Designing a Game for Upper Limb Rehabilitation Following a Stroke

<p>Background: Many stroke survivors suffer from motor impairments such as upper limb hemiparesis accompanied by cognitive and emotional impairments that can affect their ability to function. Rehabilitation interventions are effective in promoting the return of function. However, patients’ engagement is necessary in order to maintain the improvements, and research shows that stroke survivors need more opportunities to engage with rehabilitation outside of the clinic. Digital games can offer a solution by providing an engaging context for performing the exercises correctly and learning new skills. Aims: This research aims to increase engagement with upper limb rehabilitation following a stroke through a custom digital game that facilitates effective rehabilitation methods, and is played with the Able-M, a game controller designed for upper limb rehabilitation by Im-Able. Methods: The development process was based on a human-centred design approach that consisted of a literature review, personas generation, exploratory studies including field observations in a clinic and discussions with therapists, iterative design through qualitative studies including user observations, interviews with patients, and feedback from a neuro-physiotherapist. Conclusions: Based on the design process, the game prototype includes the following elements: Adaptive gameplay for physical and cognitive challenge-skill balance, obstacles to increase challenge, feedback provision to enhance engagement and facilitate motor learning, rhythmic elements to facilitate rhythmic auditory stimulation, narrative based on user research to facilitate focus diversion, and different navigation mechanisms to promote neuroplasticity. High contrast, bird eye view, and third person perspective for ease of use. Limitations and directions for further research are discussed.</p>