Impact of Game Mode on Engagement and Social Involvement in Multi-User Serious Games with Stroke Patients

The use of novel technologies for rehabilitation has been intensely researched in the last decades. As technology evolved, it has become usual to exploit virtual reality and serious games as tools for motor and cognitive rehabilitation. However, despite the increasing use of games in rehabilitation, evidence of the impact of their use in multi user settings remains scarce. To our knowledge, there are no comparative studies on stroke patients assessing the specific benefits of Competitive, Cooperative and Collaborative gaming modes for motor rehabilitation. In this study we propose to use a multiplayer motor rehabilitation gaming system, and evaluate the impact that these different game modes can have on patient's engagement and social involvement, and also to research the influence that different motor and cognitive skill levels can produce in those three different multiplayer settings. To that end, we developed a multiplayer setup - using tangible objects and a large screen interactive table - for upper limb rehabilitation purposes. We implemented a game that, while keeping the same basic mechanics, can be played on the three different multiplayer modes (Competitive, Cooperative and Collaborative). We performed a preliminary study with 11 stroke patients, and results show that behavioral involvement and positive affect is promoted more effectively with the Collaborative mode, specifically with participants with less motor and cognitive difficulties.