Motivational Factors in Physiotherapy Games Master’s thesis in Interaction Design and Technologies JONATAN LIND ANDREAS MIKKO Department of Applied Information Technology CHALMERS UNIVERSITY OF TECHNOLOGY Gothenburg, Sweden 2017 MASTER’S THESIS 2017:12 Motivational Factors in Physiotherapy Games Jonatan Lind, Andreas Mikko Department of Applied Information Technology Division of Interaction Design CHALMERS UNIVERSITY OF TECHNOLOGY Gothenburg, Sweden 2017 Motivational Factors in Physiotherapy Games JONATAN LIND, ANDREAS MIKKO © JONATAN LIND, ANDREAS MIKKO, 2017 Supervisor: Staffan Björk, Interaction Design and Technologies Examiner: Olof Torgersson, Interaction Design and Technologies Master’s Thesis 2017:12 Department of Applied Information Technology Division of Interaction Design Chalmers University of Technology SE-412 96 Gothenburg Motivational Factors in Physiotherapy Games Jonatan Lind, Andreas Mikko Department of Applied Information Technology Chalmers University of Technology ABSTRACT Physiotherapy can be a long process. Exercises can be mundane and the progress slow. For the patient, it can thus be difficult to maintain the motivation needed to follow through with the physiotherapy. Especially at home where the physiotherapist is not available to provide help. Games’ ability to engage the user could potentially be used to help the patient to stay motivated. It is not obvious how one should design physiotherapy games to make them motivating to play. Hence, this thesis asks what factors should be considered, to maintain user motivation, when designing a physiotherapy game. To find the factors, several subjects areas were explored, including interaction design, game design, gamification, motivation theory and physiotherapy. Theoretical knowledge was gathered by consulting previous studies, existing commercial games and through interviews with experts within the healthcare and rehabilitation field. The theoretical knowledge was then put into practice. By going through a design process, a concept and a prototype for a physiotherapy game was developed. The game was named Kinetispace - a game that uses Kinect to detect when the player performs physiotherapy exercises to refuel a spaceship. Kinetispace was playtested with school children to evaluate the prototype. In total, 22 different factors, to consider regarding motivation in physiotherapy games, were identified. These factors were then divided into eight categories. The list of factors is not definitive as more factors may exist. Also, no conclusions regarding the factors impact on long term motivation can be drawn since the factors should be considered as preliminary results for further studies. They can also serve as a vocabulary for discussing motivation when designing games. Keywords: Physiotherapy, interaction design, game design, Kinect, eHealth, motivation, gamification. CONTENTS INTRODUCTION .............................................................................................................. 1 Research Problem ........................................................................................................ 1 Working Process and Type of Results ......................................................................... 1 Limitations ................................................................................................................... 2 Stakeholders ................................................................................................................. 2 RELATED WORK ............................................................................................................ 4 Serious Games and Exertion Games ........................................................................... 4 Kinect ........................................................................................................................... 5 Design Theory ............................................................................................................. 6 2.3.1 Wicked Problems ................................................................................................. 6 2.3.2 Design Thinking ................................................................................................... 7 2.3.3 Human Centered Design ...................................................................................... 7 2.3.4 Activity Centered Design ..................................................................................... 8 2.3.5 Affordances .......................................................................................................... 8 2.3.6 Feedback ............................................................................................................... 9 Game Design Theory ................................................................................................. 10 2.4.1 What is a game? ................................................................................................. 10 2.4.2 Gameplay ........................................................................................................... 11 2.4.3 Playcentric Design .............................................................................................. 11 2.4.4 The Game Loop and Progression ....................................................................... 11 2.4.5 MDA ................................................................................................................... 12 Serious Games and Gamification .............................................................................. 13 2.5.1 Achievements ..................................................................................................... 15 Motivation ................................................................................................................. 16 2.6.1 Self-determination Theory ................................................................................. 16 2.6.2 The Engines of Play ........................................................................................... 17 METHODOLOGY AND TOOLS ................................................................................... 18 Research Through Design ......................................................................................... 18 Game Design ............................................................................................................. 18 Iterative Design .......................................................................................................... 19 Ideation ...................................................................................................................... 19 Prototyping ................................................................................................................ 20 Playtesting ................................................................................................................. 21 Technology ................................................................................................................ 21 3.7.1 Unity ................................................................................................................... 22 3.7.2 Kinect and Visual Gesture Builder ..................................................................... 22 TIME PLAN ..................................................................................................................... 23 PROCESS ......................................................................................................................... 24 Planning Phase ........................................................................................................... 24 5.1.1 Semcon ............................................................................................................... 24 5.1.2 Preliminary Ideation ........................................................................................... 25 5.1.3 Initial Game Ideation .......................................................................................... 26 5.1.4 Desk Research .................................................................................................... 27 5.1.5 Initial Kinect Implementation ............................................................................ 29 5.1.6 Interviews ........................................................................................................... 30 5.1.7 Time Plan Revision ............................................................................................ 35 5.1.8 Factors from Planning Phase .............................................................................. 35 Development Phase ................................................................................................... 36 5.2.1 Experience Goal ................................................................................................. 36 5.2.2 Concept Selection ............................................................................................... 37 5.2.3 Concept Refinement ........................................................................................... 40 5.2.4 Prototyping Process ............................................................................................ 41 5.2.5 Prototyping in PowerPoint ................................................................................. 42 5.2.6 Unity Prototype .................................................................................................. 44 5.2.7 Factors from Development Phase .....................................................................