The design of Physical Rehabilitation Games: The Physical Ambient Abstract Minimalist Game Style.

Abstract

Physical neurorehabilitation is essential for a large number of individuals who have suffered a stroke or cope with multiple sclerosis (MS). Stroke and MS often result in physical impairment and disability which can lead to a loss of an independent lifestyle. Through neurorehabilitation therapy, people may regain or retain their physical ability and thereby maximize their quality of life. Building on insights from previous research, we believe digital games can provide a positive contribution to physical neurorehabilitation therapy. On the one hand, the physical exercises performed during rehabilitation therapy are considered hard and repetitive, resulting in a demotivating rehabilitation experience. On the other hand, many digital games offer a pleasurable experience even when players continuously perform the same tasks. It has been suggested that rehabilitation therapy may be translated into a digital game, transforming the negative rehabilitation experience into a pleasurable gaming experience and increasing the intensity and length of time spent on the rehabilitation. The translation of neurorehabilitation therapy into a digital game presents a number of challenges. One challenge is the integration of physical exercises into the mechanics and dynamics of a challenging game. Digital games are difficult to design even without the rehabilitation context, and constructively adding specific physical exercises makes this even harder. A second challenge is digitally presenting the exercises in a manner that takes into consideration the physical, cognitive and visual impairments of persons who have had a stroke or persons with MS. The physical, cognitive and visual skills needed to play an off-the-shelf game are often high, and may potentially cause difficulties for a target audience that does not fully possess these skills. In this dissertation we present the creative design process of the physical abstract minimalist rehabilitation game style in order to address the above two challenges. This game style is constructed using a design research approach in which the exploration of design possibilities takes a central role. As such, a range of game elements are investigated through the development of four novel game prototypes. In the first prototype, the role of game mechanics as an essential connector between the game and the rehabilitation world is explored, along with the risk of including game genre conventions that unintentionally introduce barriers for those with physical, cognitive, and visual disabilities. For the second prototype, it is experimentally explored how the artistic processes of abstraction and minimization can help avoid the inclusion of such game genre conventions. In the third prototype, the second prototype is transformed into a more usable and playable game by emphasizing, among others, graphical, compositional and expositional game features. Finally, the fourth prototype explores how the style of the third prototype might be transformed into a tactile game that is integrated in the rehabilitation space in which the physical exercises are actually performed. The development of these prototypes is supported by play sessions with rehabilitation therapist as well as qualitative player and play experience tests. Researchers and designers working in the field of physical rehabilitation games can apply this game style and its features in their own rehabilitation games. The value of the work lies not only in the explication of the design process and rationale, but also in the resulting prototypes themselves. Designed game objects offer information that stretches beyond the written language, communicating in form, color, and game play. This offers researchers and designers the opportunity to directly perceive how they may implement, extent or alter the presented style. In this manner, we believe, the following dissertation presents one possibility of how a digital game world can be constructed for rehabilitation games starting from physical exercises and game mechanics while taking into consideration a number of physical, cognitive, and visual disabilities.