Flowing to the optimal challenge: An adaptive challenge framework for multiplayer games

Abstract

Rehabilitation training is a key component in the treatment of patients with neurological disorders such as stroke and spinal cord injury. A key parameter in rehabilitation is to have a high level of intensity during training—that is, training where a patient performs a high number of repetitions under high levels of mental and physical effort. To address the need for increased intensity during training we propose the use of robotic devices to deliver training in multiplayer environments. Robotic devices have the potential to train multiple patients simultaneously under the supervision of a single therapist. However, when more than one patient is involved in training, for example during a competitive game, the differences in skill level become an important factor to consider. Here we discuss the implications of two-player competitive games for rehabilitation training. We focus our discussion in training for the upper extremity and frame our ideas in the context of the flow concept—from the field of psychology—and the challenge point framework—from the field of motor learning. We discuss how the introduction of an additional player, with different skill level, can affect these concepts and how we can use Dynamic Difficulty Adaptation methods to address possible issues. We hypothesize that multiplayer environments, with appropriate adjustments for difficulty, increase the intensity and motivation of training by expanding the flow zone of trainees.