Max Well-Being: a modular platform for the gamification of rehabilitation

This study proposes a modular platform to improve the adoption of gamification in conventional physical rehabilitation programs. The effectiveness of rehabilitation is correlated to a patient’s adherence to the program. This adherence can be diminished due to factors such as motivation, feedback, and isolation. Gamification is a means of adding game-like elements to a traditionally non-game activity. This has been shown to be effective in providing a more engaging experience and improving adherence. The platform is made of three main parts; a central hardware hub, various wired and wireless sensors, and a software program with a stream-lined user interface. The software interface and hardware peripherals were all designed to be simple to use by either a medical specialist or an end-user patient without the need for technical training. A usability study was performed using a group of university students and a group of medical specialists. Using the System Usability Scale, the system received an average score of 69.25 ± 20.14 and 72.5 ± 17.16 by the students and medical specialists, respectively. We also present a framework that attempts to assist in selecting commercial games that are viable for physical rehabilitation

The extent of evidence supporting the effectiveness of extended reality telerehabilitation on different qualitative and quantitative outcomes in stroke survivors: A systematic review

This is the final version. Available on open access from MDPI via the DOI in this record. Data Availability Statement: Data are contained within this article or the Supplementary Materials.Objective: To present the extent of evidence concerning the effectiveness of extended reality telerehabilitation and patients' experiences of using different types of virtual reality exercises at home. Methods: We included studies on virtual reality and augmented reality telerehabilitation published in English. Systematic searches were undertaken in PubMed, Web of Sciences, Medline, Embase, CINAHL, and PEDro, with no date limitations. We included only RCTs and qualitative studies exploring patients' experiences. Methodological quality was assessed using the Cochrane Risk of Bias assessment tool for quantitative papers and the CASP scale for qualitative studies. All results are presented narratively. Results: Thirteen studies, nine quantitative and four qualitative, were included, with one qualitative and seven quantitative having a high risk of bias. All studies reported that extended reality-based telerehabilitation may be effective compared to conventional exercises or other extended reality exercises. Seven quantitative studies focused on upper limb function. Qualitative papers suggested that VR exercises were perceived as feasible by patients. Conclusions: The literature suggests VR home exercises are feasible and potentially effective for patients after a stroke in the upper limb. Further high-quality studies are needed to examine the effectiveness of XR exercises early adoption on different qualitative and quantitative outcomes. Registration number: (CRD42022384356).Egypt Ministry of Higher Education, Cultural Affairs, and Missions SectorNational Institute for Health and Care Research (NIHR

Reflective agents for personalisation in collaborative games

The collaborative aspect of games has been shown to potentially increase player performance and engagement over time. However, collaborating players need to perform well for the team as a whole to benefit and thus teams often end up performing no better than a strong player would have performed individually. Personalisation offers a means for improving overall performance and engagement, but in collaborative games, personalisation is seldom implemented, and when it is, it is overwhelmingly passive such that the player is not guided to goal states and the effectiveness of the personalisation is not evaluated and adapted accordingly. In this paper, we propose and apply the use of reflective agents to personalisation (‘reflective personalisation’) in collaborative gaming for individual players within collaborative teams via a combination of individual player and team profiling in order to improve player and thus team performance and engagement. The reflective agents self-evaluate, dynamically adapting their personalisation techniques to most effectively guide players towards specific goal states, match players and form teams. We incorporate this agent-based approach within a microservices architecture, which itself is a set of collaborating services, to facilitate a scalable and portable approach that enables both player and team profiles to persist across multiple games. An experiment involving 90 players over a two-month period was used to comparatively assess three versions of a collaborative game that implemented reflective, guided, and passive personalisation for individual players within teams. Our results suggest that the proposed reflective personalisation approach improves team player performance and engagement within collaborative games over guided or passive personalisation approaches, but that it is especially effective for improving engagement

A framework and serious game to support those with mild cognitive impairment

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