Sensory-Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Tannenstrasse 1, Zurich, 8092, Switzerland.
Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, Forchstrasse 340, Zurich, 8008, Switzerland.
J Neuroeng Rehabil. 2018 Nov 19;15(1):107. doi: 10.1186/s12984-018-0449-9.
Multiplayer games have emerged as a promising approach to increase the motivation of patients involved in rehabilitation therapy. In this systematic review, we evaluated recent publications in health-related multiplayer games that involved patients with cognitive and/or motor impairments. The aim was to investigate the effect of multiplayer gaming on game experience and game performance in healthy and non-healthy populations in comparison to individual game play. We further discuss the publications within the context of the theory of flow and the challenge point framework.
A systematic search was conducted through EMBASE, Medline, PubMed, Cochrane, CINAHL and PsycINFO. The search was complemented by recent publications in robot-assisted multiplayer neurorehabilitation. The search was restricted to robot-assisted or virtual reality-based training.
Thirteen articles met the inclusion criteria. Multiplayer modes used in health-related multiplayer games were: competitive, collaborative and co-active multiplayer modes. Multiplayer modes positively affected game experience in nine studies and game performance in six studies. Two articles reported increased game performance in single-player mode when compared to multiplayer mode.
The multiplayer modes of training reviewed improved game experience and game performance compared to single-player modes. However, the methods reviewed were quite heterogeneous and not exhaustive. One important take-away is that adaptation of the game conditions can individualize the difficulty of a game to a player's skill level in competitive multiplayer games. Robotic assistance and virtual reality can enhance individualization by, for example, adapting the haptic conditions, e.g. by increasing haptic support or by providing haptic resistance. The flow theory and the challenge point framework support these results and are used in this review to frame the idea of adapting players' game conditions.
多人游戏已成为提高参与康复治疗患者积极性的一种很有前途的方法。在本次系统评价中，我们评估了与健康相关的多人游戏中涉及认知和/或运动障碍患者的最新出版物。目的是调查与单人游戏相比，多人游戏对健康和非健康人群的游戏体验和游戏表现的影响。我们还根据流畅体验理论和挑战点框架进一步讨论了这些出版物。
通过 EMBASE、Medline、PubMed、Cochrane、CINAHL 和 PsycINFO 进行了系统搜索。通过机器人辅助的多人神经康复领域的最新出版物对搜索进行了补充。搜索仅限于机器人辅助或基于虚拟现实的训练。
有 13 篇文章符合纳入标准。健康相关多人游戏中使用的多人模式有：竞争性、协作性和共同活跃性多人模式。在 9 项研究中，多人模式对游戏体验有积极影响，在 6 项研究中对游戏表现有积极影响。有两篇文章报道了与多人模式相比，单人模式下游戏表现提高。
与单人模式相比，所审查的训练多人模式提高了游戏体验和游戏表现。但是，所审查的方法相当多样化，而且不全面。一个重要的收获是，游戏条件的调整可以使竞争性多人游戏中的游戏难度适应玩家的技能水平，从而实现个性化。机器人辅助和虚拟现实可以通过例如调整触觉条件来增强个性化，例如增加触觉支持或提供触觉阻力。流畅体验理论和挑战点框架支持这些结果，并在本综述中用于阐述适应玩家游戏条件的想法。
