Table 1.
Considerations for developing future gamified cognitive trainings.
| Area and considerationa | Type | |
| Gameplay |
|
|
|
|
Adopt levels of increasing complexity (with achievable goals) | Gameplay |
|
|
Introduce cognitively demanding aspects slowly | Gameplay |
|
|
Clear user-interface design (large fonts, bright colors) | User-interface |
|
|
Include a dynamic difficulty adaptation mechanism (interactive) | Personalization |
|
|
Personalize training content to individual needs in real-time | Personalization |
|
|
Add social elements (eg, play with grandchildren) | Social functions |
|
|
Add competitive elements (against oneself, computer, or others) | Social functions |
|
|
Choose actions that are familiar to patients (daily activities) | Gameplay |
|
|
Think about fun factors (appealing story, graphics, and sounds) | Gameplay |
|
|
Set long-term goals to help sustain long-term engagement | Engagement |
|
|
Provide in-game variance (keep game engaging for longer periods) | Engagement |
|
|
Reinforce positive performance with visual/audio feedback (reward) | Feedback |
|
|
Avoid negative feedback | Feedback |
|
|
Be hesitant with negative progress reports (self-monitoring) | Feedback |
| Development |
|
|
|
|
Integrate validated theories (eg, self-determination, motivation) | Design |
|
|
Use recent serious game development guidelines [36] | Design |
|
|
Participate with Parkinson disease patients and professionals in design/evaluation | Design |
|
|
Optionally add other neuroplasticity stimulants (eg, exercise) | Design |
|
|
(Re)evaluate the game with an evaluation protocol [36] | Evaluation |
| Procedural |
|
|
|
|
Provide crystal-clear and guided instructions | Instructions |
|
|
Guide the patient through the first level(s) | Instructions |
|
|
Set clear goals (distinguish game targets vs training targets) | Instructions |
|
|
Adopt cross-platform availability and plug-and-play technology | Availability |
|
|
Optionally add group-based, therapist-guided booster sessions | Efficacy |
| Methodological |
|
|
|
|
Clearly describe the training to aid in replication (publication) | Epidemiology |
|
|
Compare standardized versus personalized training | Epidemiology |
|
|
Have a solid sample size | Epidemiology |
|
|
Report standard measures of disease severity (Hoehn & Yahr Scale, Unified Parkinson’s Disease Rating Scale Part III) | Epidemiology |
|
|
Report standard measures of medication status (Levodopa equivalent daily dosage) | Epidemiology |
|
|
Report standard measures of cognitive status (Montreal Cognitive Assessment, Mini Mental State Exam) | Epidemiology |
|
|
Report objective and subjective measures of safety | Epidemiology |
|
|
Report measures of feasibility and adherence | Epidemiology |