Efficacy of Using Retro Games in Multimodal Biofeedback Systems for Mental Relaxation

Abstract

Video games are used to increase the engagement of biofeedback systems. For cost-effectiveness, the original Nintendo Entertainment System (NES) games can be used. Therefore, a multimodal biofeedback system was developed to leverage the NES games for biofeedback. This study aims to test the efficacy of the developed system, the motivation of participants, and the usability of the system. A within-group design study was conducted with 16 participants followed through four interventions: deep breathing, stress-test, non-biofeedback game (control), and biofeedback game (experiment), where their HRV was recorded. Participants showed significantly different HRV during interventions (F(1.60, 23.93) = 11.94, p < 0.001) and reported higher HRV when using biofeedback game than the non-biofeedback game (t(15) = 9.14, p < 0.0001). The motivation was reported to be the same with biofeedback and non-biofeedback version of the game and the overall system was reported as usable. The results of this study support the efficacy of using original NES games in biofeedback for mental relaxation.

BioNES: A plug-and-play MATLAB-based tool to use NES games for multimodal biofeedback

“…The software is designed to completely integrate the data acquisition, signal conditioning, feature extraction, visualization, analysis, and data logging within the MATLAB environment which minimizes the dependencies. The efficacy, intrinsic motivation of use, and system usability of the BioNES has been validated by the randomized controlled trials [25] and the system performance via benchmarking a similar real-time data acquisition system in another study [26]. The trials were preregistered 2 with Open Science Framework (OSF) registries prior to the creation of data and the trial data and analysis scripts are publicly available in the OSF project repository 3 .…”

“…We have evaluated the efficacy of the BioNES as a multimodal biofeedback system for mental relaxation [25]. The study led to the understanding of stress response evoked by the original SMB game and how the game mechanics can be modified for biofeedback to help the player achieve relaxation and combat stress.…”

A comprehensive evaluation of linear and non-linear HRV parameters between paced breathing and stressful mental state

“…This phenomenon might be attributed to the participants engaging in paced breathing, resulting in mean respiration rates closely aligned with the resonating frequency of 0.1 Hz. It is worth noting that the choice of 0.1 Hz as the respiration rate is motivated by prior literature, where similar assumptions have been made for paced breathing [ 4 , [109] , [110] , [111] , [112] , [113] ]. Furthermore, literature demonstrates that cardiac coherence can be maximized via vagal predominance to reduce stress [ 109 ].…”

“…This low-cost, non-invasive technique serves as a metric for cardiac autonomic modulation [ 2 ]. HRV has been thoroughly investigated to gain insights into the impact of stress on cardiac autonomic functioning, thereby establishing itself as a reliable stress indicator [ [3] , [4] , [5] , [6] , [7] , [8] ]. It offers an indirect representation of intricate interactions for example as those between the sympathetic nervous system (SNS) and parasympathetic nervous system (PNS), blood pressure (BP), gas exchange, and various organs including the heart and stomach [ 5 ].…”