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Al boxing game free download Archives

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Neuropsychological Consequences of Boxing and Recommendations to Improve Safety: A National Academy of Neuropsychology Education Paper

Abstract

Boxing has held appeal for many athletes and audiences for centuries, and injuries have been part of boxing since its inception. Although permanent and irreversible neurologic dysfunction does not occur in the majority of participants, an association has been reported between the number of bouts fought and the development of neurologic, psychiatric, or histopathological signs and symptoms of encephalopathy in boxers. The purpose of this paper is to (i) provide clinical neuropsychologists, other health-care professionals, and the general public with information about the potential neuropsychological consequences of boxing, and (ii) provide recommendations to improve safety standards for those who participate in the sport.

Neurological Injury in Boxing: An Overview

Individual combat competitions have occurred throughout recorded history. Despite, or because of its violent nature, boxing has held appeal for many athletes and audiences for centuries, and it has long been part of the international Olympic Games. Injuries have been part of boxing since its inception. As the sport has evolved, however, rule and equipment changes have improved safety aspects of the boxer. Consistent with most sports, boxing includes both amateur and professional levels. Differences in objectives, rules, and safety equipment convey different risks for amateur and professional boxers (see www.ozboxing.org/health/difference.htm). Because of these differences, the scientific literature reviewed in this paper is separated for amateur and professional boxing when appropriate.

Epidemiologic studies that have analyzed the frequency of neurologic injuries in amateur and professional boxing suggest that permanent and irreversible neurologic dysfunction does not occur in the majority of participants (see Heilbronner & Ravdin, 2004 for a review). The frequency of acute, transient neurologic injuries in professional boxers is estimated to be 0.8 brain injuries per 10 rounds and 2.9 brain injuries per 10 boxers. Rarely does the brain injury yield persistent neurologic dysfunction as assessed by routine neurologic examination. It is important to note, however, that neuropsychological measures were not included in most of these studies.

Deaths from boxing tend to be widely publicized; however, the actual number of deaths is quite low. One estimate indicates a fatality rate of 0.13 deaths per 1,000 participants per year (American Medical Association, 1983; cf. Cantu, 1995). This fatality rate is lower than or similar to the rates of other high-risk sports, such as college football, motorcycle racing, scuba diving, mountaineering, hang gliding, sky diving, and horse racing. Fatalities occur less often among amateur than professional boxers, averaging at about three deaths per year compared with 9–10 deaths per year from professional boxing.

Multiple Subconcussive Head Blows

Despite the dramatic effects of the knockout (KO) punch, the cumulative effects of multiple subconcussive head blows appear to be the primary cause of neurologic injury in boxers, especially for a subset of professional boxers with extensive fight histories (Jordan et al., 1992). Several studies found associations between the number of bouts fought and the development of neurologic, psychiatric, or histopathological signs and symptoms of encephalopathy (Casson, Siegel, Sham, Campbell, Tarlau, & DiDomenico, 1984; Drew, Templer, Schuyler, Newell, & Cannon, 1986; Jordan, Relkin, Ravdin, Jacobs, Bennett, & Gandy, 1997; Ross, Cole, Thompson, & Kim, 1983). The neuropathological damage sustained by boxers includes cerebellar abnormalities, cerebral scarring and atrophy, degeneration of specific nuclear groups (i.e., the substantia nigra, locus ceruleus, and nucleus basalis of Meynert), neurofibrillary tangles, and damage to the cavum septum pellucidum (Corsellis, Bruton, & Freeman-Browne, 1973; Stiller & Weinberger, 1985).

Second Impact Syndrome (SIS) is an extremely rare condition that occurs when an athlete sustains a brain injury and subsequently receives a second brain injury before the effects of the first injury have fully resolved (Saunders & Harbaugh, 1984). The second affect may initially appear minor, but can quickly evolve into respiratory failure, and death may occur (Cantu, 1992). There have been case reports of boxers who have sustained SIS (e.g., Cantu & Voy, 1995). These catastrophic events have been attributed to cerebrovascular dysregulation, vascular engorgement, and herniation of brain tissue into the foramen magnum. Similar to that observed in other sports, younger boxers are at greater risk for the SIS. Animal research suggests that there is a “critical period” during maturation when the developing brain has greater vulnerability due to slower biochemical and physiological recovery when compared with the adult brain (Prins & Hovda, 2003). Specifically, hypotension secondary to brain injury in the developmentally immature animals appears to explain the greater mortality among the younger animals. SIS has been questioned as a diagnostic entity. An alternate explanation attributes deaths in these situations to the likely post-traumatic complication of diffuse cerebral swelling (McCrory, 2001), which is a very rare and catastrophic consequence of a single seemingly mild brain injury.

It has been predicted that the incidence of chronic neurological problems related to the sport of boxing will decline over time (Clausen, McCrory, & Anderson, 2005). Such a decline in serious injuries may occur due to decreased duration of boxing careers, reduced mean number of career bouts, improved safeguards, increased medical supervision, better equipment, and more forced layoffs and retirements of boxers. In addition, increased awareness on the part of ringside physicians, athletic trainers, and boxers will likely contribute to a decreased incidence of severe neurological problems related to boxing due to earlier identification and management of initial neurological and neuropsychological signs and symptoms.

The Risk of Boxing-Induced Neurologic Complications

Neurological trauma from boxing has three primary manifestations: (i) acute neurologic injuries; (ii) persistent groggy states and the post-concussion syndrome; and (iii) chronic traumatic encephalopathy (CTE), commonly referred to as the “punch-drunk syndrome” or “dementia pugilistica.”

Acute Neurologic Injuries

KO is the most obvious acute neurologic injury in boxing. The loss of consciousness produced by the KO blow is abrupt in onset, and typically quite brief in duration. The KO usually results from a direct blow to the face resulting in an acceleration or torque rotational force which is transmitted to the brain, affecting the cerebellum and brain stem, thereby causing imbalance and unsteadiness making the boxer unable to remain standing. It is important to note that relying on “knockouts” as the measure of neurologic injury may underestimate the true rate of concussive head blows in boxing, because most studies define the classic KO as the fighter's inability to stand for 10 s, which may or may not involve a true loss of consciousness. A technical knockout (TKO) occurs when a referee stops the fight because the fighter is unable to continue for various reasons. Given the relative infrequency of the classic KO (estimated at about six per 100 bouts), these types of blows to the head do not appear to be the primary reason for the brain damage seen in some boxers (Morrison, 1986).

Post-concussion Syndrome

Some boxers experience persistent residual cognitive and physical symptoms, such as headaches, dizziness, balance difficulty, and memory problems for many days or weeks after a fight. This is often referred to as a “groggy state,” or more commonly the post-concussion syndrome. Most often, the boxer appears to recover symptomatically, returns to his previous level of cognitive and physical functioning, and fights again. Over time, however, some boxers (usually those with the most extensive fight histories) experience longer durations of symptoms. When post-concussion symptoms become more common, and last longer, that boxer is at risk of long-term problems, including the development of CTE. However, more research is needed to completely examine the role of persistent post-concussion symptoms in the possible transition into CTE.

Chronic Traumatic Encephalopathy

CTE, also referred to as “dementia pugilistica” or the “punch drunk-state” consists of a spectrum of neurologic disorders arising from chronic exposure to cerebral trauma and is characterized by disturbances in speech, gait, cognition, and behavioral or personality changes (Jordan, 1993). Motor impairments can include dysarthria, cerebellar ataxia, parkinsonism, spasticity, and hyperreflexia (Jordan, 1987). The specific neuropsychiatric manifestations include personality changes, rage reactions, impulsivity, and childishness (Johnson, 1969; Mendez, 1995). Neuropsychological investigations have documented impairments in memory, speed of information processing, complex attention, and executive functioning (Casson et al., 1984; Drew et al., 1986; Johnson, 1969; Jordan, Matser, Zimmerman, & Zazula, 1996; Kaste, Kuurne, Vilkki, Katevuo, Sainio, & Meurala, 1982; Ross, Casson, Siegel, & Cole, 1987). CTE is positively correlated with the frequency and degree of boxing-related injuries as measured by number of bouts, sparring exposure, and abnormalities on neuroimaging (Casson et al., 1984; Jordan et al., 1996; Ross et al., 1987).

The literature on CTE generally consists of studies of professional boxers. Amateur boxing affords less exposure to brain trauma because of the standard use of head gear, shorter, and fewer rounds compared with professional bouts, and reduced force based upon acceleration and mass. Chronic neurologic dysfunction in amateur boxers can involve isolated signs and symptoms that are relatively mild in degree (Thomassen, Juul-Jensen, de Fine Olivarius, Braemer, & Christensen, 1979). Stewart and colleagues (1994) reported a trend between neuropsychological test scores and past, but not recent, number of fights, and rounds fought. They suggested that there might be a latency period which is consistent with the theory that prior brain injury increases vulnerability to future neuropathology (Cantu, 1992; Carlsson, Svardsudd, & Welin, 1987), but they also acknowledged that their results may be confounded by increased safety measures instituted in 1986. Generally speaking, the majority of studies suggest that amateur boxing does not lead to the extent and degree of deficits found in professional boxers with evidence of CTE (Butler, Forsythe, Beverly, & Adams, 1993; Casson et al., 1984; Murelius & Haglund, 1991; Stewart et al., 1994).

High exposure to boxing in and of itself does not appear to be sufficient to cause CTE. Calne, Eisen, McGeer, and Spencer (1986) posited that the late life dementia experienced by some retired professional boxers results from the combined damage of boxing-related injury and age-related neuronal loss. That is, a critical number or percentage of neurons must be damaged or destroyed by a combination of trauma, age-related atrophy, and/or other causes in order to develop dementia later in life. Based on the theory of cognitive and cerebral reserve (Stern, 2002), boxers who end their boxing careers and have experienced some neuronal loss may not exhibit signs of CTE as long as a critical number or percentage of functioning neurons remain. With the combination of neuronal reduction associated with multiple subconcussive head blows, advancing age, and perhaps some other health conditions and disease processes (e.g., hypertension, heart disease, diabetes, chronic alcohol abuse), former boxers may develop clinical signs of dementia at an earlier age than non-boxers. Although epidemiological studies are needed to make such a determination, this cognitive reserve model may help to explain why, in many cases, CTE emerges after the end of a boxing career (Jordan, 1993).

Genetic factors, specifically the apolipoprotein E (APOE) genotype, may place some boxers at increased risk for the development of CTE. APOE-e4 is a genetic susceptibility factor for Alzheimer's disease (Roses et al., 1996) and other late life cognitive disorders. Jordan and colleagues (1997) found that all of the boxers in their study who sustained severe chronic TBI and cognitive impairment possessed at least one copy of the APOE-e4 allele. Research with mixed TBI populations (i.e., accidental head trauma), however, has found non-significant associations between the presence of the APOE-e4 allele and poor neuropsychological or functional outcome following mild-moderate TBI (Chamelian, Reis, & Feinstein, 2004; Han et al., 2007; Liberman, Stewart, Wesnes, & Troncoso, 2002; Millar, Nicoll, Thornhill, Murray, & Teasdale, 2003). In addition, other factors, such as age and the cumulative effects of mild TBIs, may interact with APOE-e4 allele status to affect neuropsychological outcome (Kutner, Erlanger, Tsai, Jordan, & Relkin, 2000; Teasdale, Murray, & Nicoll, 2005). Although some evidence suggests that individuals with APOE-e4 and a positive history of head trauma are at increased risk for early-onset dementia when compared with APOE-e4 carriers with no prior head trauma (e.g., Mayeux et al., 1995), Jellinger (2004) concluded that “the relationship between dementia after head/brain trauma and apolipoprotein E status is still ambiguous” (p. 719).

Factors such as a boxer's style and skills may also be important variables in the development of chronic neurological problems, yet these variables are very difficult to quantify and study systematically. Comorbid conditions (e.g., learning disorders, psychiatric problems, substance abuse) can also complicate the initial diagnosis of CTE. Thus, the relationships between TBI, other potential risk factors such as APOE-e4 allele status, comorbid conditions, and neuropsychological status in later life is extremely complex and, in the context of a particular sport, such as boxing, much more empirical evidence is needed before firm conclusions can be drawn.

Neuropsychological Studies of Boxers

Only a few published studies have examined the neuropsychological functioning of professional boxers. In one study, neurocognitive tests measuring planning, attention, and concentration, and memory were the most sensitive measures of brain dysfunction in professional boxers (McLatchie et al., 1987). In another study of professional boxers, neurocognitive test scores one month following their bouts were better than their baseline scores (Ravdin, Barr, Jordan, Lathan, & Relkin, 2003). The authors suggested that the baseline scores may have been confounded by pre-bout factors such as sparring, rapid weight loss, and pre-bout anxiety, and therefore may not have represented the boxers' true baseline abilities. Although alternate test forms were used, practice effects may have also contributed to improved test performance. These investigators also found that boxers with the most professional experience (i.e., more than 12 bouts) had some evidence of poor neurocognitive performance during the presumed recovery period. Other researchers reported that both the number of bouts and number of losses plus draws correlated with cognitive deficits in professional boxers (Drew et al., 1986; Stewart et al., 1994). In addition, increased sparring exposure was related to worse neuropsychological performance, primarily on tests involving attention, concentration, and memory (Jordan et al., 1996). Thus, degree of sparring exposure, rather than the number of actual competitions, appears to be associated with worse cognitive functioning in some boxers.

Studies of the neuropsychological affect of amateur boxing revealed few, if any, neurocognitive deficits (Moriarity et al., 2004; Porter, 2003; Porter & Fricker, 1996; Stewart et al., 1994; Timm, Wallach, Stone, & Ryan, 1993). Moriarity and other researchers (2004) examined amateur boxers participating in multiple bouts during a 7-day tournament and found that, with the exception of those whose contests were stopped by the referee, there was no evidence of cognitive dysfunction in the immediate post-bout period. Porter (2003) followed 20 amateur boxers over a 9-year period and found no evidence of decreased neurocognitive test performance. In fact, the boxers evidenced significantly better performance over time than age-matched controls. Porter and Fricker (1995) found no evidence of neuropsychological impairment in amateur boxers compared with controls, and there was no association between neuropsychological performance and boxing exposure. Timm and colleagues (1993) examined boxer safety and concluded that serious injuries occurred very rarely and that amateur boxing is generally a safe sport.

When neurocognitive deficits have been evident in amateur boxers, they occurred primarily on tasks measuring attention, concentration, memory, and motor speed (Brooks, Kupshik, Wilson, Galbraith, & Ward, 1987). Those amateur boxers with the most ring experience showed greater adverse effects, but the magnitude of their deficits was considered mild, relative to normative control groups. Compared with other examination procedures (e.g., neurologic exam, computed tomography scan, electroencephalogram), neuropsychological tests are the most sensitive method for detecting neurological dysfunction in active amateur boxers (Ross et al., 1983). This line of research has led some investigators to conclude that carefully controlled durations of amateur boxing may indeed be neuropsychologically safe (Butler et al., 1993). One limiting factor associated with boxing studies, however, is participant self-selection; that is, boxers who decline to participate in such research may differ in important ways from those who agree to participate.

Stewart and colleagues (1994) found statistical trends between the total number of bouts fought prior to a baseline exam and changes in memory, visual-constructional ability, and perceptual-motor ability over time. No significant associations were found between the number of bouts that occurred after the baseline assessment and neurocognitive abilities, or between number of bouts or sparring exposure and other outcome measures such as brain stem auditory-evoked potentials and electroencepholography. This study provided evidence that an increased number of bouts in the past might be associated with diminished performance in selected cognitive domains, but none of the observed changes were considered clinically significant. The evidence to date appears to indicate that, in general, amateur boxers may escape chronic neurological problems provided that their total ring exposure is limited both in frequency and duration.

Recommended Concussion Assessment and Management Protocol

Neuropsychological measures are sensitive to cerebral compromise, and neuropsychological evaluations generally consider a broad range of neurological, emotional, and psychosocial factors that can affect post-concussion recovery. For these reasons, neuropsychological evaluations may prove useful in the context of establishing cognitive baselines, objectively measuring post-injury deficits, as well as making decisions regarding return to the ring and retirement from the sport. Boxers may be evaluated at different times, in different settings, and with different methodologies; to date, no single protocol has demonstrated an empirically validated superiority.

It is important to note that, at present, there is no generally accepted definition or grading for the diagnosis of a concussion. Two frequently used systems for grading sports-related concussions are those proposed and revised by Cantu (1986, 2001) and the American Academy of Neurology (1997). These two systems specify loss of consciousness, confusion, and post-traumatic amnesia as important criteria for determining the presence and severity of concussion. The purpose of these gradations is to standardize the classification scheme of concussion severity, with the goal of potentially influencing clinical management (e.g., return to competition or practice) or developing interventions that are specific to various gradations of injury severity.

Baseline Neuropsychological Evaluation

Establishing a neuropsychological baseline of boxers can contribute clinically meaningful data in protocols designed to protect athletes. Through comparison of baseline scores to post-bout scores, clinicians can use quantitative neurocognitive data when making return-to-ring recommendations. The use of baseline testing also allows for the evaluation of boxers over time and assists in tracking them throughout their careers and post-boxing lives. Pre-injury individual differences in performance between boxers in attention, memory, and processing speed are common and it is important to identify these individual differences at baseline rather than misattributing weaknesses or deficits to boxing-related injury. Pre-injury learning disabilities, attention-deficit/hyperactivity disorder, limited education, cultural factors, or test-taking anxiety can affect test scores. Test results may also be affected by previous concussions sustained either inside or outside the ring. For these reasons, baseline neuropsychological evaluations performed at or near the beginning of boxers' careers may potentially add clinically meaningful data for determining intraindividual changes over time.

Ringside Evaluation

The ringside physician is usually the first professional to evaluate the boxer following a KO or TKO, performing a gross neurologic examination and possibly a cursory mental status exam. These examinations are important for identifying potentially life-threatening or seriously disabling conditions (e.g., cerebral hemorrhage or edema), but they are not sufficiently sensitive for detecting and quantifying emerging cognitive deficits which may develop following the bout.

An appropriate ringside neurocognitive evaluation should involve an assessment of the boxer's orientation to place, bout, and details of the bout. The boxer's recall of events preceding the KO/TKO should be evaluated, as well as the ability to learn and retain new information. Through these methods, retrograde and post-traumatic amnesia may be detected. Brief tests of attention and memory and observations for emerging post-concussive physical symptoms, such as headache, nausea, imbalance, or confusion, should also be performed. The Standardized Assessment of Concussion (McCrea et al., 1998) is one example of a brief, yet empirically based assessment tool that may be useful in the ringside assessment of a boxer's mental status. It may be used in conjunction with a brief neurologic examination or neurologic checklist such as the Sideline Concussion Checklist (Kutner & Barth, 1998).

Post-injury Neuropsychological Evaluation

Boxers should undergo a thorough neuropsychological evaluation following a KO or TKO. Some clinicians believe that such evaluations should be done within 24–48 hr following a bout; however, others advocate waiting until the boxer is symptom-free on a standard neurologic exam and has normal neuroimaging (which is often required by state boxing commissions under these circumstances). Even when a boxer appears to be symptom-free and denies subjective problems, a neuropsychological evaluation may detect neurocognitive dysfunction. Neuropsychological evaluations following KO or TKO is especially important because some athletes are prone to under-report their symptoms in hopes of a speedy return to competition (Echemendia, 2006). If the boxer displays any cognitive deficits on testing, a follow-up neuropsychological evaluation is indicated prior to returning to sparring or competition. Animal and in vitro neuroscience studies have demonstrated metabolic changes in the brain that persist for several days following injury (e.g., Hovda, Prins, Becker, Lee, Bergneider, & Martin, 1998). Repeat testing in 5–7 days is commonly used in college and professional sports concussion protocols (Echemendia, 2006; McCrea et al., 1998).

Return-to-Ring Guidelines

Multiple approaches to assist with return-to-play (RTP) decisions have been proposed for other sports (Echemendia & Cantu, 2003) and various states have laws about mandatory times between bouts and length of no-boxing periods following KOs. Interestingly, boxing is currently the only sport that has these clinical practices mandated by law. RTP decisions typically take into account many variables that interact in complex ways – some direct (e.g., medical factors) and some indirect (e.g., political issues). Echemendia and Cantu (2003)

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List of commercial video games released as freeware

   Title    First release Freeware release Genre Platform(s) Publisher Additional information 3 in Three1989 [1]PuzzleMac OSCliff JohnsonAdventure Fun-Pak1989 2004[2]Adventure, ActionDOSApogee SoftwareAdventureland1978 1993[3]Adventure, interactive fictionTRS-80, Apple II series, Atari 8-bit, TI-99/4A, Commodore PET, Commodore 64, IBM-PC, Commodore VIC-20, ZX Spectrum, BBC Micro/ElectronScott AdamsThe Adventures of Fatman2003 2003 A point-and-click adventure Windows Michael Doak Released on studio's closing as CC-ND-NC "abandonware" Adventures of Maddog Williams in the Dungeons of Duridian, The1992 1996[4]AdventureAmiga, Atari ST, DOSGame Crafters Adventures of Robbo1994 2006[5]PuzzleDOS Epic MegaGamesAdventures of Robby Roto!, The1981 1999[6]Maze (Puzzle) ArcadeBally MidwayAlien Cabal1997 2000[7]First-person shooterDOS, WindowsQASoftAlien Carnage (a.k.a. Halloween Harry) 1994 2007[8]Side-scrollingplatformerDOSApogee SoftwareAllegiance2000 2004[9]Space simulation/Real-time strategy/ActionWindowsMicrosoft ResearchSource code released as freeware; gaming enthusiasts developed Free Allegiance from the released code.[10]Amulets & Armor1997 2013 Action/Role-playing video gameDOSUnited Software ArtistsAnacreon: Reconstruction 40211987 2004[11]StrategyDOS Thinking Machine AssociatesUpdated in 2004 by George Moromisato to run natively on Windows. Antheads: It Came from the Desert 21990 [12]AdventureAmigaCinemawareExpansion pack to It Came from the Desert. Arctic Adventure1991 2009[13]PlatformerDOS Apogee SoftwareAres1996 2008[14]Space simulation/Real-time strategyMac OS Ambrosia SoftwareSource code has been released under GPLv3, much of the media released under creative commons, Antares, a straight port, and Xsera, a derivative project were created. At the Carnival1989 [15]PuzzleMac OS, DOS Cliff JohnsonBaseball Mogul 20062005 2006[16]Sports managementWindowsSports MogulBattlecruiser 3000AD1996 2001[17]Space simulatorWindowsDerek SmartBattlecruiser Millennium2003 2005[17]Space simulatorWindowsDerek SmartBattle of Britain2001 [18]Flight simulatorWindowsEmpire InteractiveOnly source code available. Battle of the Eras1995 2013[19]Fighting DOS Procryon BC Kid1992 [20]Platform gameAmiga Factor 5Beneath a Steel Sky1994 2003[21]Adventure Amiga, DOS Virgin InteractiveReleased to support the ScummVM Project. Beyond Castle Wolfenstein1984[22]Stealth gameDOS Muse SoftwareBeyond the Titanic1986 1998[23]Text adventure game DOS Apogee SoftwareBio Menace1993 2005[24]Side-scrolling platform gameDOS Apogee SoftwareBlackthorne1994 2013[25]Cinematic platformer DOS Interplay ProductionsBlades of Exile1997 2007[26]Role-playing video gameMacintosh, WindowsJeff Vogel of Spiderweb SoftwareThe source code has also been released; the game is still being sold on CD, but the open source version contains the full game content. Boppin'1994 2005[27]Puzzle Amiga, DOS Apogee SoftwareCastle Infinity1996 2000 MMOGWindowsStarwaveCastle of the Winds1989 1998[28]Role-playing video gameWindows 3.xEpic MegaGamesCaves of Thor1989 2005[29]Adventure DOS Apogee SoftwareChampionship Manager: Season 01/022001 2009[30]Sports managementWindows, Mac OS, Xbox Eidos InteractiveClonk Endeavour2004 2008[31]Platform game/Real-time strategyWindows, Mac OS X, Linux RedWolf Design Only Windows version was released as freeware. Clyde's Adventure1992 2005[32]Platform gameDOS Moonlite Software Clyde's Revenge1995 2005[33]Platform gameDOS Moonlite Software Command & Conquer1995 2007[34]Real-time strategyWindows, Mac OS Virgin InteractiveCommand & Conquer: Red Alert1996 2008[35]Real-time strategyWindows, Mac OS Virgin InteractiveMade freeware in 2008 to promote the release of Command & Conquer: Red Alert 3.[36]Command & Conquer: Tiberian Sun1999 2010[37]Real-time strategyWindowsElectronic ArtsMade freeware (along with its expansion pack Firestorm) on February 12, 2010 to promote the release of Command & Conquer 4: Tiberian Twilight. Cybersphere1996 2006[38]Arkanoid-style game DOS Psycon Software Cybersphere Plus1997 2006[39]Arkanoid-style game DOS Psycon Software Dark Ages1991 2009[13]Platform gameDOS Apogee SoftwareDark Horizons Lore: Invasion2005 2007[40]Mech simulationLinux, Windows, Mac OS GarageGamesDeath Rally1996 2009[41]Racing gameDOS, WindowsApogee SoftwareDefender of the Crown1986 [42]Strategy gameAmiga, Amstrad CPC, Apple II, Atari ST, Commodore 64, DOS, Game Boy Advance, Macintosh, NES, ZX SpectrumCinemawareDink Smallwood1997 1999[43]Role-playing video gameWindows, Linux, Mac OS Iridon InteractiveDreamweb1992 2012[44]AdventureAmiga, DOS Empire Interactive EntertainmentThe Elder Scrolls: Arena1994 2004[45]Role-playing video gameDOS Bethesda SoftworksFloppy disk version released as freeware in 2004 to mark the 10th anniversary of the TES series, and as publicity release prior to the 4th installment, Oblivion. The Elder Scrolls II: Daggerfall1996 2009[46]Role-playing video gameDOS Bethesda SoftworksSequel to the aforementioned Arena. Released as freeware on July 9, 2009 to mark the 15th anniversary of the TES series. Electro Man1993 2006[47]SidescrollerDOS Created by xLand Games and published by Epic MegaGamesEnemy Nations1997 2001 Real-time strategyWindowsWindward StudiosExecutioners1992 2005 Beat 'em upDOSBloodlust SoftwareF.E.A.R. Combat2005 2006[48]First-person shooter, horror Windows Monolith ProductionsOriginally released as the multiplayer portion of F.E.A.R.Fish Fillets1998 2002 Puzzle Linux, Mac OS X, Windows, and others Altar Games The original Fish Fillets was released under the GPL in 2002. Subsequently, the Fish Fillets NG project has recoded the engine to enable multi-platform release. Flight of the Amazon Queen1995 2004[49]Adventure Amiga, DOS Renegade SoftwareReleased to support the ScummVM Project. The Fool's Errand1987 [50]PuzzleMac OS, MS-DOS, Amiga, Atari ST Miles Computing Full Spectrum Warrior2004 2008 Real-time tacticsWindows Pandemic StudiosReleased as a free ad-supported download. Glider PRO1991 Mac OS, Mac OS X Casady & Greene When Casady & Greene went bankrupt, the rights to the series reverted to the author, John Calhoun, who opted to give a few versions of the game away for free on his website. God of Thunder1993 [51]Puzzle, Action DOS Adept SoftwareGridlee1983 Arcade Videa Gridrunner1982 Scrolling shooterAtari 2600, VIC-20, ZX Spectrum, Commodore 64LlamasoftGround Control2000 2004 Real-time tacticsWindowsMassive EntertainmentRegisterware freeware released on July 1, 2004 to serve as promotion for its sequel, Ground Control II: Operation Exodus. Hades 22001 2009[52]First-person shooterWindows Espaço Informática Hardwired (a pre-release version of Red Zone) 1994 ShooterSega Mega Drive/GenesisZyrinxHeartlight PC1994 2006[53]Puzzle game8-bit Atari, DOS Janusz Pelc (Atari), Epic MegaGames (DOS port) Heros: The Sanguine Seven1993 2005 PlatformerDOS Jeffrey FullertonOriginally published in cooperation with Safari Software and Epic MegaGames. Hidden & Dangerous Deluxe1999 2003[54]Action game with tactical elements Windows Illusion SoftworksReleased as freeware to serve as promotion for its sequel, Hidden & Dangerous 2. Hitchhiker's Guide to the Galaxy1984 2004[55]Adventure FlashInfocomMade publicly available as a web-based game by the BBC. Infantry Online1999 2007 2D MMORPGWindowsSony Online EntertainmentSimilar to PlanetSide. Inner Worlds1996 2001 Platform gameDOS, LinuxSleepless SoftwareSimilar to Jill of the Jungle. Iron Seed1994 2007 Space trading and combat simulatorDOS SoftdiskReleased as freeware by the author to promote Iron Seed 2. It Came From The Desert1989 [56]AdventureAmiga, Atari ST, DOS, Sega Genesis/Mega Drive, Turbo Grafx 16CinemawareJetpack1993 [57]PlatformerDOSSoftware Creations (US)Katakis1988 [20]Side-scrolling shoot-em-up Amiga Factor 5Ken's Labyrinth1993 1999[58]First-person shooterDOSEpic MegaGamesKiloblaster1992 2008[59]Space shooter DOS Epic MegaGamesKing of Chicago1987 [60]Action, adventure, strategy game Amiga, Apple II, Atari ST, DOS, MacintoshCinemawareKroz1987 2009[13]Adventure DOS Apogee SoftwareKye1992 2008[61]PuzzleWindows 3.x Colin GarbuttLode Runner Online: Mad Monks' Revenge1995 Side-scrolling game Windows, Mac OS Sierra EntertainmentBased on the game Lode Runner. Lords of the Rising Sun1989 [62]Arcade Amiga, PC-EngineCinemawareLure of the Temptress1992 2003[63]Graphic adventure Amiga, Atari ST, DOS Virgin InteractiveThe Lost Vikings1993 2014[64]Puzzle, platformer DOS Interplay ProductionsMad TV1991 Management simulation game DOS, Amiga Rainbow ArtsMajor Stryker1993 2006[29]Scrolling shooter DOS Apogee SoftwareMarathon Trilogy1994 2005 First-person shooter Mac OS, Windows, Linux BungieMechWarrior 4: Mercenaries2002 2010[65]Robotic simulation Windows FASA InteractiveMonuments of Mars1990 2009[13]Platform DOS Apogee SoftwareMystery House1980 1987[66]Adventure Apple II On-Line SystemsReleased into the Public Domain in 1987 to celebrate Sierra's 7th anniversary. Nogginknockers1993 2005 SportsDOSBloodlust SoftwareNogginknockers 21996 2005 SportsDOSBloodlust SoftwareNoGravity1998 [67]Space combat simulatorWindows, Mac OS, Linux realtech VROne Must Fall: 20971994 1999[68]FightingDOS Epic MegaGamesonEscapee1997 2006 Action-adventure gameWindows, Amiga Invictus Games, Ltd.Oo-topos1987 [69]Interactive fictionApple II, DOS PolarwareOut of the Park Baseball1999 2002 Sports managementWindows, Mac OS X, Linux Out of the Park Developments Overkill1992 2008[70]Vertical scrolling-shooterDOS Precision Software Publishing / Epic MegaGamesPharaoh's Tomb1990 2009[13]Platform DOS Apogee SoftwarePostal1997 2020[71]Top-down shooterWindows Running with ScissorsPsi-Ops: The Mindgate Conspiracy2005 Third-person shooterWindows Midway GamesReleased through FilePlanet as ad-supported freeware. Purge2003 Onlinefirst-person shooterWindows Freeform Interactive Puzzle Fun-Pak1989 2004[2]Puzzle, ActionDOSApogee SoftwareRailroad Tycoon Deluxe1993 2006[72]Business simulatorDOS, ... MicroProseRiftspace2000 2008 Space simulationWindows Starwraith 3D GamesRock n' Roll Racing1993 2014[64]Racing DOS Interplay Productions'Lite' version of the original Super Nintendo game with just three playable tracks. This version has all rock music tracks changed to simple MIDI music, because the music license expired. Rocket Ranger1988 [73]Action game Amiga, Apple II, Atari ST, Commodore 64, DOS, NESCinemawareR-Type1989 [20]Side-scrolling shoot-em-up Amiga Factor 5Sango Fighter1993 2009[74]FightingDOSPanda EntertainmentReleased as freeware by current copyright holder Super Fighter Team. Savage: The Battle for Newerth2004 A blend of FPS and RTS gameplay Windows, Linux, Mac OS X S2 GamesSavage 2: A Tortured Soul2008 2008 Windows, Linux, Mac OS X S.D.I1986 [75]Action adventure Amiga, Atari ST, Commodore 64, DOS, MacintoshCinemawareSimCity1989 2008
(as OLPC SimCity)City-building gameWindows, DOS, ... Was released under the GPLv3 for the One Laptop per Child project, and as Micropolis to the general public (the original title of the game). Sinbad and the Throne of the Falcon1987 [76]Action Amiga, Apple II, Atari ST, Commodore 64, DOS CinemawareSkiFree1991 [77]Arcade Windows 3.0 Chris Pirih SkyRoads1993 [78]Driving DOS Bluemoon InteractiveSöldner: Secret Wars2004 2011 Tactical shooterWindows JoWood ProductionsSołtys1995 2011 Adventure gameDOS LK AvalonSpheres of Chaos1992 2007[79]Shooter gameWindows, Linux, RiscOSIain McLeodThe Spirit Engine 22008 2010[80]A 2-D side-scrolling indie RPG Windows Mark Pay StarCraft1998 2017[81]Real-time strategyWindows, Mac OS Blizzard EntertainmentMade freeware (along with its expansion pack Brood War) on April 19, 2017 to promote the release of StarCraft: Remastered. Starshatter: The Gathering Storm2004 2011[82]Space combat simulatorWindows Destroyer Studios Source code also released, content Freeware.[82]Stargunner1996 2005[83]Side-scrolling shooter DOS 3D RealmsStarsiege: Tribes1998 2004[84]First-person shooterWindows Dynamix/Sierra On-LineReleased as publicity for the release of Tribes: Vengeance. Star Control II1992 2002 Action adventure DOS, Mac OS Toys For BobReleased as The Ur-Quan Masters. Star Fleet I: The War Begins1985 [85]StrategyDOS InterstelStar Fleet II: Krellan Commander1989 [85]StrategyDOS InterstelStar Legions1992 [85]StrategyDOS InterstelStar Wraith II2000 Space military simulation game Starwraith 3D GamesStar Wraith III: Shadows of Orion2000 A space military simulation featuring multiplayer capabilities Starwraith 3D GamesStar Wraith IV: Reviction2000 2008 Windows Starwraith 3D GamesStrange Adventures in Infinite Space2002 2009 by Digital EelSupaplex1991 Boulder Dash-like puzzle game Michael Stopp and Philip JespersenSupernova1987 1998[86]Text adventureDOS Apogee SoftwareSuper Fighter1993 2001[87]Fighting DOS C&E, Inc.Released as freeware by current copyright holder Super Fighter Team. Super ZZT1992 Adventure DOS Epic MegaGamesS.W.I.N.E.2001 2005 Real-time tactics game DOS StormRegion Released as S.W.I.N.E. Free Christmas Edition. Teen Agent1995 Graphic adventure DOS Telengard1982 Dungeon crawlDOS Daniel Lawrence TerraFire1997 2005[88]Space shooterDOSORT SoftwareThe Three Stooges1987 [89]Action Amiga, Apple II, Commodore 64, DOS, NESCinemawareTimeslaughter1996 2005 FightingDOSBloodlust SoftwareTimeslaughter Lost, a prototype version of Timeslaughter, was also released in 2005 as freeware after a fan realized the version he had was different from the retail release and sent it to Bloodlust Software. Total Extreme Wrestling 20052005 2009 Booking simulatorWindows Greydog Software Traffic Department 21921994 2007[90]Top-down shooterDOS Epic MegaGamesTransylvania I,II,III1982, 1985, 1989[69]Adventure Apple II, Commodore 64, DOS PolarwareTreasure Island Dizzy1987 Puzzle game Oliver twinsTribes 22001 2004[91]First-person shooterWindows, Linux Dynamix/Sierra On-LineReleased as publicity for the release of Tribes: Vengeance. Trivia Whiz1988 2005[29]Trivia game DOS Apogee SoftwareTurboraketti1993 Cavern-flying game Amiga Heikki Kosola TV Sports Baseball1990 [92]Sports Amiga, DOS, NESCinemawareTV Sports Basketball1989 [93]Sports Amiga, DOS, PC-EngineCinemawareTV Sports Boxing1991 [94]Sports Amiga, DOS CinemawareTyrian1995 2004 Scrolling shooterDOSEpic MegaGamesUltima IV: Quest of the Avatar1985 1997[95]CRPGDOSOrigin SystemsRe-released again in 2011 to promote Ultima Forever: Quest for the Avatar.[96]Ultima: Worlds of Adventure 2: Martian Dreams1991 2012[97]CRPGDOSOrigin SystemsReleased by Electronic Arts exclusively through GOG.com. Universal Combat2004 2008[17]Space simulatorWindows Derek SmartVantage Master Online1998 2002 Tactical RPGWindows Nihon FalcomVictory: The Age of Racing2014 2016 Racing game Windows Vae Victis War Wind1996 2020[98]StrategyWindows Strategic SimulationsWarzone 21001999 2004 Windows, Mac OS X, Linux, FreeBSD, AmigaOS 4, PlayStation Eidos InteractiveWings1990 [99]Flight simulator AmigaCinemawareWings1996 Cavern-flying game Miika Virpioja Wolfenstein 3D1992 2012[100]First-person shooterBrowser-based id softwareWord Whiz1988 2005[29]Trivia DOS Apogee SoftwareWorlds of Ultima: The Savage Empire1990 2012[97]CRPGDOSOrigin SystemsReleased by Electronic Arts exclusively through GOG.com.[97]X-Men: The Ravages of Apocalypse1997 2006 First-person shooterDOS, Linux, Macintosh, WindowsWizardWorksThe freeware release includes a walkthrough and a pre-installed patch (pak4.pak) to fix bugs and add additional gameplay features. Xargon1993 2008[101]Platform gameDOS Epic MegaGamesXenophage: Alien Bloodsport1995 2006[102]Fighting gameDOS Apogee SoftwareZero Tolerance1994 First-person shooterSega Mega Drive/GenesisTechnopopThe Sega Mega Drive/Genesis ROMs of the game and its sequel are offered by the owner Randel Reiss for free download.[103]
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al boxing game free download Archives

What does Boxer do?

Boxer plays all the MS-DOS games of your misspent youth, right here on your Mac.

There’s no clots of configuration and baffling DOS commands between you and your fun: just drag-drop your games onto Boxer, and you’ll be playing in minutes.

Boxer takes your CDs, floppies and bootleg game copies and wraps them into app-style gameboxes you just click to play. They’re self-contained so you can back them up or share them with friends. No mess, no fuss.

If your nostalgia demands more, then decorate your games with gorgeous icons and admire your collection from your very own Finder games shelf.

Boxer is powered by DOSBox’s robust DOS emulation, which means it’ll play almost any DOS game you throw at it.

What’s new in 1.3?

  • Drag the volume up, then down, then up again with a statusbar volume control!

  • Save screenshots to the desktop with an easy shortcut!

  • Zip through boring game intros with the fast-forward key!

  • Paste text from OS X into any DOS program!

  • Gameboxes now remember all your drives from last time, so it’s dead easy to use an extra drive for sharing files between games.

  • Expanded help for installing patches & game expansions and dealing with Windows-only games.

  • Lots of little UI improvements that you won’t consciously notice but which will make your day that teeny bit happier.

  • About six gajillion bugfixes.

Full release notes
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