearable interface device that embeds inertial and tactile sensors. The architecture of RehaBEElitation was detailed using the business process model (BPM) notation and the usability of the architecture was evaluated using the Nielsen-Shneiderman heuristics. Game accessibility was evaluated by comparing the overall scores of each phase between 15 healthy participants and 15 PD patients. The PD group interacted with the game in both the ON and OFF states. Results: The system was modularized in order to implement parallel, simultaneous and independent programming at different levels, requiring less computational effort and enabling fluidity between the game and the control of the interface elements in real time. The developed architecture allows the inclusion of new elements for patient status monitoring, extending the functionality of the tool without changing its fundamental characteristics. The heuristic evaluation contemplated all the 14 heuristics proposed by Shneiderman, which enabled the implementation of improvements in the game. The evaluation of accessibility revealed no statistically significant differences (p < 0.05) between groups, except for the healthy group and the PD group in the OFF state of medication during Phase 3 of the game. Conclusions: The proposed architecture was presented in order to facilitate the reproduction of the system and extend its application to other scenarios. In the same way, the heuristic evaluation performed can serve as a contribution to the advancement of the SG design for PD. The accessibility evaluation revealed that the game is accessible to individuals with PD.

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Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.

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ABSTRACT Introduction: Technology-enhanced simulations seem to be effective in dentistry, as they can support dental students to improve competencies in simulated environments. However, implementation of this technology in orthodontic education has not been reviewed. Objective: This scoping review aimed to comprehensively summarize the use of technology-enhanced simulations in orthodontic practice. Methods: A systematic search was conducted to identify literature on technology-enhanced simulation-based learning in orthodontic education published from 2000 to 2021. The search was conducted up to September 2021 to identify articles from Scopus, Embase, PubMed, ProQuest Dissertations & Theses Global, Google Scholar and the reference lists of identified articles. Results: The search identified 177 articles. Following the inclusion and exclusion criteria, 16 articles of 14 digital simulators were included in this review. The findings demonstrated an increasing use of technology-enhanced simulations in orthodontic education. They were designed in several formats, including three-dimensional virtual format, augmented reality, virtual reality, automaton, haptic, and scenario-based simulations. These simulations were implemented in varied areas of orthodontics including diagnosis and treatment planning, bracket positioning, orthodontic procedures, facial landmark, removable appliance and cephalometric tracing. Most included articles demonstrated the development process without outcome evaluation. Six studies provided outcome evaluations at reaction or learning levels. None of them provide the evaluation at behaviour and results levels. Conclusion: Insufficient evidence has been generated to demonstrate the effectiveness of technology-enhanced simulations in orthodontic education. However, high-fidelity computer-based simulations together with robust design research should be required to confirm educational impact in orthodontic education.

RESUMO Introdução: Simulações aprimoradas por tecnologia parecem ser eficazes em Odontologia, pois podem ajudar os estudantes a melhorar suas competências em ambientes simulados. No entanto, a implementação dessa tecnologia na educação ortodôntica ainda não foi revisada. Objetivo: A presente revisão de escopo teve como objetivo resumir, de forma abrangente, o uso de simulações aprimoradas por tecnologia na prática ortodôntica. Métodos: Uma busca sistemática foi realizada para identificar publicações de 2000 a 2021 sobre aprendizado na educação ortodôntica baseado em simulação aprimorada por tecnologia. A busca foi realizada até setembro de 2021 para identificar artigos na Scopus, Embase, PubMed, ProQuest Dissertations & Theses Global, Google Scholar e nas listas de referências dos artigos identificados. Resultados: A busca identificou 177 artigos. Foram incluídos nessa revisão 16 artigos, com 14 simulações digitais, que atenderam aos critérios de inclusão e exclusão. Os resultados demonstraram um uso crescente de simulações aprimoradas por tecnologia na educação ortodôntica. Elas foram projetadas em vários formatos, incluindo formato tridimensional virtual, realidade aumentada, realidade virtual, autômato, háptico e simulações baseadas em cenários. Essas simulações foram implementadas em diversas áreas da Ortodontia, incluindo diagnóstico e planejamento de tratamento, posicionamento de braquetes, procedimentos ortodônticos, identificação de pontos de referência faciais, aparelhos removíveis e traçados cefalométricos. A maioria dos artigos incluídos demonstrou o processo de desenvolvimento, sem avaliar os resultados. Seis estudos forneceram avaliações de resultados em níveis de reação ou aprendizado. Nenhum deles forneceu a avaliação em níveis de comportamento e resultados. Conclusão: Não foram geradas evidências suficientes para demonstrar a eficácia das simulações aprimoradas por tecnologia na educação ortodôntica. No entanto, simulações de alta fidelidade baseadas em computador, juntamente com pesquisas robustas de design, são necessárias para confirmar o impacto educacional na área ortodôntica.

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BACKGROUND: The use of health games is a promising strategy for educating and promoting healthy lifestyle behaviors among children. OBJECTIVE: We aimed to describe the design and development of a serious game, called HelperFriend, and evaluate its feasibility, acceptability, and preliminary effects in children in a pilot study. HelperFriend is a vicarious experiential video game designed to promote 3 lifestyle behaviors among young children: physical activity, healthy eating, and socioemotional wellness. METHODS: Participants aged 8 to 11 years were recruited from an elementary school and randomized to receive a healthy lifestyle behavior educational talk (control) or play six 30-minute sessions with HelperFriend (intervention). Assessments were conducted at baseline (T0) and after the intervention (ie, 4 weeks) (T1). The primary outcome was gain in knowledge. The secondary outcomes were intention to conduct healthy behaviors, dietary intake, and player satisfaction. RESULTS: Knowledge scores of intervention group participants increased from T0 to T1 for physical activity (t14=2.01, P=.03), healthy eating (t14=3.14, P=.003), and socioemotional wellness (t14=2.75, P=.008). In addition, from T0 to T1, the intervention group improved their intention to perform physical activity (t14=2.82, P=.006), healthy eating (t14=3.44, P=.002), and socioemotional wellness (t14=2.65, P=.009); and there was a reduction in their intake of 13 unhealthy foods. HelperFriend was well received by intervention group. CONCLUSIONS: HelperFriend appears to be feasible and acceptable for young children. In addition, this game seems to be a viable tool to help improve the knowledge, the intention to conduct healthy behaviors, and the dietary intake of children; however, a well-powered randomized controlled trial is needed to prove the efficacy of HelperFriend.

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Objective: Gesture-based serious games can be based on playful and interactive scenarios to enhance user engagement and experience during exercises, thereby increasing efficiency in the motor rehabilitation process. This study aimed to develop the Rehabilite Game (RG) as a complementary therapy tool for upper limb rehabilitation in clinics and home environments and to evaluate aspects of usability and user experience of it. Materials and Methods: The evaluation consisted of the use of a gesture-based serious game with motor rehabilitation sessions managed in a web platform. Thirty-three participants were recruited (21 physiotherapists and 12 patients). The protocol allowed each participant to have the experience of playing sessions with different combinations of settings. The User Experience Questionnaire (UEQ) was used to evaluate aspects of usability and user experience. The study was approved by the Research Ethics Board of the Federal University of Piaui (number 3,429,494). Results: The level of satisfaction with the RG was positive, with an excellent Net Promoter Score for 85.7% of physiotherapists and 100% of patients. All six UEQ scales (attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty) reflected acceptance. Conclusion: The study demonstrated that, according to the results obtained in the experiments, the RG had positive feedback from physiotherapists and patients, indicating that the game can be used in a clinical trial to be compared with other rehabilitation techniques.

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Serious games can be suitable tools for educational support in different areas of knowledge, such as Medicine. These applications, combined with technologies like mixed and augmented reality, provide a differentiated user experience that can keep or improve the interest and motivation of students and teachers during the teaching and learning process. In this context, this study aimed to present the development of AnemiaAR, a mixed reality serious game to support the teaching of haematology, helpful for students and professors in the visualisation and presentation of anaemia concepts. Fourteen medical students from the University of Passo Fundo participated in a pilot study to evaluate the application, considering a sociodemographic questionnaire, a questionnaire based on the Technology Acceptance Model, and two modules of the Game Experience Questionnaire. The preliminary results were satisfactory, showing good acceptance and positive experience of the game, besides improvements. The study also pointed out differences in the game evaluation among participants, considering the prior experience in games, the previously attended haematology subject, and the time spent performing the game tasks.

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BACKGROUND: Serious games are a support in the rehabilitation process for treating people with physical disabilities. However, many of these serious games are not adapted to the patient's needs because they are not developed with a software engineering framework with a set of activities, actions, and tasks that must be executed when creating a software product. Better serious games for rehabilitation will be developed if the patient and therapist requirements are identified, the development is planned, and system improvements and feedback are involved. The goal is that the serious game must offer a more attractive environment, while maintaining patient interest in the rehabilitation process. OBJECTIVE: This paper submits the results of a systematic review of serious games in physical rehabilitation identifying the benefits of using a software engineering framework. METHODS: A systematic research was conducted using PubMed, PEDro (Physiotherapy Evidence Database), IEEE Xplore, ScienceDirect, ACM Digital Library, Mary Ann Liebert, Taylor & Francis Online, Wiley Online Library, and Springer databases. The initial search resulted in 701 papers. After assessing the results according to the inclusion criteria, 83 papers were selected for this study. RESULTS: From the 83 papers reviewed, 8 used a software engineering framework for its development. Most of them focused their efforts on 1 or more aspects, such as data acquisition and processing, game levels, motivation, therapist supervision. CONCLUSIONS: This systematic review proves that most of the serious games do not use a software engineering framework for their development. As a result, development systems overlook several aspects and do not have a standardized process, eventually omitting important implementation aspects, which impact the patient's recovery time.

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This article performs a Systematic Review of studies to answer the question: What are the researches related to the learning process with (Serious) Business Games using data collection techniques with Electroencephalogram or Eye tracking signals? The PRISMA declaration method was used to guide the search and inclusion of works related to the elaboration of this study. The 19 references resulting from the critical evaluation initially point to a gap in investigations into using these devices to monitor serious games for learning in organizational environments. An approximation with equivalent sensing studies in serious games for the contribution of skills and competencies indicates that continuous monitoring measures, such as mental state and eye fixation, proved to identify the players' attention levels effectively. Also, these studies showed effectiveness in the flow at different moments of the task, motivating and justifying the replication of these studies as a source of insights for the optimized design of business learning tools. This study is the first systematic review and consolidates the existing literature on user experience analysis of business simulation games supported by human-computer interfaces.

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BACKGROUND: Serious games have been used as supportive therapy for traditional rehabilitation. However, most are designed without a systematic process to guide their development from the phases of requirement identification, planning, design, construction, and evaluation, which reflect the lack of adaptation of rehabilitation requirements and thus the patient's needs. OBJECTIVE: The aim of this study was to propose a conceptual framework with standardized elements for the development of information systems by using a flexible and an adaptable process centered on the patient's needs and focused on the creation of serious games for physical rehabilitation. METHODS: The conceptual framework is based on 3 fundamental concepts: (1) user-centered design, which is an iterative design process focused on users and their needs at each phase of the process, (2) generic structural activities of software engineering, which guides the independent development process regardless of the complexity or size of the problem, and (3) gamification elements, which allow the transformation of obstacles into positive and fun reinforcements, thereby encouraging patients in their rehabilitation process. RESULTS: We propose a conceptual framework to guide the development of serious games through a systematic process by using an iterative and incremental process applying the phases of context identification, user requirements, planning, design, construction of the interaction devices and video game, and evaluation. CONCLUSIONS: This proposed framework will provide developers of serious games a systematic process with standardized elements for the development of flexible and adaptable software with a high level of patient commitment, which will effectively contribute to their rehabilitation process.

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INTRODUCTION: There is a need to maintain rehabilitation activities and motivate movement and physical activity during quarantine in individuals with Cerebral Palsy (CP). OBJECTIVE: This paper sets out to evaluate the feasibility and potential benefits of using computer serious game in a non-immersive virtual reality (VR) implemented and evaluated completely remotely in participants with CP for Home-Based Telerehabilitation during the quarantine period for COVID-19. METHODS: Using a cross-sectional design, a total of 44 individuals participated in this study between March and June 2020, 22 of which had CP (14 males and 8 females, mean age = 19 years, ranging between 11 and 28 years) and 22 typically developing individuals, matched by age and sex to the individuals with CP. Participants practiced a coincident timing game1 and we measured movement performance and physical activity intensity using the rating of perceived exertion Borg scale. RESULTS: All participants were able to engage with the VR therapy remotely, reported enjoying sessions, and improved performance in some practice moments. The most important result in this cross-sectional study was the significant increasing in rating of perceived exertion (through Borg scale) in both groups during practice and with CP presenting a higher rating of perceived exertion. CONCLUSION: Children with CP enjoyed participating, were able to perform at the same level as their peers on certain activities and increased both their performance and physical activity intensity when using the game, supporting the use of serious games for this group for home therapy and interactive games. CLINICAL TRIALS REGISTRATION: https://Clinicaltrials.gov, NCT04402034. Registered on May 20, 2020.

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BACKGROUND: No treatment for COVID-19 is yet available; therefore, providing access to information about SARS-CoV-2, the transmission route of the virus, and ways to prevent the spread of infection is a critical sanitary measure worldwide. Serious games have advantages in the dissemination of reliable information during the pandemic; they can provide qualified content while offering interactivity to the user, and they have great reach over the internet. OBJECTIVE: This study aimed to develop a serious game with the purpose of providing science-based information on the prevention of COVID-19 and personal care during the pandemic while assessing players' knowledge about COVID-19-related topics. METHODS: The study was conducted with the interdisciplinary collaboration of specialists in health sciences, computing, and design at the Federal University of Minas Gerais, Brazil. The health recommendations were grouped into six thematic blocks, presented in a quiz format. The software languages were based on the progressive web app development methodology with the Ionic framework, JavaScript, HTML5, cascading style sheets, and TypeScript (Angular). Open data reports of how users interact with the serious game were obtained using the Google Analytics application programming interface. The visual identity, logo, infographics, and icons were carefully developed by considering a selection of colors, typography, sounds, and images that are suitable for young audiences. Cards with cartoon characters were introduced at the end of each thematic topic to interact with the player, reinforcing their correct answers or alerting them to the need to learn more about the disease. The players' performance was assessed by the rate of incorrect and correct answers and analyzed by linear correlation coefficient over 7 weeks. The agile SCRUM development methodology enabled quick and daily interactions of developers through a webchat and sequential team meetings. RESULTS: The game "COVID-19-Did You Know?" was made available for free on a public university website on April 1, 2020. The game had been accessed 17,571 times as of September 2020. Dissemination actions such as reports on social media and television showed a temporal correspondence with the access number. The players' error rate in the topic "Mask" showed a negative trend (r=-.83; P=.01) over the weeks of follow-up. The other topics showed no significant trend over the weeks. CONCLUSIONS: The gamification strategy for health education content on the theme of COVID-19 reached a young audience, which is considered to be a priority in the strategy of orientation toward social distancing. Specific educational reinforcement measures were proposed and implemented based on the players' performance. The improvement in the users' performance on the topic about the use of masks may reflect an increase in information about or adherence to mask use over time.