BioPad: Leveraging off-the-Shelf Video Games for Stress Self-Regulation.

This paper presents an approach to use commercial videogames for biofeedback training. It consists of intercepting signals from the game controller and adapting them in real-time based on physiological measurements from the player. We present three sample implementations and a case study for teaching stress self-regulation via an immersive car racing game. We use a crossover gaming device to manipulate controller signals, and a respiratory sensor to monitor the players' breathing rate. We then alter the speed of the car to encourage slow deep breathing, in this way, allowing players to reduce their arousal while playing the game. We evaluate the approach against an alternative form of biofeedback that uses a graphic overlay to convey physiological information, and a control condition (playing the game without biofeedback). Experimental results show that our approach can promote deep breathing during gameplay, and also during a subsequent task, once biofeedback is removed. Our results also indicate that delivering biofeedback through subtle changes in gameplay can be as effective as delivering them directly through a visual display. These results open the possibility to develop low-cost and engaging biofeedback interventions using a variety of commercial videogames to promote adherence.