{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T02:38:11Z","timestamp":1768790291374,"version":"3.49.0"},"reference-count":45,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2016,5,16]],"date-time":"2016-05-16T00:00:00Z","timestamp":1463356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Poor posture can result in loss of physical function, which is necessary to preserving independence in later life. Its decline is often the determining factor for loss of independence in the elderly. To avoid this, a system to correct poor posture in the elderly, designed for Kinect-based indoor applications, is proposed in this paper. Due to the importance of maintaining a healthy life style in senior citizens, the system has been integrated into a game which focuses on their physical stimulation. The game encourages users to perform physical activities while the posture correction system helps them to adopt proper posture. The system captures limb node data received from the Kinect sensor in order to detect posture variations in real time. The DTW algorithm compares the original posture with the current one to detect any deviation from the original correct position. The system was tested and achieved a successful detection percentage of 95.20%. Experimental tests performed in a nursing home with different users show the effectiveness of the proposed solution.<\/jats:p>","DOI":"10.3390\/s16050704","type":"journal-article","created":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T10:20:11Z","timestamp":1463480411000},"page":"704","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Kinect-Based Virtual Game for the Elderly that Detects Incorrect Body Postures in Real Time"],"prefix":"10.3390","volume":"16","author":[{"given":"Zelai","family":"Saenz-de-Urturi","sequence":"first","affiliation":[{"name":"DeustoTech Institute of Technology, DeustoTech-LIFE Unit, University of Deusto, Bilbao 48007, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9356-1186","authenticated-orcid":false,"given":"Begonya","family":"Garcia-Zapirain Soto","sequence":"additional","affiliation":[{"name":"DeustoTech Institute of Technology, DeustoTech-LIFE Unit, University of Deusto, Bilbao 48007, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2016,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1093\/gerona\/gls253","article-title":"Spinal posture in the sagittal plane is associated with future dependence in activities of daily living: A community-based cohort study of older adults in Japan","volume":"68","author":"Kamitani","year":"2013","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2817","DOI":"10.1097\/01.brs.0000190448.69091.53","article-title":"Incidence and course of low back pain episodes in the general population","volume":"30","author":"Cassidy","year":"2005","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Thiese, M.S., Hegmann, K.T., Wood, E.M., Garg, A., Moore, J.S., Kapellusch, J., Foster, J., and Ott, U. (2014). Prevalence of low back pain by anatomic location and intensity in an occupational population. BMC Musculoskelet. Disord., 15.","DOI":"10.1186\/1471-2474-15-283"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1590\/S1413-35552008005000002","article-title":"Effects of educational sessions on school backpack use among elementary school students","volume":"12","author":"Fernandes","year":"2008","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1007\/s00586-012-2558-7","article-title":"Effects of a postural education program on school backpack habits related to low back pain in children","volume":"22","author":"Vidal","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1056\/NEJM199302253280803","article-title":"Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men","volume":"328","author":"Sandvik","year":"1993","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1001\/jama.279.8.585","article-title":"Risk factors for 5-year mortality in older adults","volume":"279","author":"Fried","year":"1998","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"578","DOI":"10.2105\/AJPH.91.4.578","article-title":"Physical activity and mortality: A prospective study among women","volume":"91","author":"Rockhill","year":"2001","journal-title":"Am. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/00008483-200107000-00002","article-title":"Enhancing adherence to prescribed exercise: Structured behavioral interventions in clinical exercise programs","volume":"21","author":"Woodard","year":"2001","journal-title":"J. Cardiopulm. Rehabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/j.chb.2013.01.014","article-title":"Successful aging through digital games: Socioemotional differences between older adult gamers and non-gamers","volume":"29","author":"Allaire","year":"2013","journal-title":"Comput. Hum. Behav."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1089\/g4h.2012.0011","article-title":"A scoping review of health game research: Past, present, and future","volume":"1","author":"Kharrazi","year":"2012","journal-title":"Games Health J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1089\/cyber.2010.0578","article-title":"Is playing exergames really exercising? A meta-analysis of energy expenditure in active video games","volume":"14","author":"Peng","year":"2011","journal-title":"Cyberpsychol. Behav. Soc. Netw."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Webster, D., and Celik, O. (2014). Systematic review of Kinect applications in elderly care and stroke rehabilitation. J. NeuroEng. Rehabil., 11.","DOI":"10.1186\/1743-0003-11-108"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gerling, K.M., and Masuch, M. (2011, January 28). When Gaming is not suitable for everyone: Playtesting wii games with frail elderly. Proceedings of the 1st Workshop on Game Accessibility: Xtreme Interaction Design (FDG 2011), Bordeaux, France.","DOI":"10.1145\/2071423.2071501"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.ijge.2014.06.007","article-title":"Virtual reality-based wii fit training in improving muscle strength, sensory integration ability, and walking abilities in patients with parkinson\u2019s disease: A randomized control trial","volume":"9","author":"Liao","year":"2015","journal-title":"Int. J. Gerontol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chang, C.Y., Lange, B., Zhang, M., Koenig, S., Requejo, P., Somboon, N., Sawchuk, A.A., and Rizzo, A.A. (2012, January 21\u201324). Towards pervasive physical rehabilitation using Microsoft Kinect. Proceedings of the 6th International Conference on Pervasive Computing Technologies for Healthcare (Pervasive Health 2012), San Diego, CA, USA.","DOI":"10.4108\/icst.pervasivehealth.2012.248714"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.gaitpost.2012.03.033","article-title":"Validity of the Microsoft Kinect for assessment of postural control","volume":"36","author":"Clark","year":"2012","journal-title":"Gait Posture"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Obdrzalek, S., Kurillo, G., Ofli, F., Bajcsy, R., Seto, E., Jimison, H., and Pavel, M. (September, January 28). Accuracy and robustness of Kinect pose estimation in the context of coaching of elderly population. Proceedings of the 2012 Annual International IEEE Conference, Engineering in Medicine and Biology Society (EMBC), San Diego, CA, USA.","DOI":"10.1109\/EMBC.2012.6346149"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Fernandez-Baena, A., Susin, A., and Lligadas, X. (2012, January 19\u201321). Biomechanical validation of upper-body and lower-body joint movements of Kinect motion capture data for rehabilitation treatments. Proceedings of the 2012 Fourth International Conference on Intelligent Networking and Collaborative Systems, Bucharest, Romania.","DOI":"10.1109\/iNCoS.2012.66"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.cmpb.2013.10.014","article-title":"A Kinect-based system for cognitive rehabilitation exercises monitoring","volume":"113","year":"2014","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"27569","DOI":"10.3390\/s151127569","article-title":"Calibration of kinect for xbox one and comparison between the two generations of Microsoft sensors","volume":"15","author":"Pagliari","year":"2015","journal-title":"Sensors"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1089\/cpb.2005.8.187","article-title":"Virtual environments for motor rehabilitation: Review","volume":"8","author":"Holden","year":"2005","journal-title":"Cyberpsychol. Behav."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3654","DOI":"10.1016\/j.ridd.2013.08.021","article-title":"A Kinect-based upper limb rehabilitation system to assist people with cerebral palsy","volume":"34","author":"Chang","year":"2013","journal-title":"Res. Dev. Disabil."},{"key":"ref_24","unstructured":"Pastor, I., Hayes, H.A., and Bamberg, S.J. (September, January 28). A feasibility study of an upper limb rehabilitation system using Kinect and computer games. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), San Diego, CA, USA."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Eichenberg, C. (2012). Virtual Reality in Psychological, Medical and Pedagogical Applications, InTech.","DOI":"10.5772\/2607"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Carmichael, A., Rice, M., MacMillan, F., and Kirk, A. (2010, January 6\u201310). Investigating a DTV-based physical activity application to facilitate wellbeing in older adults. Proceedings of the 24th BCS Interaction Specialist Group Conference, Dundee, UK.","DOI":"10.14236\/ewic\/HCI2010.1"},{"key":"ref_27","unstructured":"Rice, M., Tan, W.P., Ong, J., Yau, L.J., Wan, M., and Ng, J. (May, January 27). The dynamics of younger and older adult's paired behavior when playing an interactive silhouette game. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, Paris, France."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Smeddinck, J.D., Herrlich, M., and Malaka, R. (2015, January 18\u201323). Exergames for physiotherapy and rehabilitation: A medium-term situated study of motivational aspects and impact on functional reach. Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems, Seoul, Korea.","DOI":"10.1145\/2702123.2702598"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tang, R., Yang, X.D., Bateman, S., Jorge, J., and Tang, A. (2015, January 18\u201323). Physio@ Home: Exploring visual guidance and feedback techniques for physiotherapy exercises. Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems, Seoul, Korea.","DOI":"10.1145\/2702123.2702401"},{"key":"ref_30","first-page":"41","article-title":"Postural adaptation in elderly patients with instability and risk of falling after balance training using a virtual-reality system","volume":"12","author":"Lavinsky","year":"2006","journal-title":"Int. Tinnitus J."},{"key":"ref_31","unstructured":"Posture Minder. Available online: http:\/\/www.postureminder.co.uk\/."},{"key":"ref_32","unstructured":"Kopani\u010d\u00e1kov\u00e1, A., and Vir\u010d\u00edkov\u00e1, M. Gesture Recognition Using DTW and Its Application Potential in Human-Centered Robotics. Available online: http:\/\/neuron.tuke.sk\/maria.vircik\/phd\/files\/documents\/publications\/Gesture%20Recognition%20using%20DTW%20and%20its%20Application%20Potential%20in%20Human-Centered%20Robotics.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Jangyodsuk, P., Conly, C., and Athitsos, V. (2014, January 27\u201330). Sign language recognition using dynamic time warping and hand shape distance based on histogram of oriented gradient features. Proceedings of the 7th International Conference on PErvasive Technologies Related to Assistive Environments, Rhodes, Greece.","DOI":"10.1145\/2674396.2674421"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1109\/34.799904","article-title":"An HMM-based threshold model approach for gesture recognition","volume":"21","author":"Kim","year":"1999","journal-title":"IEEE Trans. Pattern Anal. Mach. Intell."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wang, Y., Yang, C., Wu, X., Xu, S., and Li, H. (2012, January 26\u201327). Kinect based dynamic hand gesture recognition algorithm research. Proceedings of the 4th International Conference on Intelligent Human-Machine Systems and Cybernetics (IHMSC), Nanchang, China.","DOI":"10.1109\/IHMSC.2012.76"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1109\/72.655042","article-title":"Glove-TalkII-a neural-network interface which maps gestures to parallel formant speech synthesizer controls","volume":"9","author":"Fels","year":"1998","journal-title":"IEEE Trans. Neural Netw."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Zhao, W., Feng, H., Lun, R., Espy, D.D., and Reinthal, M. (2014, January 27\u201329). A Kinect-based rehabilitation exercise monitoring and guidance system. Proceedings of the 5th IEEE International Conference on Software Engineering and Service Science (ICSESS), Beijing, China.","DOI":"10.1109\/ICSESS.2014.6933678"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Zhao, W., Lun, R., Espy, D.D., and Reinthal, M. (2014, January 9\u201312). Rule based realtime motion assessment for rehabilitation exercises. Proceedings of the IEEE Symposium on Computational Intelligence in Healthcare and E-Health (CICARE), Orlando, FL, USA.","DOI":"10.1109\/CICARE.2014.7007845"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMinimental State\u201d: A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_40","first-page":"425","article-title":"DTW based pattern matching method for multivariate time series","volume":"24","author":"Li","year":"2011","journal-title":"Pattern Recognit. Artif. Intell."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1080\/0144929X.2015.1077889","article-title":"Elderly user experience to improve a Kinect-based game playability","volume":"34","year":"2015","journal-title":"Behav. Inf. Technol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Gerling, K., Livingston, I., Nacke, L., and Mandryk, R. (2012, January 5\u201310). Full-body motion-based game interaction for older adults. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, Austin, TX, USA.","DOI":"10.1145\/2207676.2208324"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Jordan, P.W.B., Weerdmeester, A., and Thomas, M.I.L. (1996). Usability Evaluation in Industry, Taylor & Francis.","DOI":"10.1201\/9781498710411"},{"key":"ref_44","unstructured":"Nacke, L., Schild, J., and Niesenhaus, J. (2010, January 15\u201317). Gameplay experience testing with playability and usability surveys\u2014An experimental pilot study. Proceedings of the Fun and Games 2010 Workshop, NHTV Expertise Series 10 Workshop Paper: Playability and Player Experience, Leuven, Belgium."},{"key":"ref_45","unstructured":"Tullis, T., and Albert, B. (2008). Measuring the User Experience: Collecting, Analyzing, and Presenting Usability Metrics. Burlington, Morgan Kaufmann."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/16\/5\/704\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:23:57Z","timestamp":1760210637000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/16\/5\/704"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,16]]},"references-count":45,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,5]]}},"alternative-id":["s16050704"],"URL":"https:\/\/doi.org\/10.3390\/s16050704","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,16]]}}}