Digital Biomarkers for Well-being Through Exergame Interactions: Exploratory Study

Despoina Petsani, Evdokimos Konstantinidis, Aikaterini Marina Katsouli, Vasiliki Zilidou, Sofia B. Dias, Leontios Hadjileontiadis, Panagiotis Bamidis

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Ecologically valid evaluations of patient states or well-being by means of new technologies is a key issue in contemporary research in health and well-being of the aging population. The in-game metrics generated from the interaction of users with serious games (SG) can potentially be used to predict or characterize a user’s state of health and well-being. There is currently an increasing body of research that investigates the use of measures of interaction with games as digital biomarkers for health and well-being. Objective: The aim of this paper is to predict well-being digital biomarkers from data collected during interactions with SG, using the values of standard clinical assessment tests as ground truth. Methods: The data set was gathered during the interaction with patients with Parkinson disease with the webFitForAll exergame platform, an SG engine designed to promote physical activity among older adults, patients, and vulnerable populations. The collected data, referred to as in-game metrics, represent the body movements captured by a 3D sensor camera and translated into game analytics. Standard clinical tests gathered before and after the long-term interaction with exergames (preintervention test vs postintervention test) were used to provide user baselines. Results: Our results showed that in-game metrics can effectively categorize participants into groups of different cognitive and physical states. Different in-game metrics have higher descriptive values for specific tests and can be used to predict the value range for these tests. Conclusions: Our results provide encouraging evidence for the value of in-game metrics as digital biomarkers and can boost the analysis of improving in-game metrics to obtain more detailed results.

Original languageBritish English
Article numbere34768
JournalJMIR Serious Games
Issue number3
StatePublished - Jul 2022


  • cognitive well-being
  • machine learning
  • physical well-being
  • serious games


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