Trends in robot-assisted and virtual reality-assisted neuromuscular therapy: a systematic review of health-related multiplayer games

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

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Multiplayer video game

A multiplayer video game is a video game in which more than one person can play in the same game environment at the same time, either locally on the same computing system (couch co-op), on different computing systems via a local area network, or via a wide area network, most commonly the Internet (e.g. World of Warcraft, Call of Duty, DayZ). Multiplayer games usually require players to share a single game system or use networking technology to play together over a greater distance; players may compete against one or more human contestants, work cooperatively with a human partner to achieve a common goal, or supervise other players' activity.

Cooperative video game

A cooperative video game, often abbreviated as co-op, is a video game that allows players to work together as teammates, usually against one or more non-player character opponents (PvE). Co-op games can be played locally using one or multiple input controllers or over a network via local area networks, wide area networks, or the internet. Co-op gameplay has gained popularity as controller and networking technology has developed.

Massively multiplayer online role-playing game

A massively multiplayer online role-playing game (MMORPG) is a video game that combines aspects of a role-playing video game and a massively multiplayer online game. As in role-playing games (RPGs), the player assumes the role of a character (often in a fantasy world or science-fiction world) and takes control over many of that character's actions. MMORPGs are distinguished from single-player or small multi-player online RPGs by the number of players able to interact together, and by the game's persistent world (usually hosted by the game's publisher), which continues to exist and evolve while the player is offline and away from the game.

A mirror therapy system using virtual reality and an actuated exoskeleton for the recovery of hand motor impairments: a study of acceptability, usability, and embodiment

Luca Randazzo, Antonio Paolillo

Hand motor impairments are one of the main causes of disabilities worldwide. Rehabilitation procedures like mirror therapy are given crucial importance. In the traditional setup, the patient moves the healthy hand in front of a mirror; the view of the mirr ...

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Alternation makes the adversary weaker in two-player games

Volkan Cevher, Efstratios Panteleimon Skoulakis, Luca Viano, Ali Kavis

Motivated by alternating game-play in two-player games, we study an altenating variant of the Online Linear Optimization (OLO). In alternating OLO, a learner at each round t ∈[n] selects a vector xt and then an adversary selects a cost-vector ct ∈[−1,1]n. ...

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A Game-Based Approach to Develop Engineering Students’ Awareness About Artificial Intelligence Ethical Challenges

Patrick Jermann, Roland John Tormey, Cécile Hardebolle, Helena Kovacs, Maria Carla Di Vincenzo, Ester Simkova

The past few decades have seen important efforts to introduce more ethics into engineering education programs around the world, while adapting to the evolution of ethical concerns, notably in relation to digital technology and artificial intelligence. Even ...

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