Differences in Physiological Reactions Due to a Competitive Rehabilitation Game Modality

Interpersonal rehabilitation games, compared to single-player games, enhance motivation and intensity level. Usually, it is complicated to restrict the use of the system to pairs of impaired patients who have a similar skill level. Thus, such games must be dynamically adapted. Difficulty-adaptation algorithms are usually based only on performance parameters. In this way, the patient's condition cannot be considered when adapting the game. Introducing physiological reactions could help to improve decision-making. However, it is difficult to control how social interaction influences physiological reactions, making it difficult to interpret physiological responses. This article aimed to explore the changes in physiological responses due to the social interaction of a competitive game modality. This pilot study involved ten unimpaired participants (five pairs). We defined different therapy sessions: (i) a session without a competitor; (ii) two sessions with a virtual competitor with different difficulty levels; (iii) a competitive game. Results showed a difference in the physiological response in the competitive mode concerning single-player mode only due to the interpersonal game modality. In addition, feedback from participants suggested that it was necessary to keep a certain difficulty level to make the activity more challenging, and therefore be more engaging and rewarding.