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Book Excerpt : Serious Games: Games That Educate, Train, and Inform - Games for Physical and Mental Health
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Book Excerpt : Serious Games: Games That Educate, Train, and Inform - Games for Physical and Mental Health

October 31, 2005 Article Start Previous Page 2 of 2

Health Education and Physical Fitness

Other games try to help healthy players stay healthy. These games teach the players about topics like nutrition, physical fitness, and sexually transmitted diseases. Beyond just providing information, the games also try to promote changes in the player's behavior and future choices: to eat better, to exercise more, and to practice safe sex.

Using a video game, Squire's Quest, and related take-home assignments, researchers at Baylor College of Medicine reported improvements in the diets of Houston-area fourth-graders. Squire's Quest is a medieval-themed game where the player is a squire seeking to become a full knight. The player's knowledge of the nutritional content of different foods is tested as he designs healthy meals for King Cornwell and the royal family in a virtual kitchen and battles a variety of vegetable-destroying enemies. After five weeks of playing the game about 40 minutes per week during class, the nearly 800 students who participated in the program increased their fruit and vegetable intake by one serving a day on average.

Video games can also promote other healthy habits. Education has “edutainment,” and now physical fitness has “exergaming” or “exertainment.” Exergaming, also called “fitness gaming,” is a new marketing term coined to describe the combination of exercise equipment or aerobic workout regimens with video games. These products seek to make physical exercise more attractive to people by adding the mentally engaging elements of video games to the activity.

Figure 1: Dance Dance Revolution uses a dance pad as its input device.

Konami's Dance Dance Revolution (DDR), originally released in Japan in 1991 as an arcade game, is an example of a video game that mixes physical activity with game play mechanics. DDR uses the special input controller (see Figure 1): a dance pad, with four panels, up, down, left, and right, arranged around where the player stands. The player presses the panels with his or her feet in response to arrows that flash on the game's screen. The arrows are synchronized to the rhythm or beat of a song played by the game, and success depends on the player's ability to time his or her steps accordingly. Since its days in the arcade, DDR has been released as specialized cabinets that players can buy to play at home and for game consoles like the Sony PlayStation.

RedOctane, makers of Ignition Pad, the top-selling dance pad in 2004, created the Get Up & Move PR campaign in January 2004. According to the Get Up & Move Web site, Tanya Jessen, the campaign spokesperson, lost 95 pounds (43 kilograms) by repeatedly playing the Dance Dance Revolution series of games. Dean Ku, speaking at the Serious Games Summit at the 2005 Game Developer's conference, said that the campaign grew out of RedOctane's decision to stay close to the dance game community. After receiving a lot of e-mails from players who were losing weight, the company decided to see if it could help promote this type of wellness program. Tanya Jessen, for example, didn't start dancing to lose weight. It happened naturally as she began playing the game and noticed a slimmer figure. In addition to helping players lose weight, the Get Up & Move campaign had a huge sales impact for DDR and its sequel, DDR2.

DDR has been the subject of a number of studies in recent years. In a 2005 research study, George Graham and Stephen Yang of Penn State University measured the heart rates of children who played DDR for 45 minutes. The researchers found that the children had an average heart rate of 144 beats per minute when playing, compared to the average resting heart rate of 60 to 70 beats per minute. The increased heart rate increases the metabolism and causes the body to burn more calories.

In another study currently underway, researchers at West Virginia University also aim to study children playing DDR. The six-month study, coordinated with the state's Public Employees Insurance Agency, examines the possibility of cutting claim costs from obesity. In the same vein, Bryan Haddock, an Associate Professor of Kinesiology at Cal State San Bernardino, is planning a summer 2005 study with Riverside-based game company, QMotions, on how exergaming products can help reduce childhood obesity.

Figure 2: The EyeToy allows players to interact with specially designed games by moving their bodies, including their head, arms, hands, and legs.

In 2003, Sony released the EyeToy (see Figure 2), a digital camera device for the PlayStation 2 that allows players to interact with specially designed games by moving their bodies, including their head, arms, hands, and legs. Lisa Liddane, in her February 26, 2005, article for the Orange County Register, “Acting Out: Kids Get into the Game,” described a nine year old boy playing EyeToy: Play, a collection of mini-games: “As the animated fighters jump from balconies on the screen, Mitchell jabs swiftly into the air to knock them down. He executes a sharp kick with his left leg and bounces an opponent out of the screen. Every now and then, he shuffles left and right like a boxer. For bonus points, he breaks wooden boards left and right.”

Following the examples of DDR and the EyeToy, there is an emerging market for new controllers and interfaces, and accompanying games, that allow players to get involved with video games in new, highly active ways. The Cateye GameBike and the Reebok CyberRider hook up to a game console, such as the PlayStation 2 or XBox, so that the player can pedal a stationary bike and play games that involve driving or riding vehicles. Priced at $1200 (as of this writing), these peripherals show the revenue potential for exergaming.

At the 2005 Electronic Entertainment Expo (E3), QMotions showed off its baseball controller for console and PC video games, adding to its line of full-motion video game controllers. Many other companies were also showcasing their new exercise-oriented gaming products. Such controllers make the experience of playing the video game versions of sports like baseball and golf much more like the original sport. At the least, with these controllers the player's interaction with the game exceeds the standard “activity” of clicking buttons and pushing a mouse around.

Mark Wolf, in his book The Medium of the Video Game, listed other games that involved physical activity that have been released over the years. Many of these were full-sized arcade games, and players would sit inside or ride on top of the consoles. The player's physical movements control the game to simulate everything from driving to flying, pedaling a bicycle (Prop Cycle, 1993), or holding ski pole handles while standing on moveable skis (Alpine Racer, 1995). Other examples include Sega's Top Skater (1997), which has a skateboard, and Namco's Final Furlong (1997), a game about racehorse riding.

Another use of serious games is in sex education and/or the prevention of sexually transmitted diseases, such as herpes and HIV/AIDS. The very serious nature of the subject matter, combined with the political and religious controversies, could be enough to make designers look for less-troublesome arenas, but these types of games are just another type of self-management. An example of a game that does tackle these issues is Will Interactive's HIV Interactive Nights Out. Designed to promote HIV prevention, the game was given to over 200 soldiers ages 19 to 29 years old in a study by the U.S. Army. The study found that more than half of the soldiers voluntarily played the game more than once and that the program reinforced the participants' existing inclinations to protect themselves against HIV infection.

Exergaming Case Study—responDESIGN's Yourself!Fitness

In late 2004 and early 2005, responDESIGN, a Portland, Oregon, company devoted to creating “games that are good for you,” released Yourself!Fitness for the XBox, PC, and PlayStation 2. Designed to surpass fitness videos and self-help books, Yourself!Fitness bills itself as “the first game title created solely to improve the health and fitness of the user.” With information provided by the player, the game creates a personalized fitness program, and Maya, a virtual personal trainer, coaches the player through the training sessions.

Yourself!Fitness incorporates yoga, Pilates, cardio fitness, strength training, flexibility exercises, and targeted weight loss routines. Yourself!Fitness will also integrate any training equipment the player has. Unlike home fitness DVDs, which only provide a list of options that users can choose from and a static set of exercises and activities, company co-founder Phineas Barnes said the game provides all the tools to create a “personal, interactive, goal oriented fitness program at home.” The personalization is derived from information inputted by the user about his or her personal fitness level at the start of Yourself!Fitness. Yourself!Fitness then creates a customized fitness program based on user fitness and preferences. Add to that full user control over the camera angles, the playback speed of the exercise demonstration, different environments, and adjustable order of exercises each day, and the product offers a lot of advantages over the traditional home fitness DVD.

Barnes does not consider Yourself!Fitness a game. Though Yourself!Fitness employs game elements like a system of rewards, including new environments, new music, and new levels, its primary aim is to be a personal fitness program. Even so, it was important to responDESIGN to make the product fun and engaging.

Yourself!Fitness required a development budget of less than $500,000, which, Barnes pointed out, is a fraction of the budgets required for most console titles, and it was created with 100 percent game technology. The 21 members of the project team, which included a number of fitness experts, put special effort into guaranteeing correct joint movement in Maya, the virtual personal trainer. As seen in Figure 3, this ensures that when Maya demonstrates a particular exercise or technique, the player is seeing it done exactly right.

Correct joint movement in Maya, the virtual personal trainer in Yourself!Fitness, ensures that when she demonstrates a particular exercise or technique, the player is seeing it done exactly right.

The home fitness market sells 30 to 40 million fitness videos and DVDs each year, with 90 percent of those purchases being made by women. That is the market segment reponDESIGN wanted to tap into with Yourself!Fitness, and so, the game was designed to appeal to women. However, the company has heard from men who have started using Yourself!Fitness as well. Getting men to participate, Barnes noted, is considered a significant achievement in the home fitness market.

Unlike video game sales, home fitness sales do not peak at Christmas and are at the highest just after the beginning of the year, in January and February. responDESIGN has targeted this period for its marketing. However, with its game-like properties, Yourself!Fitness can capitalize on both the shortage of new video games on store shelves just before Christmas and the general home fitness craze that follows the holiday season.

This combination of elements from two markets, though, has also forced responDESIGN to explore alternatives to the normal video game retail outlets. Further, because the product resembles a home fitness DVD, but isn't a DVD, and requires either a computer or game console, the company has also run into issues selling to some home fitness retail outlets. Despite those issues, responDESIGN has been able to reach mothers in video game stores, professional women at stores like Best Buy, and a wide range of female buyers at Nordstrom. It continues to look for new marketing venues and would like to be able to reach even into the hardcore game player arena.

Barnes said that responDESIGN has big plans for the future. Eventually, the company expects Yourself!Fitness to be a full “health lifestyle monitoring tool.” responDESIGN wants users to be able to track their progress through the use of networked equipment and next-generation game consoles. This tracking could even extend throughout the day, covering diet and other lifestyle aspects. “The more information you plug in,” Barnes added, “the more access to health and fitness resources you'll have through the program.”


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