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Categories Categories. Special Sections. Player Support. Community Hub. Choose your next step wisely and keep in mind that your every move will change the future. Create your own 'Corps' and explore through various regions in the Pillar of Despair: forests, lakes, mountains, cities, cathedrals, castles, and much more. All Reviews:. Popular user-defined tags for this product:.

Is this game relevant to you? Sign In or Open in Steam. Languages :. English and 4 more. View Steam Achievements Includes 77 Steam Achievements. Share Embed. Add to Cart. Bundle info. Add to Account. Add all DLC to Cart. View Community Hub. Defenseless and vulnerable, mankind was soon on the verge of extinction.

When all hope was lost, a miracle happened and the creatures suddenly vanished. Desperate to prevent the next invasion, the survivors created a group called the 'Corps' that journeys into the Vortex from whence the creatures emerged.

You will lead the Corps to reveal the secrets behind the incidents. Will the human race succeed in changing the course of their destiny? In the Mist of the Vortex, Pillar of Despair Research staff sent the questionnaires to participants via email. Participants uploaded the completed questionnaires to the cloud-based server. Fatigue and depression were measured via self-report, short-form questionnaires from the Neuro-QoL Quality of Life in Neurological Disorders Pediatric archive [ 36 ].

Each questionnaire had eight items that could be scored on a scale ranging from 1 none of the time to 5 all of the time. Higher scores reflect higher levels of fatigue and depression. Neuro-QoL tests were systematically developed by a multisite collaboration and psychometrically evaluated among a large population-based sample [ 37 ]; they are currently being tested for further validation among more specific groups of people with neurological conditions eg, traumatic brain injury, epilepsy, and muscular dystrophy [ 38 , 39 ], albeit not yet among people with SB.

Additional Neuro-QoL details and an extensive list of validation studies can be found elsewhere [ 36 ]. Participants underwent a semistructured interview with the researcher BL at the end of the program. The interview script is provided in Textbox 1. The interview included 10 overarching questions with several follow-up questions. The interviews were conducted through videoconference.

The participants were accompanied by their caregivers. The principal investigator BL had a background in adapted physical activity, along with several years of experience conducting qualitative interviews related to exercise and disability.

Each interview lasted approximately 2 hours. This interview will include 10 questions, along with several follow-up questions.

The questions will explore your perceptions of using the Oculus Quest headset to achieve exercise recommendations. This interview will be recorded so that we can later type and analyze the data for publication as a research study. This study is completely confidential and we will not include your name or any other identifying information. Your participation in the study will not affect any services or relationships you have with people at the University or Hospital.

Once again, your participation in this study is totally voluntary and your verbal consent over the phone now indicates that we have gone over the study details and that we have permission from you and one of your parents to participate in this phone call interview. Please say the first things that come to your head: what you think and what you feel.

There are no right or wrong answers. Please just tell your story. I will try to be listening more than talking during the interview. As an icebreaker, tell me about yourself.

What do you like to do for fun or in your free time? What does exercise mean to you? For this question, we will discuss your story about your experiences with the virtual reality headset, the Oculus Quest. We will talk about your thoughts of exercise starting from when you first started the program all the way to the end of the month.

Before you started the program, like when I first called you, how did you feel about starting an exercise program using the virtual reality headset? How confident were you that you could exercise with the technology? Okay, so in the first week of the program show data.

What did you think about exercising with the headset? Were there any problems you had with using the technology for exercise? Were there any things you think we could have done in this first week to make the experience better? What did you think about exercising with the headset during the second week? What did you think about exercising with the headset during the third week? What did you think about exercising with the headset during this last week?

Okay, next question; we are planning to give the same program you went through to other kids with spina bifida around your age. Are there any thoughts you have that could make the program better for other kids? What did you like about each game? Did you find it easy to get your heart rate to the moderate zone from that game? For each game you mentioned, what are some tips or strategies you can recommend for other kids? Go through each game they can recall.

All quantitative outcomes ie, objectively recorded exercise data and self-reported questionnaire data were descriptively reported. Neuro-QoL depression and fatigue scores at baseline and postintervention were summed and converted to T scores [ 40 ].

The qualitative component utilized an explanatory narrative approach [ 41 ] to explain the potential usefulness of the program and expand interpretations of the quantitative data.

Interview data were transcribed and double-checked for accuracy. The results were reported in narrative format, underpinned by an interpretivism paradigm. The specific philosophical assumptions that underpinned the qualitative study methods were critical realism ontological perspective [ 42 ] and interpretivism epistemological perspective [ 43 ].

In other words, the researcher team acknowledged that youth with SB perceived a reality when reporting their responses, and the recollection of this reality or experience was recreated by the interaction between the youth and the interviewer, as well as the interpretation of the data.

Characteristics of the two participants are presented in Table 1. The quantitative exercise data are reported below, followed by an explanatory narrative of each case. There were no adverse events reported by participants throughout the program. The participants completed the program in April , a period when states within the United States were under a social distancing and shelter-in-place order. The total average minutes of moderate-to-vigorous-intensity exercise per week for cases 1 and 2 were SD and SD 90 minutes, respectively.

Accordingly, both case participants were classified as sufficiently active. These values were below the exercise guidelines for children, but exceeded exercise guidelines for adults see Figure 2.

On average, participants spent Weekly exercise data are reported in Table 2. Case 1 reported an improvement in depression from baseline to postintervention change in T score of Case 2 reported no change in depression score at postintervention. Johnny used a wheelchair as a primary means of mobility and used an ankle-foot orthosis AFO when walking short distances. Prior to the COVIDrelated shelter-in-place order and the study, Johnny engaged in no exercise behavior outside of school physical education classes.

Yet, he was unable to engage in most sports and activities with his peers during physical education class. The activities in his class were not fully adapted or modified for a wheelchair user. Thus, Johnny spent much of his physical education time isolated from participation on the sidelines. Most of his free time was spent watching sports on television or playing nonactive video games. At the start of the program, Johnny reported that he was not confident that he could complete 60 minutes of moderate-intensity exercise in a day.

He felt intimidated by these instructions, and stated that the duration felt long and he could not remember the last time he completed 60 minutes of any exercise in one day. These feelings were maintained until he opened the box with the headset that was sent to his home. Immediately upon viewing the headset, Johnny was extremely excited by the quality of the technology and quickly set up the system and played the games. The first day he received the headset, he used it for over 3 hours.

After using the VR headset for 1 week, he realized that exercising for 60 minutes a day at a moderate intensity could easily be achieved and did so in his first day of using the headset. He was very excited and proud of his ability to exercise with the headset and would consistently show his family some of the VR experiences and demonstrate his physical prowess during gameplay. His mother reported that she would have to limit his daily use of the headset so as not to interfere with mealtime and schoolwork.

His mother also reported that he spent approximately three times as much time using the headset than what was recorded through the VR system: approximately 4 hours each day. Johnny exercised with the headset in a wheelchair, chair, or bed or on the floor. All of it. I loved it. Johnny did not spend much of his time playing online multiplayer games, but one particularly enjoyable multiplayer game was Acron: Attack of the Squirrels! Johnny played this game with his entire family, which created some memorable experiences.

Johnny reported that VR games were more enjoyable than typical console games and that he liked being able to play the game while moving his arms. Notably, Johnny and his mother reported that he seemed to have lost some weight based on his facial features and some other areas of his body.

Both Johnny and his mother were elated at being able to see an observable change in such a short period. Johnny was particularly thrilled that he was able to lose weight, which was an important goal of his, while doing activities that were so enjoyable that he was unaware he was exercising. He also reported that the calories expended after each session provided him with a sense of accomplishment.

By accomplishing these feats and realizing that he was capable of performing a high volume of exercise, Johnny felt more motivated to engage in general exercise after the program. No objective measurement of weight was obtained, due to difficulties with obtaining body weight measurements while using a wheelchair. The last weight measurement that the family obtained was during a visit to their physician prior to the COVID quarantine. Johnny did much less exercise in weeks 2 and 3 than in weeks 1 and 4.

Johnny and his mother noted that this was because he was traveling with his father in a conventional sleeper truck. Johnny brought the Quest with him while accompanying his father and would play in the truck while his father drove or before bed. Also, during week 3, Johnny did not feel well due to a flare-up of his allergies and this reduced his playing time. Johnny reported that he did not like to wear and equip the heart rate monitor before exercise. He noted that it felt uncomfortable and he would occasionally unfasten the strap during long bouts of exercise.

For these reasons, much of the exercise he did was not recorded with the VR system. Johnny recommended that his heart rate be recorded from a wrist-worn device, such as his Apple Watch. Johnny reported that he tried the multiplayer games but did not engage in them regularly.

He and his mother reported that there did not appear to be many other players when joining a game lobby. Unlike Xbox Live, they did not notice a big community of players. Instead, he spent more time playing local multiplayer games with his entire family. Family members played the games—Acron: Attack of the Squirrels! Sapphire used a wheelchair as a primary means of mobility and used an AFO when walking short distances. At school, she was not included in most sports and activities with her peers during physical education class.

However, at a previous school she did have an adapted physical education teacher. The teacher developed a personalized program for Sapphire and modified activities to include her in the activities with peers. During the COVID quarantine, Sapphire engaged in no exercise behavior and spent most of her free time watching television or using her phone.

However, Sapphire and her mother reported that she had a high volume of schoolwork in the form of homework and virtual class sessions via videoconferencing. Since the family shared one laptop for work and school, they operated around a strict schedule. This meant that VR exercise had to be performed early in the morning before school or later in the evening.

Before Sapphire began the program, she was worried that she would not be able to complete the prescribed 60 minutes. The amount of time was perceived as too long and intimidating. When the headset arrived at their home and Sapphire saw it, she was extremely excited and could not wait to try it out.

She was surprised to realize that she completed 78 minutes of exercise in her first session. By the end of the study, it was very easy for her to complete 60 minutes of moderate exercise. She often wanted to play the VR games longer than prescribed and to get back on the headset later in the day. When exercising, Sapphire would sit in a wheelchair or chair.

Sapphire expressed a high level of enjoyment with the program. Sapphire was so encapsulated by the virtual environment that she pleasantly described her experience and knowledge of four friends she made in a game, Dance Central, which the interviewer did not realize were in-game characters, not actual online players, until further clarification. However, the games that Sapphire preferred were slightly different than the opponent-driven fighting games preferred by Johnny.

Sapphire specifically mentioned her enjoyment playing multiplayer games online, such as Rec Room, with other users and, most notably, at home with the family: Acron: Attack of the Squirrels! Sapphire consistently desired to play with her family and asked her father to play as soon as he returned home from work:.

When asked how she was able to achieve so much exercise time, she stated that in the first week of the program she completed multiple minute bouts as opposed to one minute session. It became easier for her to complete minute exercise bouts during the second week of the program.

Another factor that motivated her to exercise was being able to view the calories she expended each day within the VR Health Exercise Tracker app. I would get the VR off of her, charge it, hand it to her. She would put it on. This assistance was instrumental during the first 2 weeks of the program. However, during the latter 2 weeks of the program, Sapphire appeared internally motivated to complete her exercises.

No matter what, she would say we were going to make an hour or more each time. This required them to adjust their already strict schedule, which contributed to a lower amount of exercise. Sapphire reported that there was a learning curve to using the VR headset and games. It took 2 days of exercise before she and her mother figured out how to equip the headset comfortably over her glasses and adjust the headset appropriately to avoid pressure on the front of the face, which would cause uncomfortable temporary imprints on her forehead.

Although Sapphire reported that some games were perfectly suitable for playing in a wheelchair, other games—Dance Central and Racket Fury—required lowering the player height in either the game or Oculus Quest settings for optimal play. Default settings for the player height of these games caused many of the activities to be out of physical reach for Sapphire.

Additionally, Dance Central instructed players to move their lower extremities, which Sapphire could not follow. Sturmgewehr Brecher. DMR Schneesturm. Holen Sie sich das Spiel. Call of Duty: Modern Warfare. Blockbuster-Kampagne, Mehrspieler und Zombies. Call of Duty: Vanguard. Call of Duty: Battle Pass. Call of Duty: Warzone. At Participating Retailers.

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