PTOTRCTJournal of neuroengineering and rehabilitation2021

The use of game modes to promote engagement and social involvement in multi-user serious games: a within-person randomized trial with stroke survivors.

Fábio Pereira, Sergi Bermúdez I Badia, Carolina Jorge and 1 others

PMID 33853609

WHAT IT FOUND

Collaborative game modes drove significantly higher behavioral involvement than competitive or co-active modes.

Competitive modes generated more flow and challenge, particularly for participants with better motor skills and higher cognitive function. Co-active modes produced the lowest engagement metrics.

Key findings

01The Collaborative mode resulted in significantly higher Behavioral Involvement scores compared to both the Competitive and Co-active modes.

02Participants reported significantly higher Flow and Challenge in the Competitive mode compared to the Co-active mode.

03Participants with higher cognitive deficits reported more Negative Affect and Tension in the Competitive mode, while those with lower deficits felt more competent in the Co-active mode.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The sample size was small (20 participants), which limits the power of subgroup analyses. The study used a convenience sample, which may introduce selection bias. One participant was excluded after data collection due to unreported aphasia, highlighting the difficulty of screening for cognitive/communication barriers in this population. The results may not generalize to other game mechanics or interaction setups.

Declared interests

Funded by Interreg and NOVA LINCS. No other conflicts of interest reported.

The easy way to misread this

Do not assume that Competitive modes are universally more engaging. While they produced higher Flow in the overall group, participants with higher cognitive deficits reported significantly more Negative Affect and Tension in this mode, suggesting it may be counterproductive for some patients.

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