HIT to Escape the Lava: A Serious Game for High-Intensity Training in Patients with Chronic Low Back Pain

Abstract

Chronic low back pain (CLBP) is a disabling condition that significantly limits overall functioning and quality of life. Although exercise therapy (ET) is a widely recommended treatment, patient adherence and motivation remain low, especially in home-based rehabilitation. This study presents the design, development, and initial evaluation of a gamified cycling exercise with high intensity interval training (HIIT) tailored for persons with CLBP. The game integrates cardiorespiratory interval training into a gamified environment to create a motivating and personalised exercise experience. Based on a formative expert evaluation, we conclude that the game concept provides a natural and motivating setting for a high-intensity cycling exercise. Some recommended design improvements to enhance the natural alignment of the game and the HIIT training have been identified. Further exploration of the game concept with patients is needed to determine its feasibility and effectiveness. The results of the current study will shape the design and development of digital health interventions that support motivating and enjoyable rehabilitation in and outside clinical settings.