JMIR Serious Games

Exergaming can promote adolescent health by encouraging repetition of game-related tasks, potentially contributing to academic success by developing motor and cognitive skills. Studies have highlighted the influence of exergaming on motor skill learning but have not clarified its effects on general motor coordination. Other studies suggest that exergames may influence math success, particularly with nonmathematical, dance-based exergames, possibly through mental rotation or general motor coordination training. However, the influence of a single exergaming sequence on these abilities and on math achievement in the same participants has not been studied.

Game elements may inform the design of both simulations and games. However, evidence on how individual game elements inform the design of military trauma training simulations and their educational purpose remains limited.

Childhood and adolescent malnutrition, encompassing undernutrition and overnutrition, poses significant global health challenges, necessitating comprehensive dietary assessment tools. Existing dietary assessment methods, such as 24-hour dietary recalls (24HR), often fail to capture eating behaviors and food preferences.

Immersive virtual reality (VR) is promising in stroke rehabilitation; it is believed to promote motivation and intervention adherence among patients. However, existing work often lacks a structured assessment of user experience over a longer period of time.

Children with developmental coordination disorder (DCD) experience motor difficulties that limit daily activities and reduce physical activity enjoyment. Immersive virtual reality (VR) offers the potential for feedback-rich movement practice, but evidence for these effects in DCD remains limited.

Adolescents’ internet adaptability (IA) is crucial for their online behavior and mental health. Serious games (SGs), as an emerging educational tool, hold promise for enhancing this adaptability through engaging, goal-oriented learning. Yet, direct evidence in this area remains limited. This viewpoint aims to clarify the mechanisms through which SGs enhance adolescents’ IA and to derive corresponding design principles that can inform educational practice and game development. Drawing on insights from both Chinese and international studies, this study adopts a cross-contextual perspective to explore how SGs can foster IA in varied educational environments. Beyond synthesizing existing findings, this viewpoint provides an integrated account of why IA is essential in contemporary digital life and how SGs can support its development. It proposes a 3-stage framework, illustrating how contextualized design, real-time feedback, and dynamic tasks promote experiential learning, self-regulation, and the transfer of online skills. Based on this framework, the study further articulates 6 core design principles: clear goal definition, interaction diversity, contextual authenticity, immediate, scaffolding and explanatory feedback, a dynamically adaptive learning environment, and safety-by-design for digital well-being. These principles translate the core characteristics and mechanisms of SGs into actionable guidance for developing effective IA interventions. By synthesizing theoretical insights with practical considerations, this viewpoint highlights how SGs can serve as accessible and scalable tools to support adolescents in navigating increasingly complex digital environments. Together, these insights provide practical implications for educators, curriculum designers, and digital game developers seeking to foster adolescents’ safe, responsible, and adaptive engagement in online environments.

Internet gaming disorder (IGD) and school refusal are increasingly prevalent during adolescence, yet limited research has examined how they influence each other over time. Moreover, it is unclear whether the association differs by sex.

Children with autism spectrum disorder (ASD) exhibit cognitive, motor, and social difficulties that affect engagement, causing developmental delays, behavioral challenges, and obesity—interrelated concerns in daily functioning and well-being. Although interactive interventions have incorporated physical activity, they often rely on limited physical involvement and lack iterative, expert-informed design, as built on pre-existing game frameworks. Physical activity is often operationalized as constrained input (eg, gestures or in-place actions) rather than exertion-intensive, whole-body exercise, and design guidance for adapting exercise content under ASD-oriented safety and cognitive-sensory constraints remains limited. These limitations highlight the need for exergames that promote sustained, full-body participation aligned with developmental goals, motivating formative, co-design with expertise and initial field testing in this population.

Slowness in voluntary movements is a hallmark of Parkinson disease (PD); yet, objective measurement outside clinical settings is limited. Serious games represent a promising alternative to extract motor performance metrics during interactions. However, evidence on the effectiveness of these games in discriminating motor performance between individuals with and those without PD is still scarce.

Managing blood pressure (BP) in prehypertensive individuals is crucial to prevent the incidence of hypertension. While physical activity has proven effective in BP management, physical inactivity remains prevalent. Gamification has shown promise in addressing physical inactivity; however, its effectiveness is limited due to the suboptimal intervention design.

The metaverse provides an immersive, interactive medium for health education, but most studies evaluate immersion and gamification together. Randomized evidence disentangling their separate effects on immediate learning and short-term retention in breast health education is lacking.

Exergaming, which combines physical activity with interactive gaming, has been shown to improve motor skills and fitness. However, exergaming’s potential in complex, open-skill sports such as tennis, which require real-time coordination, decision-making, and technical precision, remains underexplored. Furthermore, only a few studies have evaluated the impact of exergaming on both technical skill development and psychological outcomes such as motivation and confidence, especially among novice players. This study addresses these gaps by comparing the combination of exergame-based tennis training and on-court tennis training (EBTT+OCTT) with on-court tennis training alone (OCTT×2) in improving technical skills, grip strength, confidence, and motivation.