Objective: The aim of this article is to describe the development and testing of a prototype application (ââ?¬Ë?ââ?¬Ë?The Heart\nGameââ?¬â?¢Ã¢â?¬â?¢) using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog\nproject.\nMaterials and Methods: A prototype game was developed via user-driven innovation and tested on 10 patients\n48ââ?¬â??89 years of age and their relatives for a period of 2 weeks. The application consisted of a series of daily\nchallenges given to the patients and relatives and was based on several gamification principles. A triangulation\nof data collection techniques (interviews, participant observations, focus group interviews, and workshop) was\nused. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in\norder to evaluate the use of the prototype.\nResults: The heart patients reported the application to be a useful tool as a part of their telerehabilitation process\nin everyday life. Gamification and gameful design principles such as leaderboards, relationships, and\nachievements engaged the patients and relatives. The inclusion of a close relative in the game motivated the\npatients to perform rehabilitation activities.\nConclusions: ââ?¬Ë?ââ?¬Ë?The Heart Gameââ?¬â?¢Ã¢â?¬â?¢ concept presents a new way to motivate heart patients by using technology as\na social and active approach to telerehabilitation. The findings show the potential of using gamification for heart\npatients as part of a telerehabilitation program. The evaluation indicated that the inclusion of the patientââ?¬â?¢s\nspouse in the rehabilitation activities could be an effective strategy. A major challenge in using gamification for\nheart patients is avoiding a sense of defeat while still adjusting the level of difficulty to the individual patient.
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