Game Features Research Articles

Physiological and Nutritional Considerations for Elite Squash: A Systematic Review

Abstract Purpose To systematically review all the physiological and nutritional research conducted in squash to guide practitioners and researchers on how best to interpret the data, while identifying gaps in the literature to determine future directions of research within squash. Methods Following PRISMA guidelines, studies investigating an aspect of physiology or nutrition within squash were identified using scientific databases CINAHL, MEDLINE, PUBMED, and SPORTDiscus, from March 2022 to October 2023. Results Of the 1208 studies identified, 35 met the inclusion criteria across a variety of physiological and nutritional topics, such as the physiological demands of squash, anthropometric and physiological characteristics of squash players, squash-specific performance tests, training demands of squash, nutritional requirements of squash, hydration demands of squash, nutrition knowledge of squash players, and nutritional supplements for squash players. Ten studies had poor methodological quality, 19 as fair, four as good, and two as excellent. Seventeen out of 35 studies included were undertaken post the 2009 rule change, and 14 studies were conducted on either elite or world class players. Twenty-nine of the studies involved male players, with 15 involving female players. Conclusion Much of the physiological and nutritional literature is of low quality and outdated. We present future research focuses throughout the review, such as quantifying the game characteristics of male and female players, the energy expenditures during a training and competition microcycle, and the efficacy of certain nutritional supplements. These efforts aim to create sport specific guidelines and advance evidence-based practice within squash.

Effect of match location on the playing style of teams coached by ‘Pep’ Guardiola

IntroductionAnalysis in football seeks to find the performance factors that bring teams closer to success.MethodsThis study aims to analyze the playing styles of two teams managed by Pep Guardiola (F.C. Barcelona and Manchester City) based on match location (home or away). Two methods of analysis were used: descriptive statistics through chi-square tests to evaluate game characteristics and the polar coordinates technique to analyze the relationships between the different lines of each team (goalkeeper, defenders, midfielders, and forwards).ResultsThe results showed that F.C. Barcelona maintained a consistent playing style regardless of location, exhibiting significant differences only in actions that involved shots or header (p = 0.035), with better performance at home. In contrast, Manchester City displayed significantly different performance in action success (p < 0.001), level of play elaboration (p = 0.004), density (p = 0.033), duration (p = 0.036), and actions that included a shot (p = 0.001) depending on the location. Additionally, qualitative analyses revealed differences in the relationships among the team lines according to match location, with Manchester City displaying more variability in these interactions than F.C. Barcelona.DiscussionThe study concludes that although Guardiola applies a consistent set of strategies, match location has a greater influence on Manchester City’s performance, suggesting that this team adjusts its playing style on the basis of contextual conditions. These findings highlight the importance of considering factors such as location when preparing tactics to increase the probability of success in elite football.

Gender differences in internet gaming among university students: a discriminant analysis

IntroductionResearch on gaming and gaming habits has predominantly focused on younger populations, particularly males. The main objective of this study was to analyze gender-based differences in gamer profiles, considering variables related to gaming habits and the gaming community.MethodsA total of 180 Spanish university students currently engaged in video gaming (M = 21.51 years, SD = 3.09, 57.4% male) participated in the study by completing an online questionnaire addressing gaming characteristics such as the age of onset, gaming hours, motives of gaming, and perceived toxicity in the video gaming community.ResultsThe results revealed statistically significant gender differences in the age of gaming initiation, weekly gaming hours, community toxicity, and several gaming motivations, including customization, cognitive challenge, violent gratification, and social interaction. Linear discriminant analysis identified that higher scores in the age of initiation and customization, along with lower scores in violent gratification and community toxicity, formed the combination of predictor variables that most strongly distinguished between genders.ConclusionUnderstanding these gender differences is essential for capturing current gaming trends and addressing the needs of diverse gamers. Finally, the potential clinical implications of these findings are discussed.

Unreal Games

Throughout the history of game studies, intellectual debates have sought to identify scholars have reflected on the essential features of games. In the past decade, these discussions have extended beyond academia to the broader gaming community, where certain genres have been elevated as “real games.” Genres like walking simulators, dating sims, visual novels, and hybrid forms are often at the center of these debates. , criticized for their simplicity, lack of challenge, or sometimes overtly sexual content. Despite this, the popularity of these genres is undeniable: since 2007, over 50,000 titles have been documented on the Visual Novel Database, and thousands of walking simulators are available on Steam and other platforms. Many of these titles also appear on MobyGames and have been referenced as “games” throughout history. In this article, we delve into this vast and often overlooked corpus to examine the qualities that can elevate gameplay to unreal levels.

Enhancing visitor experiences and economic outcomes through gamified AR: The impact of a Location-Based Augmented Reality Game in agritourism

Agritourism merges agricultural activities with tourism, offering visitors immersive and educational experiences. While augmented reality (AR) has been studied in various tourism contexts, limited research explores its application in agritourism. This study explores the integration of a location-based augmented reality game (LBARG) into agritourism, assessing its impact on visitor experiences, time spent, spending behavior, and revisit intentions. To compare the quality of experiences, revisit intentions, spending, and time spent between the intervention and control groups, a one-way MANOVA was conducted. Pearson correlation analysis examined the relationship between coupons received and spending. Linear regressions explored the impact of game features (e.g., voucher redemption, exploration, coin collection, spinning the wheel) on revisit intentions, time spent, and spending. These analyses highlighted the connections between game features, user behavior, and spending patterns. The findings reveal that a LBARG significantly enhances immediate visitor experiences and spending, although it do not significantly increase revisit intentions. This research provides empirical evidence on the impact of LBARGs in agritourism, showing that augmented reality technologies can enhance visitor engagement and spending at agritourism sites.

Construction and application of the multidimensional quantitative model for game evaluation

Abstract. This article is a modeling study on the self-rating of board games. This article has reviewed and understood board games and various indicators of board games and stated the background of the topic and the questions raised. It has determined the dimensions of game characteristics that need to be evaluated. Through keyword retrieval, the text is transformed into the required numerical information, and through public calculation, the required data is obtained to fit the geek ratings and average player ratings of the 25 games in the target. Next, analyze the specific issues of each data through descriptive statistics. Then, through correlation analysis, which indicators are related were obtained, and a series of conclusions were drawn. Next, a second linear regression analysis will be conducted on the Geek rating and average rating, and a series of conclusions will be drawn. Summarize the conclusion, consider the advantages of the model, and reflect on the shortcomings of the model. Use sensitivity analysis to check if the conclusion is complete. This article randomly selected a game and analyzed it through a model. And draw relevant conclusions. Finally, the analysis and summary improved the modeling.

Cartography of board games

ABSTRACT This paper focuses on the maps and map-like features in games. It discusses games with special topics or components, and it collects several titles of games named after a geographical object (city, land, etc.). Finally, it provides a proposed classification of the types of maps observed in the board games investigated. The popularity of board games has been increasing in an unstoppable way in the last years. Several modern board games work with maps or with map-like features. This article focuses on the maps and map-like features in games and attempts to classify the types of map in board games. The board games usually use maps on the main board. There are games that work with the map of the World in various map scales. These maps sometimes look as if they were old maps or they represented the present world. Some games' main board is similar to a map series or a classic atlas. Modular boards help to increase the replayability and give another experience game by game. Other games work with tiles (square, rectanglular or hexagonal shaped) representing a terrain type (forest, moorland, farmland, built in area, etc.). The tiles have to be placed next to each other, thereby the players can collect victory points. Fantasy maps depict fictional worlds: this helps the players to imagine better the fictional world and the characters. Fantasy maps often use partially orthogonal projection and partially bird's eye view.

Adaptive Tabu Search Algorithm Based on Quantum Dwelling and KNN Classifier for Creative Game Selection in Preschool Education

In order to select the best creative games for preschool education more quickly and accurately, a method for selecting creative games for preschool education based on tabu search tabu search (TS) algorithm is proposed. The TS algorithm is improved by using quantum population, and an adaptive neighborhood mapping mechanism is formed to dynamically adjust the tabu length and accelerate the convergence of the algorithm. The KNN algorithm is used to calculate the initial solution of the characteristics of preschool creative games, and the quantum adaptive optimization tabu search algorithm is used to iterate from the initial solution, and the subset of feature vectors containing feature weights and feature selection vectors is continuously searched as the input of KNN classifier. The improved objective function is used as a guide to combine the selection results of classifiers by simple voting, and the output of the selection results of creative games in preschool education is realized. Experiments show that this method can select more critical features of creative games in preschool education at a faster speed while ensuring the accuracy of the selection results. At the same time, the improved tabu search algorithm has faster convergence speed and better search performance, and can recommend creative games that are most suitable for preschool education according to the actual situation.

Balancing Playability and Historical Accuracy in Game Design - Developing the Struve Geodetic Arc Mobile Game

Numerous digital games and media with historical themes aim to educate or engage audiences with heritage. When developing a historical video game, some of the most critical design decisions are centered around finding the balance between an accurate presentation of historical facts and engaging gameplay. This paper examines the game developer's role in selecting and presenting historical content through a case study of a mobile game development process. The design choices and developers' positions related to using historical facts are examined through thematic analysis of interview data and game design documents. Recurring themes in the data reveal a constant interplay between game features and historical content, supported by historical knowledge and technology. In small teams, individual developers often make crucial design decisions while performing multiple roles. As key findings, we report that the resourcing and timing of historical research significantly impacts developers' decisions, and note varying degrees of interest in historical accuracy within the development team.

Exergaming interventions for older adults: The effect of game characteristics on gameplay

PurposeExergames can be used to train physical and cognitive abilities and have been shown to be effective in reducing the risk of falls in older adults. However, there is limited evidence about how people play exergames and how gameplay is affected by game settings and, thus, the potential training effects. The aim of this study was to investigate the impact of repeated exergaming sessions over 4 weeks and two game settings (difficulty level and game speed) on gameplay (performance, physical activity and perceived exertion) in older adults over a four-week exergaming intervention. Methods28 independently living older adults (mean age 74.47 years; 14 females) played two different exergames (Puzzle and Fox) at two difficulty levels 3× per week for 4 weeks. Physical activity measures from an accelerometer at the lower back, performance as game scores from the exergaming system, and self-reported measures of physical and cognitive exertion were collected at sessions 1,2,3,6,9 and 12. ResultsFor the Puzzle game, performance and physical activity increased significantly across the 12 training sessions. For the Fox game, an increased game speed was associated with increased performance, physical activity, and exertion across the exergaming sessions. Across all exergaming sessions, increasing difficulty by adding cognitive elements decreased the performance and amount of physical activity. ConclusionGame characteristics significantly influence how the exergames are played during a 4-week exergaming intervention. Hence, individual tailoring of the difficulty level and game speed is important. This study highlights the importance of understanding the interplay between game characteristics and gameplay during an exergaming intervention, thereby adding critical information for interpreting intervention effects – or the lack thereof.

Gamification: characteristics, trends, risks

Digital technologies development stimulates game elements inclusion into culture and different spheres of society. The identification of regularities and specifics of this process became the purpose of the study. The research methodology was based on the J. Huizing’s “man playing” concept and K. Verbach’s system description of gamification mechanisms. On the basis of these concepts, a grid of typical features of gamification has been compiled and gamification processes in different sociospheres analyzed. The research methods included the emerging gamification practices analysis. Based on the analysis results, trends and risks of implementing the game element into culture have been identified. The complex influence of gamification process on society and culture is manifested by consumers’ demand for interactivity, personal participation, and involvement (immersiveness) in almost all types of activities. These needs are strengthened under the influence of clip culture, making it easier for individuals to assimilate disparate and fragmented pieces of information. The request for immersiveness is closely related to the human need to be the author of the “text”, to control the plot, to create a plurality of readings (hypertext). It has been shown that gamification stimulates innovation in various areas, leads to the emergence of new products, processes, and services. The main risks of gamification development have been highlighted: hyperorientation to entertainment in areas that traditionally involve effort, and manipulation of people’s behavior in areas related to “shoulds”.

Enhancing Literacy and Numeracy: Developing Snakes and Ladders Oriented Toward Higher Order Thinking Skills

This research aims to develop learning media for the snake and ladder game oriented toward higher-order thinking Skills (HOTS) to enhance literacy and numeracy in elementary schools. The method used is Research and Development (RD) with the ADDIE model. The subjects of this research are fifth-grade students. The instruments include validation sheets for content and design experts and teacher and student response questionnaires. Instrument testing was conducted using a feasibility validity test. Data collection techniques involve document analysis, observation, interviews, questionnaires, and tests. Data analysis was performed using descriptive analysis and descriptive statistics. The results show that the snake and ladder media received a validation score of 0.91 from content experts and 0.93 from design experts. Teacher responses scored 0.94, while student responses reached 0.93, indicating excellent criteria. This media also enhanced students' literacy and numeracy skills, with average scores of 69.22 in Cycle 1 and 85.55 in Cycle 2. Based on these results, improving game features and increasing the variety of HOTS questions is recommended.

The Role of Relevance in Shaping Perceptions of Sleep Hygiene Games Among University Students: Mixed Methods Study.

Sleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge. This study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero's Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health. A mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health. Surprisingly, while Hero's Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users' personal lives, logical relevance to sleep health, and situational relevance to users' circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations. Our serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users' personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.

Understanding Stakeholder Perspectives: Towards the Design of a Serious Game for Positive Energy Districts

Positive Energy Districts (PEDs) are highly energy-efficient urban areas that manage a surplus production of renewable energy. Recognising the key role they can play in the transition to a less carbon-dependent society, the European Commission launched its PED Programme in 2018, to implement and support the development of PEDs. However, as PEDs are still a relatively new concept, their implementation can be challenging, and local administrators often lack clear guidance and reference points for their design, implementation and evaluation. To address this issue, the Positive RObust PEd Localities (PROPEL) project has among its main objectives the design of a serious game to provide practical insights and user-friendly tools for local administrators interested in implementing and developing PEDs. Indeed, by drawing on the power of digital games to set goals and allow the player to autonomously define a strategy to achieve them within a set of constraints, serious games can be a very powerful tool to support local administrators in their decision-making process, enabling them to explore multiple scenarios and to evaluate the results of their choices. This paper outlines the design principles and the main features of a serious game aimed at supporting local administrators in the implementation of PEDs. These design principles and features are derived from a research process comprising several steps. Firstly, the drivers and barriers to the adoption of a serious game among local administrators were identified. This was done through in-depth interviews with local administrators and PEDs experts from the different countries involved in the PROPEL project, namely Italy, Sweden, and Turkey. Secondly, a comparative analysis of serious games developed for related research purposes was carried out. This provided further suggestions for the features of the serious game. The findings underscore the significance of incorporating real data, adopting a modular structure to emulate the systemic complexity of PEDs, and ensuring accessibility across multiple devices as paramount features that the serious game should have.

The Influence of Social Competition and Maths Anxiety on Game Performance

Digital Game-Based Learning (DGBL) uses serious games to deliver educational content. DGBL has the potential to aid children’s development of maths skills, providing educators with alternatives to traditional mathematics teaching. However, the efficacy of serious games can be affected by their attributes, including whether they are single or multi-player. While competition in a multi-player environment may enhance players’ interest and motivation, potential social pressure may lead to anxiety and affect performance. In maths education, there are additional challenges. Mathematics Anxiety (MA), the negative emotional response to mathematics, may interact with game features and impact players’ experience. This study assesses players' performance in a digital maths game called ’Seven Spells’ across two different game modes (vs. Human and vs. CPU), and it also investigates whether MA levels impacted players’ performance. 43 children from two classes in an Irish primary school participated in thisstudy. Each class played a different game mode of the ‘Seven Spells’ game, one group playing against computer-controlled characters (vs. CPU) and the other playing against their classmates (vs. Human). The game mechanics were identical between the two competition game modes. The children completed the modified Abbreviated Mathematics Anxiety Scale (mAMAS) and a mathematics questionnaire before participating in the intervention, which included 4 sessions. They also participated in a focus group session at the end of the intervention. Data on their gameplay were collected throughout the first three sessions and analysed through multiple linear regression models to investigate possible connections between MA, maths knowledge, game modes and game performance. The results of the multiple linear regressions indicate that game performance was positively influenced by the duration of gameplay and the complexity of moves — measured by the number of moves and cards used — while being negatively affected by MA. However, a significant interaction between MA and the competition game mode was observed, suggesting that MA had a more pronounced negative impact on players in the vs. Human game mode compared to the vs. CPU game mode.

Play with Purpose: A Heuristic Approach to Evaluating Tabletop Serious Games for Academic Integrity Education

This article introduces a heuristic evaluation of CiteSaga, a tabletop serious game designed to enhance skills in referencing and citation, crucial for academic writing in higher education. We detail the application and outcomes of a novel heuristic evaluation framework tailored for tabletop serious games, dubbed "Play with Purpose." This framework is distinguished by its focus on eight essential categories: Learning Experience, Utility, Game Features, Social Dynamics, Adaptability, Learning and Feedback, Play Experience, and Accessibility, marking a significant contribution to the evaluation of non-digital game-based learning tools. Furthermore, we delve into the insights gained from participatory design sessions with students, aimed at evaluating CiteSaga's component appeal and game mechanics. The paper culminates in a discussion on how student feedback has informed subsequent iterations of CiteSaga, underscoring the critical role of heuristic evaluations in refining game-based learning experiences. Our findings not only advance understanding of empirical evaluation methodologies for tabletop serious games but also provide a valuable framework for future research and development in educational game design.

Fostering Inclusivity and Creativity: A Card Game for Color Perception and Inclusion

The gaming industry has undergone a dramatic transformation in recent years, with inclusivity emerging as a core value in the development of new games. Despite these efforts, there remains a gap in the inclusivity of visually impaired individuals in gaming. This paper seeks to address this gap by asking: How can game design enhance colour perception and inclusivity for visually impaired players? The industry has recognized the importance of addressing the needs of individuals with diverse needs and abilities and has responded with innovative approaches aimed at creating games that are accessible to all. One such approach is the development of a card game that has been meticulously designed to stimulate color perception and promote the inclusion of visually impaired individuals. Chroma Harmony is a pioneering mobile application meticulously crafted to facilitate users' understanding of color concepts and the outcomes of different color combinations. Its primary aim is to promote inclusivity by offering features tailored to individuals with visual impairments. Leveraging the innovative ColorADD system, it revolutionizes the perception and communication of color, thereby paving the way for enhanced participation in gaming among those with vision impairments. Its main objective is to paint a cube by combining cards in the player's possession to achieve the closest or exact combination to the objective. With each move, a new card is presented, challenging players to choose the best one to achieve their goals and improve their color perception abilities. By the end of the game, players will have a better understanding of how colors are combined, preparing them for real-world scenarios. Furthermore, the game features a multiplayer mode to foster a sense of community and healthy competition among players. This multiplayer mode not only promotes inclusivity but also provides an opportunity for players to collaborate and challenge each other fostering community sense. In terms of competencies and skills, this game aims to develop several key abilities in its users such as the ability to identify colors, the ability to combine different colors effectively and the necessary motivation and drive for results. By focusing on these competencies and skills, Chroma Harmony strives to provide a comprehensive and engaging experience for all players, regardless of their abilities or background. This study highlights the ongoing challenge in the gaming industry to enhance accessibility and inclusivity, especially for visually impaired individuals, while also standing as a testament to the industry's commitment to inclusivity and innovation, pushing the boundaries of what is possible in gaming.

Escaping the Bondage of Bullying: A Game-based Learning Approach

School bullying is a phenomenon of great concern worldwide, with profound implications for the emotional development of those involved. Leveraging the interactive nature of game-based learning provides a unique opportunity for active student engagement that goes beyond traditional pedagogical methods. This article aims to explore students' perceptions of bullying and present a digital game as an alternative educational approach to raising students' awareness, empathy, and empowerment. Furthermore, it will be demonstrated how an art-based virtual museum game engages students in exploring and understanding the phenomenon. A needs assessment on bullying was conducted on a student population sample during the school year 2023 - 2024. Subsequently, a digital 3D escape room type game (named "e-BOB") was used, which was redesigned and reconstructed by the students from an initial project within the Panhellenic Students Competition of Onassis Foundation "Hack the Art: Yiannoulis Halepas". The game was developed using Unity, Blender, and Krita platforms and is set in an art museum. Players interact with the sculptor's exhibits through micro-scenarios and quizzes drawn from the sculptor's life and artwork that tackle the issue of bullying. Key game features include goal achievement within a time limit and discovery of hidden elements. The analysis of the needs assessment data found that all students had been involved in bullying behaviors either as victims, perpetrators or observers. The majority of students focused mainly on direct forms of bullying and less on indirect forms, and most were unable to distinguish bullying from 'simple teasing', demeaning bullying behavior. Those at greater risk are the ones who show some element of differentiation in relation to the stereotypes of the social context in which they live. Several students indicated that the school environment needs to address the issue sufficiently. Finally, the game contributed to students' empathy about bullying, enhancing their self-reflection and managing strategies. Raising awareness, mental empowerment, and empathy for bullying requires dynamic and innovative approaches. With its potential for self-awareness and student activation, game-based learning should be incorporated into educational programs for bullying prevention and management within schools.

Games in Mathematics Education: Trends and Methodological Approaches in the Context of the Congress of European Research in Mathematics Education (CERME) Review

This study aimed to examine the studies on digital games presented in The Congress of European Research in Mathematics Education (CERME) using a systematic analysis approach in terms of research method, data collection tool, and how they define digital games. Sixteen studies related to games were selected from the proceedings. The findings of the research revealed that the number of studies on games has increased in recent years, and the interest of the mathematics education community in this subject has gradually increased. It was seen that qualitative research approaches were used in most of these studies. As a data collection tool, a semi-structured or clinical interview form was mainly used. To reach more comprehensive results, it is necessary to give importance to quantitative research approaches and even to prefer the use of both approaches together. It was indicated that the tendency towards mathematical reasoning and puzzle games has continued predominantly in recent years. Although it was seen that the number of studies on digital games has increased in the last five years, only six studies in total were presented at the CERME. Moreover, three digital games developed by using the tools in the context of dynamic geometry environments were found. Another significant finding was that most of these studies did not define games. Only a few studies that defined the game considered the game as a tool used to acquire a mathematical concept or knowledge. Based on the findings, it can be argued that digital games are not among the interests of the mathematics education community. Finally, it was observed that mathematical theorems and approaches were central to the studies reviewed. Games were generally defined as tools within these studies. Therefore, future research should particularly consider fundamental game features such as game mechanics to create more integrated research environments with mathematics education.

Game-Based Assessment of Peripheral Neuropathy Combining Sensor-Equipped Insoles, Video Games, and AI: Proof-of-Concept Study.

Detecting peripheral neuropathy (PNP) is crucial in preventing complications such as foot ulceration. Clinical examinations for PNP are infrequently provided to patients at high risk due to restrictions on facilities, care providers, or time. A gamified health assessment approach combining wearable sensors holds the potential to address these challenges and provide individuals with instantaneous feedback on their health status. We aimed to develop and evaluate an application that assesses PNP through video games controlled by pressure sensor-equipped insoles. In the proof-of-concept exploratory cohort study, a complete game-based framework that allowed the study participant to play 4 video games solely by modulating plantar pressure values was established in an outpatient clinic setting. Foot plantar pressures were measured by the sensor-equipped insole and transferred via Bluetooth to an Android tablet for game control in real time. Game results and sensor data were delivered to the study server for visualization and analysis. Each session lasted about 15 minutes. In total, 299 patients with diabetes mellitus and 30 with metabolic syndrome were tested using the game application. Patients' game performance was initially assessed by hypothesis-driven key capabilities that consisted of reaction time, sensation, skillfulness, balance, endurance, and muscle strength. Subsequently, specific game features were extracted from gaming data sets and compared with nerve conduction study findings, neuropathy symptoms, or disability scores. Multiple machine learning algorithms were applied to 70% (n=122) of acquired data to train predictive models for PNP, while the remaining data were held out for final model evaluation. Overall, clinically evident PNP was present in 247 of 329 (75.1%) participants, with 88 (26.7%) individuals showing asymmetric nerve deficits. In a subcohort (n=37) undergoing nerve conduction study as the gold standard, sensory and motor nerve conduction velocities and nerve amplitudes in lower extremities significantly correlated with 79 game features (|R|>0.4, highest R value +0.65; P<.001; adjusted R2=0.36). Within another subcohort (n=173) with normal cognition and matched covariates (age, sex, BMI, etc), hypothesis-driven key capabilities and specific game features were significantly correlated with the presence of PNP. Predictive models using selected game features achieved 76.1% (left) and 81.7% (right foot) accuracy for PNP detection. Multiclass models yielded an area under the receiver operating characteristic curve of 0.76 (left foot) and 0.72 (right foot) for assessing nerve damage patterns (small, large, or mixed nerve fiber damage). The game-based application presents a promising avenue for PNP screening and classification. Evaluation in expanded cohorts may iteratively optimize artificial intelligence model efficacy. The integration of engaging motivational elements and automated data interpretation will support acceptance as a telemedical application.