Gaming with a physical disability

About 32.9% of the U.S. population suffers from at least one severe physical disability, according to the CDC. Physical disabilities include (but are not limited to): paralysis, neurological disorders, Repetitive Strain Injury (RSI) and age related issues.

Paralysis
Paralysis is the loss of the ability to move a body part. It can be the result of an accident, a birth defect or a disease. Games that require a high skill level in hand/eye coordination are therefore generally not accessible, although some can be made (more) accessible using special hardware. However, assistive hardware can not always comply with the increasing large number of controls and the time needed to switch between these controls.

Neurological Disorders
There are various neurological disorders that cause physical disabilities, such as Amyotrophic Lateral Sclerosis (ALS, often called Lou Gehrig’s disease) and (Progressive) Spinal Muscular Atrophy (PSMA/SMA). Due to problems with transmitting impulses to the muscles, people with neurological disorders suffer many of the same issues affecting paralysis victims.

Repetitive Strain Injury (RSI)
Repetitive strain injury, also called Repetitive Stress Injury or Typing Injury, is an occupational overuse syndrome affecting muscles, tendons and nerves that occurs when muscles in these areas are kept tense for very long periods of time, for instance due to repetitive motions. Repetitive strain injury is not a specific disease but a loose group of other, more specific conditions, like Tendonitis, Trigger finger/thumb and Carpal tunnel syndrome. Gamers can actually get RSI from playing games that require repetitive controlling. People with RSI are often adviced not to play computer games. In many cases, non-repetitive gameplay, changes in the ergonomics of where games are played or the use of a different type of controller may help prevent or solve such problems.

Age Related Issues
Gamers are getting older and older. One of the unfortunate aspects of aging is the gradual loss of flexibility in joints and difficulties moving as fast or as well as one used to. Gamers can get degenerative diseases like arthritis. Games that require much physical partitipation, such as “Dance, Dance Revolution”, may not be physically possible. Controllers can cause problems for an increasingly older population, because there is often a gradual loss of muscle tone, making fine movements more difficult. Other factors like Parkinson’s disease can also affect the ability to control a game. Therefore games often require highly trained motoric skills and fast reaction speeds may not be playable and/or appealing for aging gamers.

There are two important aspects for making games accessible for people with a physical disability.

1 – The first aspect is the adaptation of the way of controlling a game. This enables gamers to control the game with a specific remapped or adapted interface. Some gamers are only able to use a limited number of controls and might need grouping the controls in order to fulfill al the actions that need combined actions.

2 – The second aspect is the adaptation of game play or extending the game itself with extra functionality to make the game (more) accessible. The ability to turn on slow-motion game play (often referred to as bullet-time) helps gamers in very difficult passages in a game. The option to reduce the number of controls is very important for gamers that are limited to only a few controls at a time. The ability to remap controls is essential in order to support different external controllers.

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