# Effectiveness of High-Intensity Therapy in Rehabilitation of Parkinson's Disease Patients
## 3 Intervention
### Exergaming  
The measurement setup was based on the Microsoft Xbox 360 core system. As the successor of the first console, it offers online gaming and updates, media streaming, and connection to several peripheral devices, such as the Kinect motion-sensing camera [35]. The Kinect sensor is a widely known and used external device for the Xbox. It contains RGB cameras and infrared detectors for depth mapping, which allows real-time recognition of gestures/body movements. Although there exist various updates and newer versions of the Xbox family, this system is also capable of providing an exergaming environment for scientific experiments [36-39]. Kinect Adventures! is a sports video game collection for the Xbox 360. It uses the Kinect camera and is one of the most popular games for this system. Five mini-games are included, all of them using full-body motion. In these short games, players aim to collect as many points (called adventure pins) as possible. This gaming environment has been available for scientific purposes since the introduction of the platform [10,12,40,41]. For our experiment, two of the games were selected: Reflex Ridge and Space Pop. Reflex Ridge is a competitive game where players are placed on a virtual moving platform. During the game, players race on this platform, jumping over and leaning away from obstacles and limboing to avoid hitting the head. They also gain points by touching collectibles. Space Pop is very similar. Here, players move and float in a zero-gravity environment. The goal is to pop transparent virtual soap balls. This environment utilizes depth information; thus, players have to move back and forth in front of the sensor. Additionally, they can fly upward by flapping their arms. Both games are time-limited (about 3 min). Third-party developers also offer applications for the console. Just Dance is a motion-based rhythm game (Ubisoft) that features various songs, along with pre-designed choreography and dance moves on the screen. Players have to mimic the routines and are scored on their accuracy. The game can be played with the Kinect system [42]. This was the third game selected as an exergaming solution for our experiment.  
Figure 1a shows screenshots of the games. To provide a clear understanding of the intervention structure, the sequence, duration, and break periods for the exergamingsessions are detailed here. Each training session included three exergames: _Reflex Ridge, Space Pop_, and _Just Dance_. These games were played in a fixed sequence during each session, beginning with _Reflex Ridge_, followed by _Space Pop_, and concluding with _Just Dance_. Each game lasted approximately 3 min, resulting in a total active gameplay time of 9 min per session. Between games, participants were allowed a 1 to 2 min rest period to recover and rehydrate, ensuring both safety and consistent performance. This structure was repeated in each of the twice-weekly sessions across the 14-week intervention period. The inclusion of short breaks between games was crucial for maintaining the intended high-intensity level while minimizing fatigue and cardiovascular strain in individuals with [PERSON]'s disease. All sessions followed a standardized warm-up (5 min), main training (20-35 min, including the games), and cool-down protocol (5 min), ensuring uniformity across the intervention.  
Figure 1b illustrates the Kinect-based motion tracking setup used during the exergaming sessions. This configuration enabled full-body motion capture in a VR-free setting, allowing participants to engage interactively with the exergames while maintaining safety and ease of use. The setup's real-time feedback capability played a critical role in enhancing engagement and monitoring performance.