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Aim: To investigate the biomechanics of lower extremities duringtraining with the ExerCube and identify movements withpotential risk for ACL injury. Background: Exergaming, which combines physical training with cognitivechallenges, is known to be motivating during rehabilitation; however, the external focus of attention and cognitive load of agame may decrease the ability to control knee joint performance,which can be a risk factor for ACL rupture. Methods: The biomechanics during ExerCube training was measured usinga sensor-based motion capture system (Xsens) in seven healthy, female athletes. Two risk factors (10°- 30°knee flexion, knee adduction) were identified during jumps, squats, and lunges. Forstatistical analysis, a two-way within subject linear mixed modelwas used. Results: Healthy female athletes presented both risk factors (10°-30°kneeflexion, knee adduction) in all movements, although to a differentextent. While no significant differences were found for the knee flexion angle, the mean knee adduction angle was significantly higher in lunges (20.53°) compared to jumps (11.99°, p = 0.04).The fraction of movement duration during which the knee flexion angle was between 10°and 30°was 9.04% in lunges, 23.68% insquats, and 34.61% in jumps. Conclusion: Lunges, squats, and jumps are movements with risk for ACLinjury in the ExerCube environment.Further research in a larger sample and with a focus oncombinations of risk factors is needed to evaluate how ExerCube training is best applicable in ACL rehabilitation.

Physical inactivity remains one of the biggest societal challenges of the 21st century. The gaming industry and the fitness sector have responded to this alarming fact with game-based or gamified training scenarios and thus established the promising trend of exergaming. Exergames—games played with the (whole) body as physical input—have been extolled as potential attractive and effective training tools. Simultaneously, researchers and designers are still exploring new approaches to exploit the full potential of this innovative and enjoyable training method. One way to boost the attractiveness and effectiveness of an exergame is to individualize it with game adaptations. A physiological parameter that is often used to balance the physical challenge and intensity of exergames to the player’s fitness skills is the heart rate (HR). Therefore, researchers and designers often rely on age-based, maximum HR (HRmax) formulas originating from performance diagnostics. In combination with the player’s assessed real-time HR during an exergame session, the pre-determined HRmax is used to adapt the game’s challenge to reach a pre-defined HR and physical intensity level (in-exergame adaptations), respectively. Although the validity and reliability of these age-based HRmax formulas were proven in heterogeneous target populations, their use is still often criticized as HR is an individual parameter that is affected by various internal and external factors. So far, no study has investigated whether the formula-based pre-calculated HRmax compared to a standardized individually pre-assessed HRmax elicits different training intensities, training experiences, and flow feelings in an exergame. Therefore, we compared both variants for in-exergame adaptation with the ExerCube – a functional high-intensity interval training exergame – in healthy young adults. Comparing the results of the two conditions, no significant differences were found for HR parameters and perceived physical and cognitive exertion, nor for overall flow feelings and physical activity enjoyment. Thus, the formula-based in-exergame adaptation approach was suitable in the presented study population, and the ExerCube provided an equally reliable in-exergame adaptation and comparable exergame play experiences. We discuss our findings in the context of related work on exergame adaptation approaches and draw out some implications for future adaptive exergame design and research topics., Frontiers in Psychology, 12, ISSN:1664-1078

Regular physical activity is crucial for a physically and mentally healthy lifestyle. Training methods such as high-intensity interval training (HIIT) have become increasingly popular as they enable substantial training effects in little time. HIIT typically involves recurring short phases of close-to-maximal exercise intensity, interspersed with low-intensity recovery phases. Originally mainly practiced via uniformly repetitive movements, newer variations include varied functional and holistic exercises (fHIIT). While HIIT facilitates many health advantages, fHIIT is considered more beneficial since it activates more muscles, requires more coordination, strength and balance, and mimics more natural movements which transfer well to daily life. However, fHIIT is a very intense training approach; it requires strong focus and intrinsic motivation to frequently push beyond perceived physical and mental limits. This is a common barrier to exploiting the full potential of this efficient training method. Exergames may facilitate this kind of training due to their playful, immersive, motivating nature. Yet so far, few studies have investigated HIIT-exergames – no fHIIT-exergames. This is possibly because few exergames featured both (1) an effective training concept that is comparable to HIIT, and (2) an attractive and motivating game design. We believe that this lack of holistic integration of both aspects is partly why there is currently little evidence for long-term motivation and training effects in exergame-based training. Our work addresses this gap through the design of an adaptive fHIIT protocol for the ExerCube fitness game system, creating a HIIT-level functional exergame. We conducted a within-subjects study to compare objective and subjective training intensity induced by the ExerCube against a conventional fHIIT session with healthy young adults. Furthermore, we evaluated participants' subjective experience with regards to motivation, flow, and enjoyment during both conditions. Our results contribute empirical evidence that exergames can induce HIIT-level intensity. While perceived physical exertion was slightly lower in the ExerCube condition, it yielded significantly better results for flow, enjoyment, and motivation. Moreover, the ExerCube seemed to enable a dual-domain training (higher cognitive load). We discuss these results in the context of exergame design for fHIIT, and provide practical suggestions covering topics such as safety precautions and physical-cognitive load balancing., Frontiers in Computer Science, 2, ISSN:2624-9898