Published by Maney Publishing (c) W. S. Maney & Son Limited O 10.1179/108331909X12488667117258 DOI ß ucinwiepsigtecnnso physical, of confines of the recovery pushing of level while maximal and a function promote (TBI) to injury is brain spinal stroke traumatic following (SCI), rehabilitation injury of cord goal primary The Introduction Keywords: determine to collected ( SCI were with males) data five females, (two questionnaire enjoyment. and and appeal usability, Results: observational system’s and demonstration each a devices, of traumatic Following perception injury, presented. participants’ the cord are spinal studies of from two recovering from trial Findings people stroke. of a and sample and injury a brain with games research off-the-shelf group and focus disabilities. these with and clinic for people the for evaluations developed within specifically usability device) Methods: used off-the-shelf initial be an out (using can game carried prototype and group accessible entertainment. and Our of affordable, interaction purpose social home. are exercise, the for they devices for off-the-shelf because tested these of rehabilitation and use the developed adopting been are clinics have Many EyeToy 2 PlayStation Sony Aims/background: 90292, CA Rey, Del Marina California, Southern of University USA Technologies, Creative Rizzo for Institute A. and Flynn S. Lange, B. game-based rehabilitation clinical motor for consoles game off-the-shelf video of assessment usability Initial lhuhsm atcpnshddfiut aiaigtemn ftePaSainEeo.The EyeToy. PlayStation the of (SCI menu participants six the of device, navigating evaluation interaction involved Wii-mote difficulty study the second had of use participants the than some intuitive more although be to appeared interface EyeToy the o ag fpyia iaiiis h s fvrulraiyadvdogmsfrrehabilitation for games video tasks. and therapy reality specific virtual perform of to use patients motivating The for disabilities. potential physical offers and of clinic range the a both that in for reported games participants of studies, types both these Conclusion: In playing if them. exercise to setting. to challenging was home motivated was participant more haptic that each be that level off-the-shelf would so a they an level at skill using work their task), on to depending of able rehabilitation participant, difficulty bimanual each the decrease for for or device, increase feedback specifically to able (developed was game investigator The a years. 58 and 25 between aged .S ae o t 2009 Ltd Son & Maney S. 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Maney & Son Limited hsclTeayReviews Therapy Physical atrsadrdcdidpnec ihatvte of activities gait living. with daily abnormal independence in left reduced resulting and are patterns 90% weakness however, sided live, one with to with likely persons associated more treatments, are indirect) current stroke and With (direct stroke. cost with health to uted eeeTIcnrah$ million. $4 reach can TBI surviving person severe one for a costs lifetime lost United the the as and in States such billion $60 costs at estimated indirect are productivity and costs medical Direct approximately with 300,000 year. is each cases new SCI 12,000 with States quality high providing price. afford- able reasonably with a at interventions associated challenged and evaluations, impairments is commu- rehabilitation of the nity stroke, array and TBI SCI, vast with the stays. hospital Given shorter and measures independence nuyo ies otenrossse sthrough is system nervous practice. the skillful to intense disease or 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Maney & Son Limited aetefr fhuitc omtv rsummative or formative heuristic, can of evaluation. surveys form and the observation take User surveys. observa- to and user can and tion want analysis, research task they Usability groups, do focus user?). include (what the researchers about/from the learn and of device/application goal the of the tested, completion being of application level or device the depending the forms, of scope many the on take can research Usability yial ossso he phases. three of consists and business group typically focus commercial of type the This of environment. manufacturing out grew product a rehabilitation for tools rare. initial of relatively on remains usability application/device The the how to exposure. into relate insight users focus provides new to testing attributed completion. often Usability feedback groups. upon biased of and risk reducing individually, the development assessed often are of Participants range levels a at testing of usability undergo applications and h rdc n eemn asi hc h product the which evaluate in to ways helpful determine some is and for product group the focus use the phase in third of is a product prototype time, the next after the Lastly, groups into product. focus Often incorporated the is development. from that feedback product given of plans are phase tune designers next fine help the different to for used of This typically one. number is each focus information contrast a and The compare test and prototypes development. often of members the in stages group useful a Focus are planning and test developed. ideas of pilot early source being to rich a product is are groups the group focus of phase prototype purpose second The under- the product. particular sees, of a end-user values the and how stands mission understand fact-finding a better on the to is understanding Typically coordinator audience. gain group target focus or to end-user aims the about researcher the phase, h s ffcsgop ogi nomto about information gain to groups focus of use The ii eoaiiy hnuesrtr otedesign the to return users when memorability: (iii) i)err:tenme ferr sr ae how make, users errors of number the errors: (iv) i)efcec:oc sr aelandtedesign, the learned have users once efficiency: (ii) v aifcin o laati st s the use to is it pleasant how satisfaction: (v) i eraiiy o ayi sfruesto users for is it easy how learnability: (i) fe eido o sn t o aiythey easily how it, proficiency using reestablish not of period a after tasks perform they quickly how they time first design; the the encounter tasks basic accomplish design. they errors easily the how from and recover can are, errors these severe 29–32 29–31 ierneo rdcs devices products, of range wide A 33,34 ntefirst the In ag tal. et Lange rpormcudb improved. be could program or pn ufiin hleg n raigafnand fun a creating experience. and challenge entertaining devel- sufficient environment, a principles immersive oping design an are providing game as address such methodologies to developed Specific of being field the design. in area critical user-centered a becoming is design Game games video and testing Usability user. viewpoint novice the ask a possible the applica- of as to far the in as is through adopting work tion/device, involved process to core designers been expert experienced The not with process. people have development from that to perspectives team knowledge design the the efficiency, for evalua- obtain opportunity content, Heuristic an provide structure. design, tions overall that identified: issues and of be navigation type to the on need based chosen are Experts ealeet n cin.Sresaees to easy are sizes. 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S. Maney & Son Limited hsclTeayReviews Therapy Physical n oiiepae experience. player positive a provid- and ing interest player is maintaining challenge for of important level and narrative devices, interaction omdo Rdvcsdvlpdseiclyfor specifically developed devices VR telerehabilitation. on formed or games off-the-shelf the of consoles. many gaming of requirements the design in if game considered were known disabilities with not individuals is for adjunct It an a of tool. focus on primary rehabilitation a tested as with designed or been devices not medical were have they the however, video games audience, for diverse off-the-shelf and 2 tested consoles The PlayStation and game entertainment. 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Participants were (Fig. upper games motion the excessive which of requiring range without extremity or the balance standing used challenged sitting have game each never and may before be devices who to thought patients The were for games). they intuitive bowling because and chosen the (golf were withgames Wii soccer demonstration, the and and (boxing a individuals games) EyeToy user Following the for trialled enjoyable, CVA. participants motivating most and SCI were and EyeToy, that 2 friendly, PlayStation Wii) (Sony Nintendo systems off-the-shelf game of to characteristics video and were the research SCI define preliminary and with this identify people of goals of The sample CVA. a was with research group undertaken focus and evaluation Summative summative observations and usability group focus from Findings hc a fetteuaiiyo rdc are product a of usability the factors considered. affect all that may ensure to be which framework will a product provides the significantly. used which used in are context games the Considering these which the in alters rehabilitation context for games video off-the-shelf 43 oee hne eemd otewording the to made were changes however 42 ic hs ae eeinitially were games these Since 42 h ocp fusing of concept The Published by Maney Publishing (c) W. 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Maney & Son Limited - ae5 2SIC/ SACYsYsNo Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes No C ASIA SCI-C6/7 No C No ASIA No SCI-T10 No C ASIA SCI-C4/5 No A ASIA SCI-C6/7 CVA-L CVA-R CVA-R 42 12 71 120 55 47 6 50 21 Male 55 Male 53 Male Male 61 Female 49 65 Female S-4 Male S-3 S-2 S-1 C-3 C-2 (years) C-1 Age Gender number Subject participants of Description 1 Table five ( females, SCI (two with participants males) seven of groups, discussions small participants. all in with group undertaken focus the was demonstration by followed play The hours. game session 4 and collection within data completed sugges- The was and improvement. audio presence, for graphics, tions of play, negative game themes comments, comments, positive into interactivity, grouped feedback, and were Responses rehabilitation. recorded for changes games potential improve to exploring session brainstorming including a devices, discussion Finally, the group regarding of investigators investigators. the hours with 2 the in part by took participants recorded were and testing usability noted the during made Observations re–sm atcpnscudntfidtegames the find participants not those choices) particular, could In select immediately). participants menu section to some through screen – navigate the to tree (difficult of (could cognitively top and physically the both reach EyeToy, not PlayStation that menu the the indicated of navigating difficulty findings on had buttons participants Observational some correct the device. finding required the with participants assist with Participants four to themselves and cueing device. device familiarize Wii-mote to interaction the time more Wii-mote use required the than the intuitive more of be to EyeToy appeared the with interface Interaction games. the more bowling Wii and the for golf to and compared requirements games soccer and understand interaction boxing EyeToy the to grasp that able quickly were the testing were by usability participants recorded the Observations during mode. investigators game into moving full before the sessions tutorial or for practice need the more to expressed cumbersome participants devices were five devices the However, the use. that using Responses feel confident not learn. did felt to and they easy that to and indicated easy integrated, were well devices the use, participants thought they responses, that indicated questionnaire the Through 55 was participants of age h td novdeauto n ou group focus and evaluation involved study The n 5 )adCA( CVA and 4) . 2( 42 ¡ 5 . 7 er Tbe1). 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Maney & Son Limited hsclTeayReviews Therapy Physical a lytegm ihteteaetcga nmind. in goal therapeutic the be patients with how game to but the game play the need can about provid- Instructions only not not instructions. provided, are observa- therapists enough that the ing suggest from data findings tional and interesting rehabilita- Initial findings for games tion. interesting of development of for suggestions range have a findings upon Preliminary demonstrated to questions tasks. closed asked game and of being open completion of are series participants a complete patient and by therapist), is experienced game or which difficulties used, any (in being played, is analyzed being device the and EyeToy. how of recorded of 2 Wii, terms observation being Playstation Nintendo are Sony and Observations and the groups WiiFit using Nintendo focus participants of individual form in CA pro- Beach, the in Long Rehabilitation, currently Precision at is gress assessment summative Further video games off-the-shelf of evaluations master!’ Summative to games hard games yet sport learn wanted to the Participants ‘easy were sessions. than that the other in challenges trialled puzzles game of form the or in would challenge they movement. cognitive how more discussed enjoy correct Participants thought helpful. the were be feedback to made auditory and had sound often Realistic they were games if participants EyeToy and unsure and control to Wii difficult the were of within some movements However, helpful. the the considered of was the device game handheld in Wii the objects from with was feedback contact participants The made game. view the had feedback, they EyeToy one that haptic ‘felt’ the provide no Although not does and beneficial. more environment considered game within times different and virtual the at view helpful a was person view with first person of or third use wheelchair The in virtual aide. move a frame/walking nor via disabled game look the not creatingthe (using need avatar themselves enjoyed the to Wii), similar participants looked when that consensus although important avatars group that not The was games. was one-off Wii short the occasions. playing for their multiple of avatar use on own the that game suggested a participants However, to feature useful returning a be when would to screen able on being themselves or felt watch avatar Participants own their movement. having was that specific strongly game very the a more of create goal be to the could when themselves a especially of or beneficial, themselves image to captured similar looked video that avatar an and nta sblt seseto f-h-hl ie aeconsoles game video off-the-shelf of assessment usability Initial 2009 VOL 14 NO 5 efr l fterqie oeet ihnthe within movements required the patient game. of cannot or the all play game are perform the because for that enough fast effectively move patients cannot to tasks movement feedback performing visual safe negative is providing and and are patient auditory games appropriate the some Finally, if an pattern. determine in to behaving patient with the As to patient. observe need the therapists the on techniques, treatment focusing watching conventional not observed and play been game have therapists Some iue2Nvn acndevice Falcon Novint 2 Figure hywr sn hi r n oyeog.In the enough. using body that and felt SCI arm with like their participants feel not particular, using did and were grasp found to they they Precision difficult that however was reported feedback, device the haptic CA, at the Beach, liked they Long evaluation a in during game), Rehabilitation group/usability catching mini-games ball a focus 19 trialling to (playing initially as device games Participants the well Novint. computer as by developed feedback off-the-shelf of user place with the enhance in mouse used be can a device per objects This with screen. and times interact the to grips on dimensions 1000 The three interchangeable in updated user. move uses can the is device by handle The felt second. the force is a in that in handle current resulting the into motor, to device’s applied comes the updates controller computer to the currents the object, virtual Once the with the contact hand. game, contact into their catching coming ball with ball the of a impact the play. feels playing ‘natural’ player if more and for the example, allowing dimension For device, object, texture, an this of shape, force using weight, feels When player 2). 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Fulk 18 R, Bojan AS, Merians SV, Adamovich 15 individuals for practice task of Conditions J. Stewart C, Winstein 11 MH. Woollacott A, Shumway-Cook 10 J. Sniezek J, Guerrero K, Dunn C, Alverson D, injury. Thurman brain of aspects Epidemiologic 6 DL. MacArthur JF, Kraus http:// at: Available 5 Prevention. and Control Disease for Report Centers Annual NSCISC network. information 4 injury cord Spinal brain traumatic 3 mild on congress to report The JL. Gerberding 2 9BrmY ilrA ita elt usfripoeeto atin gait of improvement for cues reality Virtual A. Miller Y, Baram 19 7Fn ,MlunF caynBJ, McFadyen F, Malouin J, Fung 17 video-capture within Reaching PL. Weiss M, Shahar AY, Dvorkin 16 injury: brain traumatic after Physiotherapy S. 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