JMIR Serious Games

Immersive exercise systems may support guided movement practice and physical activity among older adults, but adoption of head-mounted systems cannot be inferred from single-session usability or intention ratings. Older adults must negotiate unfamiliar equipment, movement safety, comfort, perceived control, trust, and perceived benefit. Virtual reality (VR) and mixed reality (MR) are often grouped as extended reality despite different sensory and safety affordances.

Exergaming, or active video gaming, may make physical activity more engaging for children and adolescents. Earlier reviews have focused on activity, adiposity, fitness, or psychosocial outcomes, leaving effects on glycemic and lipid biomarkers uncertain. Their cardiometabolic relevance warrants synthesis.

People with multiple sclerosis (MS) are at high risk of falls, with approximately half experiencing at least 1 fall within 6 months. Multidirectional step training has shown potential for fall prevention, but evidence in people with MS remains inconsistent. Mixed reality (MR) offers adaptive and home-based rehabilitation opportunities. However, successful implementation of MR-based serious games requires structured co-design processes integrating patient, clinician, and technical perspectives.

Despite science, technology, engineering, and mathematics (STEM) fields driving socioeconomic development and career prospects, they continue to struggle with low enrollment and high dropout rates. An important predictor of academic performance and career persistence is self-efficacy, which is the belief in one’s ability to succeed. Research indicates that collaboration improves learning outcomes and is associated with improved STEM motivation. Computational thinking (CT) is also increasingly valued in STEM education due to its reliance on computational tools and problem-solving processes. Early exposure to STEM content in a child’s educational journey may thus be a key opportunity for shaping their STEM self-efficacy and future career path.

Early bystander cardiopulmonary resuscitation (CPR) and prompt defibrillation are key determinants of survival after out-of-hospital cardiac arrest, and school-based adult basic life support (BLS) education is a high-impact public health strategy. However, scalability and standardized assessment remain challenging. Gamified digital environments may sustain engagement while enabling comparable, rubric-based evaluation of learning artifacts. Few evaluations have examined whether a fully online gamified platform can support large-scale school-based adult BLS participation while generating standardized class-level artifacts for structured assessment.

Alzheimer disease (AD) is increasingly conceptualized as a disorder of large-scale brain network disruption rather than isolated regional dysfunction. Immersive virtual reality (VR) may provide a controlled sensory challenge for neurophysiological assessment, but its association with whole-brain electroencephalography (EEG) functional network organization across AD and mild cognitive impairment (MCI) remains insufficiently characterized.

Adolescents and young adults account for a disproportionate number of new HIV diagnoses in the United States due to missed opportunities for education, testing, and prevention.

Immersive virtual reality (IVR) is increasingly used for task training. Adjusting sensory and cognitive complexity to individual capacity is important for effective training, yet it remains unclear how varying visual, auditory, and cognitive demands influence behavioral responses, physiological activity, and task performance during goal-directed activities in IVR.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsivity that significantly disrupt daily functioning. Comprehensive ADHD assessment requires multimethod and multi-informant evaluation, and objective attention measures can complement this process. Serious game–based assessments may further support this process by combining structured task mechanics and dynamic audiovisual guidance in a child-oriented digital environment.

Patient education is central to orthodontic care; however, most patients still learn about their malocclusion from conventional records, such as 2D image records. Immersive virtual reality (VR) allows patients to view and manipulate 3D dental models in a head-tracked environment, as part of the serious-games and extended reality family for health education. Evidence on patient-facing immersive VR in orthodontics remains limited, as most dental VR work has addressed student training rather than patient education.

Traditional neuropsychological assessments often lack ecological validity and have limited sensitivity for detecting executive dysfunction (ED) in daily life. Although grounded in standardized tasks, they do not represent the complexity of real-world contexts. Serious games (SGs) have emerged as a promising approach by simulating ecologically valid environments involving dynamic, emotional, and socially embedded interactions.