Several years ago I bought "Giana Sisters Twisted Dreams". It ran fine on Windows 8.1, but it crashed after I upgraded to Windows 10. I contacted the support of Black Forest Games. The person answering my email told me that the game does not run very well with the integrated graphics of my system (Intel 4600). He advised me to try some different graphics settings which fixed the issue. I basically switched from DX10 to DX9 and turned down the graphics quality.
I changed the config.ini file (in \Documents\Giana Sisters - Twisted Dreams) to contain the following settings:
The settings can also be changed within the game: