Variety is the Spice
“Computer games are especially clear illustrations of how the unique capabilities of computers can be used to create motivating environments.”
(Malone, 1981, p. 340)
The knowledge explored in the earlier chapters was used to generate the concepts that follow. Each concept was subject to critique from clinicians and assessed using matrix evaluation. Clinician responses prompted an atypical approach to development whereby the initial concepts were expanded before narrowed down to the most applicable idea. These expanded concepts were also evaluated via matrix, albeit with more precise criteria. The criteria for both matrix evaluations represented specific aspects of adaptability, connectivity and meaningful interactions.
5.1 Beginning Hypotheses
The information compiled from literature reviews formed the basis of the game’s content thematically, mechanically, and aesthetically. We hypothesised that a digitized version of a familiar game, such as cards (Poker, Euchre, Bridge etc.) or board games (Chess, Mahjong, Backgammon etc.) would likely be the most effective concept. The concept was not required to be a digitized version of such games, as the recycling of familiar mechanics could prove equally as effective.
As discussed in Chapter 3, older adults who recognise thematic elements of the game may feel more confident in its use. This is critical if they rarely interact with digital technology (Mahmud et al. 2008, p. 403, Orvis et al., 2008, p. 2418) and could make the difference between them trying the system or not.
5.2 First Iteration Concepts
The rapid turnaround of these concepts and their second iterations meant there was not enough time to develop digital prototypes. Subsequently, each concept manifested as a miniature game design document. An expanded description of each concept can be found in Appendix B.
5.2.1 - Four Seasons
This concept stemmed from the idea of familiarity. It was a simple tile game built from the combination of a number of card game mechanics. The primary strength of Four Seasons was how the game had enough recognisable elements to be encouraging to new players, yet enough new elements to be exciting. It also promoted connectivity through the potential of local multiplayer. This concept’s greatest weakness was the arbitrary way the exercises would be integrated into gameplay. However, the abstract connection between these aspects allowed for flexibility in what players needed to perform.
This concept was the most developed in this phase because it appeared to be the most promising. This assessment came from Four Seasons’ heavy grounding in literature. It was chosen to be the datum for matrix evaluation as a result.
5.2.2 - Plane Concept
This concept worked as both a 2D and 3D game. The player performed regular exercises to keep the plane aloft as they delivered packages to different airports. This concept’s strength came from the logical connection it provided between players raising their affected limb and keeping the plane aloft. Its greatest weakness was the repetitive gameplay that lessened replayability. The concept felt more appropriate as a game for a clinical session rather than something players took home to practice with.
5.2.3 - Dominoes Concept
This concept was similar to Four Seasons, being a digital recreation of classic tabletop dominoes. As a result it held all the same strengths as Four Seasons but with greater simplicity and accessibility. The portability of the tablet and turn-based play allowed it to be passed from player to player, minimizing the amount of devices needed for local multiplayer. The similarity dominoes had to Four Seasons meant it also shared its weaknesses. Using exercises to interact with the game was reliant on novelty, which wanes over time.
5.2.4 - Perpetual Motion Concept
This concept revolved around removing forward motion from the player’s control, making gameplay more reactive. Players guided their avatar as they perpetually moved forward, avoiding obstacles and collecting points. The advantage of this concept was the simplicity of interaction, making it easier to learn. It’s most prominent weakness was the reliance on reaction time. Reducing the pacing to something more manageable risked the forward motion losing meaning. Additionally, the core play loop revolved around playing until a point of failure (hitting an obstacle), rather than playing until a point of success (reaching the summit of a mountain).
5.2.5 - Painting Concept
This concept functioned as a colouring book for adults whose mobility is very limited. Players completed detailed vector illustrations by tapping on the area they wished to paint and completing repetitions to fill it with colour. One of the strongest aspects of this concept came from granting players complete control over the pace of their experience. This was a double-edged sword however, which ran the risk of less motivated patients leaving exercises incomplete. The main weakness was the same as Four Seasons and Dominoes, whereby the inclusion of exercises was more of a novelty than a core component of the game.
5.2.6 - Sports Concept
This concept presented two visualisations of the same idea. Players completed exercises to shoot hoops or kick goals etc. Preference would be given to the golf theme due to its popularity and pacing. The strongest aspect of this concept was how it hosted meaningful interactions. The theme of sports helped establish a clear connection between the player’s motions and the in-game response. It also promoted salience by representing the desire players may have to be active outside, or a sport they used to play. The largest weakness of this concept was that it required a fair bit of mobility from its users to be effective and may have been difficult to learn as a result.
5.2.7 - Sneaking Concept
This concept explored the use of fantasy elements in gameplay whilst maintaining clear translation of player motions. The game’s appeal came through its playful representation of the player. The incorporation of exercises into gameplay was the strongest aspect of this game, where player actions were given clear responses. This tied into the game’s primary weakness, which was the limitation of exercises that could be applied yet maintain a strong connection. Without this connection the fantasy context lost meaning and the novelty wore thin.
5.2.4 - Mountain Climbing Concept
This concept held the strongest metaphors for the player’s recovery. Play consisted of exploring mountains, temples, caverns etc., all of which involved ascension in some way. The strongest aspect of this game was its connection to the therapy process, both figuratively and through logical motion mappings. The primary weakness of this concept was the lack of multiplayer capabilities. Goals in the game were completely self-focused and adding additional players did not contribute to the experience in any meaningful way.
5.2.9 - Cycling Concepts
These concepts were a brief deviation from our attempts to integrate William Duncan’s device. Instead, they used a cycling machine to play. The primary focus of these concepts was to establish a strong mental connection between the motions the player conducts in real life and those in-game. Due to the lack of connectivity and the adaptability of input motion, they were not developed beyond their inception.
5.3 First Concepts Review
Each concept was presented to clinicians as part of their review. Through their critique we were able to calculate the value for each point in the matrix. The totals for positives, negatives and equivalents were deliberately left separate as the weighting of some positives and negatives were not equal to their counterparts. For example, the painting and cycling concepts yielded the same amount of positive and negative values, yet the painting score was deemed to be strong by the clinicians.
Appropriately, other considerations were involved for selecting how each idea would be developed. Such considerations included the simplicity of setting up the system, whether or not a clinician would be required to learn it, how the system enables goal setting and realisation and whether or not it requires online functionality.
5.4 Expansion of Ideas
Critique from Dr. Signal and Prof. Taylor prompted an expansion of concepts to explore potential genres and mechanics more broadly. The doctors wished to examine the accessibility of each concept and the viability of incorporating physiotherapeutic exercises into gameplay without the influence of thematics. This meant the second iteration of concepts was more about styles of gameplay than specific applications. The results were less focused, albeit more diverse.
5.4.1 - Tabletop Games
The hypothesis that a familiar game such as dominoes or cards would be widely accepted by an older audience was supported by the doctors, reinforcing the claims of Mahmud et al. (2008) and Orvis et al. (2008, p. 2418). It was possible for this familiarity to greatly improve the game’s initial accessibility. The other strength this concept had was its firm grounding in connectivity. Tabletop games are primarily social experiences (Costikyan, 2006, p. 208). Such a game allowed the patient’s loved ones to support them in a fun and meaningful way.
Much like the painting concept, the connection between player input and in-game action was abstract. Players could struggle with making the connection that their leg movements control a game that is generally played by hand. These interactions stemmed towards novelty rather than being meaningful. In paying this cost, the game’s input was not limited to being entirely logical and allowed the required exercise to be adapted to the player’s needs.
5.4.2 - Single Input Games
Interaction with these games could be isolated to one button/exercise. The input could prioritise whatever exercise the player needed to be practicing. Ideally the motion would be mapped to in-game action logically (e.g. raising a limb for vertical translation), but this was dependent on the context the game set. These games primarily embody the simplicity Gerling et al. found to be so popular (2010, p. 68). The minimal input would be easy to remember and apply, benefiting those whose cognition has been affected.
To encourage expanding players’ range of motion, powerups could be placed near and above each individual's calibrated maximum. The potential for these games to be meaningful and adaptable was high, however the sheer simplicity of the game risked users becoming bored with them over a long period of time. Moreira et al. emphasise the importance of extended adherence to physiotherapy (2010), making these games less effective in the long run.
5.4.3 - Literal Motion Games
These games prioritised meaningful interactions at the cost of connectivity and, to a lesser degree, adaptability. Flexibility in the types of motions that could be implemented was largely dependent on the quality of calibration. Discussion with Prof. Taylor revealed the positive influence that variety can have during task training (personal communication, 10 August 2015), highlighting the benefits of having distinctive motions for separate in-game actions. The context of the game contributed greatly to making the interactions meaningful (such as the mental connection between climbing stairs to climbing a rock face), but this resulted in grounding the theme, thereby reducing the potential target audience.
5.4.4 - Digital Colouring
This concept was possibly the most adaptable of those presented. Like the first iteration, the level of separation between the player’s motions and the resulting in-game action was drastic enough to reach a point of novelty. This allowed for the painting motion to be substituted by any exercise the player needed to be practicing. The UI of the system would be minimal and unobtrusive, acting purely as a host for whatever vector packs the user downloads. Enabling users the choice of which drawing to download allowed them to make a personal investment in their recovery. This investment could result in greater motivation to complete the associated task, as explained by Dr. Kayes (personal communication, 10 August 2015) and yield greater satisfaction on its completion (Malone, 1981, p. 335).
The specialists from AUT suggested an alternate mode of interaction whereby painting was location-based. Users would calibrate their range of motion and the cursor on the canvas would adjust to fit the new range. The problem with this concept was that removing the masked section mechanic meant that users would be doing little more than finger painting, albeit using their feet. Considering people tend to be less dextrous with their feet, the novelty of this interaction would likely be short-lived.
5.4.5 - Cooperative Games
This style of game required two players to work together to achieve a common goal and was built on the potential Alankus et al. saw in cooperative games over competitive games (2010, p. 2121). Players were not necessarily performing identical tasks. In the example given, one player would control the flight pattern of the ship, the other the defensive turret. This enabled different task training, dependent on what each player needed to be improving. The connection (and dependency) this game fostered between its players was its main strength.
A suggested alternative for when two players are not available was to have the singular player coordinate two limbs. This would be limited to those who have advanced enough motor control and could prove difficult even for people unaffected by stroke. A more applicable alternative was to have the missing functionality automated by the computer with a range of difficulties to suit the each player’s skill level.
It became apparent during this process that any game using a camera perpendicular to the action (as depicted in the example) should adjust the direction of action to match that of the player’s exercises. This may help establish a visual connection between the player’s input and the game’s output.
5.4.6 - Puzzle Games
The strength of puzzle games was the cognitive challenge they harbour. They were generally free from thematic bounds as they did not depend on particular action or narrative elements to keep players engaged. Appropriately, puzzle games tended to have broad audience appeal (Gerling et al., 2010, p. 67, Nap et al., 2009, p. 247).
The difficulty of such games was highly dependent on how the puzzles were generated. If the puzzles were predetermined (functionally similar to a riddle with a singular answer) then the game lost any replay value unless new variants were constantly made available. In cases such as Sudoku, Tetris and Bejewelled, the generative nature of the puzzles grants endless replayability where the difficulty can be adapted to the player based on how much information they are given, how quickly they have to react, or how many moves they have to succeed.
Additionally, the physical input needed to play the game could increase the difficulty by requiring more accuracy from the user. Some processes could be automated in the beginning where the player is only capable of single joint - mono-directional - movement, progressing to multi-joint - multi-directional - movement once they regain mobility.
The connectivity of puzzle games was somewhat lacking. Generally puzzles are more satisfying if solved individually rather than having the help of another. This placed a single-player limit on these games. Social variants of classic puzzle games do exist (see Tetris Battle) but with significant enough differences to their core mechanics that they are quite separate to their original concept.
5.5 Expansion Review
(For more detail on the criteria for this matrix evaluation see Appendix B)
The criteria for the evaluation of this iteration were expanded to provide a more detailed exploration of the benefits of each concept. It became clear during this phase that one of the primary weaknesses of matrix evaluation is that it does not represent the comparative significance of each criterion. While some concepts netted more positive values than others, that did not necessarily mean they were the most appropriate decision. Any weighting added to specific criteria is subject to the bias of the researcher. Therefore, matrix evaluation seems more appropriate as a method of summarising the relevant properties of concepts rather than a measure for their overall quality.
Ulrich & Eppinger state that using more detailed criteria for assessment is largely meaningless due to the concepts only being general notions of what they might become (2004, p. 131). To this end, matrix evaluation had served its purpose and led on to the creation of the minimum viable product (MVP), version 1.0 of the rehabilitation game, Tiddlywinks. And so began the next phase of the design process.