{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T21:58:09Z","timestamp":1709589489706},"reference-count":56,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["304818\/2018-6"],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"Coordination for the Improvement of Higher Education Personnel","doi-asserted-by":"crossref","award":["CAPES\/DFATD-88887.159028\/2017-00","Program CAPES\/COFECUB-88881.370894\/2019-01"],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004901","name":"Foundation for Research Support of the State of Minas Gerais","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004901","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Program CAPES\/COFECUB","award":["88887.612297\/2021-00","88887.628121\/2021-01","MA957\/20 2019-2023"]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n 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\u2019s 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<\/jats:italic>, and assess the accessibility of the game.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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\u2014Movement Disorder Society-Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS)\u2014for 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<\/jats:italic> 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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<\/jats:italic>\u00a0<\u00a00.05) between groups, except for the healthy group and the PD group in the OFF state of medication during Phase 3 of the game.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.7717\/peerj-cs.1267","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T08:35:22Z","timestamp":1678869322000},"page":"e1267","source":"Crossref","is-referenced-by-count":2,"title":["RehaBEElitation<\/i>: the architecture and organization of a serious game to evaluate motor signs in Parkinson\u2019s disease"],"prefix":"10.7717","volume":"9","author":[{"given":"Luanne","family":"Cardoso Mendes","sequence":"first","affiliation":[{"name":"Centre for Innovation and Technology Assessment in Health (NIATS), Faculty of Electrical Engineering, Federal University of Uberl\u00e2ndia, Universidade Federal de Uberl\u00e2ndia, Uberl\u00e2ndia, Minas Gerais, Brazil"},{"name":"Laboratoire de Conception, d\u2019Optimisation et de Mod\u00e9lisation des Syst\u00e8mes (LCOMS), Universit\u00e9 de Lorraine, Metz, Moselle, 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