It Depends: Re_Authoring Play Through Clinical Reasoning in Wearable AR Rehab Games

2026-03-13

AI Summary

Existing augmented reality (AR) rehabilitation games often remain confined to laboratory settings and struggle to integrate into real-world clinical and daily contexts. To address this gap, this study systematically analyzes 132 applications and collaborates with 14 physical therapists through gameplay evaluations, proposing “It depends” as a generative design principle to formulate a lightweight, clinically reasoned AR rehabilitation game design framework. Leveraging eyewear-based spatial computing devices and drawing on clinical observations, user testing, and qualitative analysis, the research identifies three therapist-led game reconfiguration patterns: co-creation, contextual adaptation, and dual support. These patterns offer a practical pathway and actionable design guidance for translating AR rehabilitation games from experimental prototypes into authentic clinical practice.

Technology Category

• Humans and AI: Game Design — Virtual Humans, NPCs and Autonomous Characters
• Game Theory and Economic Paradigms: Mechanism Design
• Cognitive Modeling & Cognitive Systems: Computational Creativity

Application Category

• User Modeling, Personalization and Recommendation: Practical large-scale studies of user experience
• Responsible Web: Machine-in-the-loop, human agency and autonomy
• Search and Retrieval-Augmented AI: Personalized, context-aware and across-device search

Abstract

Augmented reality games hold promise for rehabilitation, yet most remain confined to laboratory studies with limited clinical uptake. Recent advances in spatial computing, especially lightweight, glasses_form_factor AR, create a timely opportunity to embed rehabilitative play into clinical practice and daily contexts. To investigate this potential, we systematically reviewed 132 applications and conducted playtesting with 14 licensed physical therapists. Our analysis revealed three ways therapists re_authored AR games: co_authored play (reshaping movements, progressions, and difficulty), situated play (adapting across specialties, conditions, and contexts), and dual play (mediating both physical recovery and psychological support). We reframe therapists' frequent phrase_It depends_as a generative design principle. This study contributes a clinical reasoning_based framework and design principles and guidelines for creating personalized, situated forms of play that align with therapists' everyday workflows and inform future lab_to_clinic translation.

Problem

• augmented reality
• rehabilitation
• clinical reasoning
• wearable AR
• therapist adaptation

Innovation

• clinical reasoning
• wearable AR
• re-authoring
• situated play
• rehabilitation games