Designing an augmented reality video game to assist stroke patients with independent rehabilitation

Early, intense practice of functional, repetitive rehabilitation interventions has shown positive results towards lower-limb recovery for stroke patients. However, long-term engagement in daily physical activity is necessary to maximise the physical and cognitive benefits of rehabilitation. The mundane, repetitive nature of traditional physiotherapy interventions and other personal, environmental and physical elements create barriers to participation. It is well documented that stroke patients engage in as little as 30% of their rehabilitation therapies. Digital gamified systems have shown positive results towards addressing these barriers of engagement in rehabilitation, but there is a lack of low-cost commercially available systems that are designed and personalised for home use. At the same time, emerging mixed reality technologies offer the ability to seamlessly integrate digital objects into the real world, generating an immersive, unique virtual world that leverages the physicality of the real world for a personalised, engaging experience.  This thesis explored how the design of an augmented reality exergame can facilitate engagement in independent lower-limb stroke rehabilitation. Our system converted prescribed exercises into active gameplay using commercially available augmented reality mobile technology. Such a system introduced an engaging, interactive alternative to existing mundane physiotherapy exercises.  The development of the system was based on a user-centered iterative design process. The involvement of health care professionals and stroke patients throughout each stage of the design and development process helped understand users’ needs, requirements and environment to refine the system and ensure its validity as a substitute for traditional rehabilitation interventions.  The final output was an augmented reality exergame that progressively facilitates sit-to-stand exercises by offering immersive interactions with digital exotic wildlife. We hypothesize that the immersive, active nature of a mobile, mixed reality exergame will increase engagement in independent task training for lower-limb rehabilitation.