Exergaming system for exercise-based cardiac rehabilitation in heart failure patients: HEFMOB development and usability assessment study (Preprint)

BACKGROUND Heart failure is a growing global health concern. Exergaming is a promising alternative to conventional exercise programs for patients with heart failure (HF). However, existing research has limitations, and the integration of exergaming into clinical practice remains challenging. OBJECTIVE The aims of this study were to design and develop an exergaming prototype (i.e., HEFMOB), which encompasses a lower limb aerobic exercise game and an upper limb coordination and mobilization game, and to assess the usability of the prototype. METHODS The usability evaluation had two phases: the initial assessment by the researchers, and the user-rated analysis of a single session by 10 patients (4 women) with HF. The sessions were recorded and individually evaluated by two researchers using the Serious Game Usability Evaluator (SGUE) tool. After each session, the participants completed the System Usability Scale (SUS) and a subscale of Intrinsic Motivation Inventory (IMI) to rate the usability of the exergaming prototype and enjoyment, respectively. Participants reported more negative events (e.g., confusion [n = 76]) than neutral (n = 49) and positive events (n = 11). RESULTS The mean ± standard deviation (SD) SUS score was 71.5 ± 17.8 and the mean ± SD IMI score was 25.1 ± 3.5, showing a good user-rated usability and high level of interest, respectively. CONCLUSIONS HEFMOB represents a significant initial step in developing an exergaming prototype customized for CHF. HEFMOB seems usable, and participants experienced satisfaction in a single session. Future research is required to conclusively demonstrate the efficacy and effectiveness of HEFMOB.