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A framework and serious game to support those with mild cognitive impairmentÂ
This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonCognitive decline is common in the elderly. As a result, a range of cognitive rehabilitation
games have been proposed to supplement or replace traditional rehabilitative training by
offering benefits such as improved engagement. This research project focuses on mild
cognitive impairment (MCI), an initial stage of cognitive decline that does not affect
functioning in daily life, but which may progress towards more serious cognitive
deteriorations, notably dementia. Unfortunately, while a variety of serious game
frameworks and rehabilitative serious games have been proposed, there is a distinct lack
of those which support the distinctive characteristics of MCI patients. Consequently, to
optimise the advantages of serious games for MCI, the research proposes the MCI-GaTE
(MCI-Game Therapy Experience) framework that may be used to develop serious games
as effective cognitive and physical rehabilitation tools. The framework is derived from a
combination of a survey of related research literature in the area, analysis of resident
profiles from a nursing home, and in-depth interviews with occupational therapists (OTs)
who work with MCI patients on a daily basis to help them overcome the disabling effects
so that they can carry out everyday tasks. The conceptual framework comprises four
sectors that may be used to guide game design and development: an MCI player profile
that represents the capabilities of a player with MCI, core gaming elements that support
gameful and playful activities, therapeutic elements that support cognitive and physical
rehabilitation through tasks and scenarios according to the player’s abilities, and
motivational elements to enhance the player’s attitude towards the serious tasks. Together,
they provide tailored support for rehabilitation needs and may also serve as a set of
comprehensive and established criteria by which an MCI serious game may be evaluated.
To demonstrate the use of MCI-GaTE, an immersive and gesture-based serious game, A go!, is designed that exploits the framework to enable MCI-diagnosed players to
undertake a series of tailored therapeutic tasks supported by an assigned OT. To this end,
a goal-directed design approach is employed, whereby personas, scenarios and journey
maps are developed that satisfy the goals of both the MCI player and their OT, and enable
the derivation of functional requirements leading to a visual design. A-go! is realised as a
responsive and interactive high-fidelity prototype that supports gesture recognition and
3D game objects from a first-person perspective to facilitate immersion without the need
for additional worn devices, such as headsets, which would prove impractical for the targeted elderly players. Evaluation with OTs revealed that the immersive game
potentially offers more effective and tailored support to MCI patients than traditional
methods, contributing new possibilities for enhancing MCI rehabilitative training, while
a comparative assessment of MCI-GaTE demonstrated that it provides a comprehensive
approach not currently offered by state-of-the-art rehabilitative frameworks.GRACE Healthcare Ltd. & Hong Kong Caritas in
Evergreen Home and Integrated Home Care Services, TWGHs Fung Yiu King Hospital
HA, Kwai Chung Hospital HA, and TWGHs Jockey Club Rehabilitation Comple