Monocular-Camera-Based Mobile Exergame for Type 2 Diabetes Prevention

Development and Evaluation of a Monocular-Camera-Based Mobile Exergame for At-Home Intervention in Individuals at High Risk of Type 2 Diabetes

Exergames have demonstrated potential as effective interventions for promoting physical activity and preventing type 2 diabetes (T2D), particularly among older adults. Kinect-based exergames, in particular, have been associated with improved adherence to exercise regimens and positive health outcomes. However, widespread implementation is limited by the high cost and reduced accessibility of the required hardware, restricting their use in home-based settings. Recent advances in computer vision have enabled the development of exergames using monocular camera systems, which may represent a cost-effective and scalable alternative. This study investigates the feasibility of monocular-camera-based exergames as a cost-effective and convenient alternative for home-dwelling individuals.

A total of 45 community-dwelling older adults aged 60-74 years, identified as high risk for T2D were recruited through local community health centers. Participants were randomly assigned to one of three groups (n = 15 per group): (1) Control group (traditional offline exercise with printed instructions), (2) Kinect group (Kinect-based exergames targeting aerobic capacity, balance, and strength), and (3) Monocular group (monocular-camera-based exergames using real-time 2D pose estimation). The intervention lasted six weeks, with participants completing three 30-minute sessions per week at home. Primary outcomes included exercise performance (completion rate and movement accuracy) and intrinsic motivation. Secondary outcomes included perceived enjoyment, challenge, and usability. Data were analyzed using one-way ANOVA.

Inclusion Criteria:

1. age between 60-74;
2. a score of 25 or higher on the Chinese Diabetes Risk Score;
3. community-dwelling individuals, not reside in assisted living or long-term care facilities;
4. physically capable of engaging in light to moderate exercise, as determined by self-report and/or physician clearance;
5. normal cognitive function that enable the participant to complete the experiment independently or with minimal assistance;
6. Written informed consent provided by participants or their families.

Exclusion Criteria:

1. diagnosis of type 1 or type 2 diabetes;
2. current participation in another exercise intervention study;
3. severe cognitive impairment with MMSE < 24;
4. major mobility limitations such as severe osteoarthritis and recent orthopedic surgery.