Adaptive gameplay and difficulty adjustment in a gamified upper-limb rehabilitation

Pinto, Joana F.; Carvalho, Herculano; Chambel, Goncalo R. R.; Ramiro, Joao; Gonçalves, Afonso

doi:10.1109/segah.2018.8401363

Cited by 28 publications

(19 citation statements)

References 19 publications

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“…In terms of the selection and implementation of exercises and game design elements, it would be necessary to include patient-specific characteristics. However, only 2 consider either of these characteristics, that is, age and gender [ 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Whereas 11 publications focus on the implementation of a single, sometimes incredibly broad game [ 22 , 23 , 29 , 37 , 38 , 43 - 48 ], just as many publications provide several games [ 24 , 28 , 32 , 36 , 39 - 42 , 49 - 51 ]. By implementing different games, a higher variability is gained.…”

Section: Resultsmentioning

confidence: 99%

“…A user’s personal preferences can be also addressed, even if only indirectly. For example, in the application system InMotion users can choose to touch butterflies in a beautiful garden, hit and shoot paintballs towards a canvas, control a rowboat through several checkpoints, or mimic the motions of a pendulum [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…When playing Cupid’s Arrow, for example, players collect points by shooting an arrow at a heart through correct arm movements [ 41 ]. Also, in Classic Clock, points can be earned by imitating movements of a pendulum as precisely as possible [ 42 ]. However, points can also be used in application systems implementing no specific game.…”

Section: Resultsmentioning

confidence: 99%

“…Since all application systems were implemented to support training, half do not give feedback on the game (game feedback) but instead give feedback on the performance of exercises (therapy feedback). Therapy feedback often quantifies either the quality of exercise performance [ 37 , 42 , 45 , 46 , 52 ] or the progress/current status [ 44 , 50 ] to motivate patients or to ensure correct practice. Almost all application systems provided instructions, or even complete tutorials, for exercising correctly.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Gamification in Rehabilitation of Patients With Musculoskeletal Diseases of the Shoulder: Scoping Review

Steiner¹,

Elgert²,

Saalfeld³

et al. 2020

JMIR Serious Games

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Background Gamification has become increasingly important both in research and in practice. Particularly in long-term care processes, such as rehabilitation, playful concepts are gaining in importance to increase motivation and adherence. In addition to neurological diseases, this also affects the treatment of patients with musculoskeletal diseases such as shoulder disorders. Although it would be important to assist patients during more than one rehabilitation phase, it is hypothesized that existing systems only support a single phase. It is also unclear which game design elements are currently used in this context and how they are combined to achieve optimal positive effects on motivation. Objective This scoping review aims to identify and analyze information and communication technologies that use game design elements to support the rehabilitation processes of patients with musculoskeletal diseases of the shoulder. The state of the art with regard to fields of application, game design elements, and motivation concepts will be determined. Methods We conducted a scoping review to identify relevant application systems. The search was performed in 3 literature databases: PubMed, IEEE Xplore, and Scopus. Following the PICO (population, intervention, comparison, outcome) framework, keywords and Medical Subject Headings for shoulder, rehabilitation, and gamification were derived to define a suitable search term. Two independent reviewers, a physical therapist and a medical informatician, completed the search as specified by the search strategy. There was no restriction on year of publication. Data synthesis was done by deductive-inductive coding based on qualitative content analysis. Results A total of 1994 articles were screened; 31 articles in English, published between 2006 and 2019, were included. Within, 27 application systems that support patients with musculoskeletal diseases of the shoulder in exercising, usually at home but also in inpatient or outpatient rehabilitation clinics, were described. Only 2 application systems carried out monitoring of adherence. Almost all were based on in-house developed software. The most frequently used game components were points, tasks, and avatars. More complex game components, such as collections and teams, were rarely used. When selecting game components, patient-specific characteristics, such as age and gender, were only considered in 2 application systems. Most were described as motivating, though an evaluation of motivational effects was usually not conducted. Conclusions There are only a few application systems supporting patients with musculoskeletal diseases of the shoulder in rehabilitation by using game design elements. Almost all application systems are exergames for supporting self-exercising. Application systems for multiple rehabilitation phases seem to be nonexistent. It is also evident that only a few complex game design elements are used. Patient-specific characteristic are generally neglected when selecting and implementing game components. Consequently, a holistic approach to enhance adherence to rehabilitation is required supporting patients during the entire rehabilitation process by providing motivational game design elements based on patient-specific characteristics.

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Section: Resultsmentioning

confidence: 99%