Honours Readings

When reading the papers, the following structure was applied:

Title, Author, Research Question, Method, Results, What does this mean, Whats next.

Common Headings / Subheadings:

VR physical rehabilitation

VR gamification techniques

Gamification and Motivation

Autonomy and Motivation

The gap and trends that are appearing are the effects of autonomy on a players motivation within virtual reality, but for the sake of this study it will be applied in the context of physical upper body rehabilitation simulations.

Level of relevance / Importance – HIGH

Paper Title – VR gaming in the rehabilitation of upper extremities post-stroke

Author – Michael Yates, Arpad Kelemen, Cecilia Sik Lanyi

Research Question – “How efficient are VR games with rehabilitation”

Method – Selected and reviewed 15 articles relating to “Applying VR systems to physical rehabilitation”

Results – The literature supports the use of VR for rehabilitation as equivalent to traditional therapies. Small samples, variation in study lengths and unequal controls reduce the generalizability and comparability of the outcome.

What does this mean – Literature does support the efficiency and effectiveness of VR rehabilitation, however not enough studies have implemented controlled experiments to further support the reasoning behind this.


Relevance – MEDIUM

Title – How gamification motivates

Author – Michael Sailer

Research Question – “Gamification is not effective per se, but specific game design elements have specific psych effects”

Method – Randomised controlled study that used an online simulation environment. Randomised configuration of “Competence, Autonomy and Relatedness”

Results – Badges, leader boards and performance graphs affect competence. Avatars, meaningful stories and teammates affect experiences of social relatedness. Perceived decision freedom could not be affected as intended.

What does this mean – Some gamification techniques positively affect psych, however autonomy techniques affect players differently.

Relevance – MEDIUM/LOW

Title –  Pay to Play: Effects of Money and Choice on Intrinsic Motivation, Enjoyment, and Self-Esteem in Video Game Players

Author – Michael D Hanus

Research Question – How the ability to make choices influences players motivation, self esteem and enjoyment

Method – 6 experiments, varying choice / no choice / paid / unpaid.

Results – Payment decreased intrinsic motivation and had no effect on enjoyment for players who could choose. Payment increased intrinsic motivation and enjoyment for those who could not choose.

What does this mean – “Reward decreases motivation to play video games when players can choose what to play”

Relevance – Medium / Low

Title – The effects of customisation on motivation

Author – Selen Turkay

Research Question – “How customisation, as a way of user control, affects player motivation within an MMO”

Method – A mixed method study that was designed with two conditions, customisation vs no customisation.

Results – The players desire to play the game increased over time, since the experiment lasted over an extended months period. Customisation also affected the players motivation positively.

Relevance – Medium

Title – Is it a sense of Autonomy, Control or Attachment? Exploring the effects of in-game customisation on game enjoyment?

Author – Keunyeong Kim

Research Question – “How does autonomy, control and perceived attachment to game characters affect enjoyment”

Method – This was done through 2 studies using different variations and types of customisation: functional vs aesthetic.

Results – Feelings of autonomy and control contribute to enjoyment. Attachment contributes to enjoyment through immersion. Players perceived control through avatar customisation. Autonomy and control are more critical predictors of enjoyment then attachment.


Relevance – Medium

Title – Contextual Autonomy Support in Video Game play: A grounded theory

Author – Sebastian Deterding

Research Question – What is the role of autonomy within a social context, particularly engaging with serious gamers.

Method – Done through a qualitative interview study that compared gameplay experience in leisure and work contexts.

Results – Leisure contexts, particular solitary play, support autonomy through a time and space shielded from outer demands. Thwarted autonomy occurs both in leisure and work contexts when players spontaneous interests mismatch socially demand gameplay.


Relevance – LOW

Title – Hands, Tables and Groups Make Rehabilitation

Author – Michelle Annett

Research Question – Designers have ignored multi-user interaction in favour of single-user interactions, however social interacting helps with the rehabilitation process.

Results – “Rehabilitation-Based Design Recommendations”

  • Include positive and salient elements in multi-user activities can help patients to become emotionally immersed. This allows patients to temporarily forget the pain or cognitive defects they may have and focus on the activity at hand.
  • Encourage communication
  • Cooperation
  • Patients are more likely to try harder and work at an activity longer if they become competitively immersed
  • Activities should be configurable and have elements of uncertainty.


Relevance – LOW

Title – Does Agency Matter?: Exploring the impact of controlled behaviours within a game-based environment

Author – Erica L.Snow

Research Question – The link between performance and controlled choice patterns is driven by students experiences of agency.

Method -70 students assigned a choice pattern (controlled or disordered) and removing their ability to exert agency within a game environment.

Results -No differences in self-explanation quality between the controlled and disordered patterns. Collectively, findings support the notion that success within game based systems is related to students ability to exert agency over their learning paths.

What does this mean – Agency is important to user motivation within learning.

Relevance – High/Medium

Title – A meta-analysis and systematic literature review of virtual reality rehabilitation programs

Author – Howard M.C.

Research Question – Are virtual reality rehabilitation programs effective? If so then why?

Method – 

A meta analysis – to determine the efficacy of VRR programs and one of four outcomes: Motor control, balance, gait and strength.

A systematic literature review to determine the mechanisms of the VRR programs to succeed or fail.

Results – The results dictate that VRRR programs are more effective than tradition rehabilitation for physical outcome development. The results also show three major components that cause this outcome: excitement, physical and cognitive fidelity. However, there is no empirical research to show that these prompt better rehabilitation outcomes.

What does this mean – This report proves the underlying dictating question that VRR programs are effective for PHYSICAL REHABILITATION, allowing further progress within the VR discipline, without worry of the counter argument that there is no proof that they work.

Whats next – The next step is to test whether making this programs more gameful helps to stimulate player motivation.

Serious game for physical rehabilitation: Measuring the effectiveness of virtual and real training environments


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