Fourth wall breaks are commonly understood as reflexive techniques that disrupt immersion by foregrounding the constructed nature of a fictional work. While this account holds for non-interactive media, it does not fully explain how fourth wall breaks function in video games, where events unfold through player action. This paper argues that interactivity enables fourth wall breaks to operate in two distinct experiential directions.

This paper presents the iterative design of Druida, a virtual reality (VR) game for upper limb rehabilitation tailored for adults with intellectual disabilities. The game integrates therapeutic exercises into a fantasy-based narrative to enhance motivation and emotional engagement. Using a cocreation methodology involving therapists and clients, interviews, usability tests, and heuristic validation were conducted to identify usability barriers and redesign the game interface, instructions, and feedback mechanisms. Results revealed crucial usability barriers and opportunities for game design iteration to align with users' cognitive profiles, thereby enhancing engagement.

This paper explores how the fourth wall concept has evolved from traditional media to video games, focusing on its influence on player experience. Video game players, as active participants, prompt a reevaluation of the fourth wall by engaging directly with the narrative. We analyze the use of complex narrative techniques, especially fourth wall breaks, to enhance player immersion and agency. Recognizing players as essential components of the game’s architecture highlights the need for updated theoretical frameworks that address the intricate interactions between game narratives and player engagement. This research demonstrates that fourth wall breaks not only enrich narrative involvement but also fundamentally transform player participation, providing new insights into the narrative dynamics of video games and their impact on player experience.