A Collaborative Rehabilitation-Exercise Serious Game for People with Stroke and their Caregivers: A Pilot Study

2026-05-18

AI Summary

This study addresses low rehabilitation adherence among stroke patients and caregiver burnout by proposing an innovative dyadic collaborative health gaming system. For the first time, the system integrates caregivers’ physical exercise—performed via seated stepping using either a pedal or keyboard—with patients’ upper-limb rehabilitation involving wrist movements, enabling reciprocal interaction. Combining therapeutic movement with validated affective assessment scales, the system quantifies user experience through both physiological and emotional metrics. Preliminary experimental results demonstrate that when caregivers use the pedal interface, their engagement increases significantly, while patients exhibit notably enhanced positive affect and perceived competence. These findings underscore the potential of this collaborative exergaming approach to simultaneously bolster patient motivation for rehabilitation and support the psychological and physical well-being of informal caregivers.

Abstract

Motivation to perform movement therapy and caregiver burnout are major challenges to post-stroke life. Serious games have been shown to support therapeutic tasks in people with stroke, but there are few activities that simultaneously support informal caregiver health, which is also impacted post-stroke. Here, we present a collaborative, mutually beneficial, serious game designed to support therapy for persons with stroke and also exercise for their informal caregivers. One player performs rehabilitative wrist movements - useful to people with stroke - and the other performs a seated march exercise - useful to informal caregivers - via pedals or a keyboard to control their avatar. We present a pilot study with 6 healthy dyads to evaluate how exercise-based input of one player, the Pseudo Caregiver (PCG), impacts motivation and emotional experience in both the PCG and Pseudo Person with Stroke (PPS). While not statistically significant, we find that PCGs Interest subscale scores trended higher when using a pedal (the exercised-based input) compared to a keyboard, regardless of game play mode. PPSs' positive affect scale scores and Competence subscale scores trended higher when their partner played collaboratively with a pedal compared to a keyboard. These trends encourage future work toward incorporating an exercise-based device, such as a pedal, to enhance the emotional and motivational experience of rehabilitative serious games for people with different movement ability levels.

Problem

• stroke rehabilitation
• caregiver burnout
• serious games
• motivation
• collaborative exercise

Innovation

• collaborative serious game
• stroke rehabilitation
• caregiver exercise
• exercise-based input
• motivational design