Abstract
BackgroundHigh quality head-mounted display based virtual reality (HMD-VR) has become widely available, spurring greater development of HMD-VR health games. As a behavior change approach, these applications use HMD-VR and game-based formats to support long-term engagement with therapeutic interventions. While the bulk of research to date has primarily focused on the therapeutic efficacy of particular HMD-VR health games, how developers and researchers incorporate best-practices in game design to achieve engaging experiences remains underexplored. This paper presents the findings of a narrative review exploring the trends and future directions of game design for HMD-VR health games.MethodsWe searched the literature on the intersection between HMD-VR, games, and health in databases including MEDLINE, Embase, CINAHL, PsycINFO, and Compendex. We identified articles describing HMD-VR games designed specifically as health applications from 2015 onwards in English. HMD-VR health games were charted and tabulated according to technology, health context, outcomes, and user engagement in game design.FindingsWe identified 29 HMD-VR health games from 2015 to 2020, with the majority addressing health contexts related to physical exercise, motor rehabilitation, and pain. These games typically involved obstacle-based challenges and extrinsic reward systems to engage clients in interventions related to physical functioning and pain. Less common were games emphasizing narrative experiences and non-physical exercise interventions. However, discourse regarding game design was diverse and often lacked sufficient detail. Game experience was evaluated using primarily ad-hoc questionnaires. User engagement in the development of HMD-VR health games primarily manifested as user studies.ConclusionHMD-VR health games are promising tools for engaging clients in highly immersive experiences designed to address diverse health contexts. However, more in-depth and structured attention to how HMD-VR health games are designed as game experiences is needed. Future development of HMD-VR health games may also benefit from greater involvement of end-users in participatory approaches.
Highlights
High quality head-mounted display based virtual reality (HMD-VR) has become widely available, spurring greater development of HMD-VR health games
Upon full-text screening, 30 articles were identified as describing HMD-VR games designed for health contexts [48–77]
HMD-VR health games is a relatively new and growing field of tools for engaging clients in highly immersive games designed to address health contexts ranging from rehabilitation exercise to pain management to sensory disorders
Summary
High quality head-mounted display based virtual reality (HMD-VR) has become widely available, spurring greater development of HMD-VR health games. In 2005, basic cloth simulation was hailed as showpiece technology, whilst modern 3D rendering cards with integrated physics support can simulate individual human hair movement in complex lighting situations. This technological progress has made modern VR devices much more immersive, providing a much better sense of presence for demanding VR gaming users, and more importantly, less prone to technical problems than their early counterparts. VR technology companies have released more accessible, affordable, and easy to use HMDs, e.g. Oculus Quest (Facebook, Menlo Park, USA) These advancements will support greater accessibility of HMD-VR, including HMD-VR health applications
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