IEEE Systems, Man and Cybernetics Magazine - October 2020 - 59

"Box" was designed following A1; the ludic activity to
meet therapy objectives. The second design approach, A2,
replicate is a simulation of box training by hitting a virconsists of the selection and virtualization of the physiotual punch mitt. The patient has to use his/her hand to
therapy functional exercises being used at the hospital.
punch the mitt. Once it is touched, a new one will
The design decision and implemented mechanics of each
spawn. The mitts appear at the
game are presented as follows
edges of the patient's current
"The nest" was designed followworking space.
ing A2; the functional exercise to
All of the games
In addition to the games, gamireproduce is feeding. The patient
fication elements were added to
has to locate his/her hand 20 cm in
provide text and
the system. These elements are
front of his/her chest (the abstracaudio instructions
provided to motivate the user to
tion of reaching for a plate) and
continue playing the games as
bring the hand to his/her mouth. In
to the patient so
much as possible. The elements
the game, this trajectory is encourthat he/she can
and their implementation are
aged by setting a path of virtual
described as follows.
objects to touch. In the abstraction
be informed on
as a game, the patient's hand is rephow to achieve the
resented by a bird, and the virtual
Points and Score
game goals.
objects are cherries. Finally, the
Based on the in-game perforpatient's lips are the nest with the
mance of the patient, he/she is
offspring of the bird.
rewarded with points after every
"The man" followed A2; the
significant action. Whenever a sigfunctional exercise to reproduce is combing his/her hair.
nificant action happens, visual and auditory feedback is
The patient has to position his/her hand toward the upper
provided. The score is the sum of all the points obtained
part of his/her head and descend to the side up to 10 cm
by the patient.
from his/her shoulder. In the designed game, the trajectory
is indicated by the virtual objects to touch. The game presCoins, Experience Points, and Levels
ents an avatar representing the patient's head and coins as
At the end of each game session, the score obtained by the
the interaction objects to touch.
patient is transformed into experience points and coins.
"SpaceShooter" was based on the subgenre of games
Experience points can increase the player's in-game level,
from which it takes its name; hence, it followed A1. The
and coins can be used to acquire virtual goods in the form
game consists of a spaceship that is constantly encounterof collections.
ing meteoroids. The player has the option to avoid or
destroy them by shooting the spaceship's laser. The
Leaderboards
patient's hand provides the position for the spaceship; this
Following each game session, the score is used to genposition is in a 2D plane related to the patient's X and Y
erate leaderboards. Two types of leaderboards are
working space. In addition, the patient can exert force with
present in the system. The first type shows the maxihis/her arm to shoot the laser.
mum score obtained; these data are used to encourage
"LittleBird" was designed following A2; the functional
the user to surpass his/her record. The second type of
exercise to reproduce is moving an object on a table. To
leaderboa rd shows si m i la r h ig h scores of ot her
achieve the functional exercise, two points (p1 and p2) are
patients. This type of leaderboard is used to provide
defined on a table in front of the patient. The patient is tasked
some social support and reachable objectives based on
with performing a parabolic movement with his/her hand
the performance of peers.
from p1 to p2 and back while avoiding touching an object
located in the middle of the two points. In the designed game,
Instructions
p1 is shown as a little bird on an island, a fish is located in p2,
All of the games provide text and audio instructions to the
and finally, a stream of steam is located in the middle of p1
patient so that he/she can be informed on how to achieve
and p2. The in-game objective is to feed the bird by taking it
the game goals. To reduce the cognitive load, the instrucfrom p1 to the fish located in p2 and then returning it to the
tions are separated into chunks of information and preisland in p1, all while avoiding burning it with the steam.
sented only when necessary.
"Throw the Ball" followed A1; the ludic activity to replicate is playing with a ball by throwing it against a wall. To
Help and Challenge (Working Space Adaptation)
make the game more attractive for patients, a target is situMost of the games force the patient to work at the edges of
ated in front of the patient. The target grants more points
his/her current working space; however, these games also
to the patient based on how high he/she hits it with the
have an algorithm to adapt to the current working space.
ball. This decision was made to encourage the patient to
Based on the patient's current ROM, the algorithm can renmake throws by extending his/her arm against gravity.
der the task easier or more challenging.
O c tob e r 2020

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