JMIR Publications

ABSTRACT

Background:

Restoring hand and finger function after a traumatic hand injury necessitates a regimen of consistent and conscientious exercise. However, motivation frequently wanes due to unchallenging repetitive tasks or discomfort, causing exercises to be performed carelessly or not at all. Introducing gamification to these repetitive tasks can enhance their appeal to patients, ultimately boosting their motivation for consistent exercise performance.

Objective:

This study aimed to iteratively develop a serious virtual reality game for hand and finger rehabilitation within an appealing and engaging digital environment, encouraging patient motivation for at least two weeks of continuous therapy.

Methods:

The development process comprised three distinct stages, each of which was subject to evaluation. Initially, a prototype was created to encompass the game’s core functionalities, which was assessed by 18 healthy participants and 7 patients with impaired hand function. Subsequently, Version 1 of the game was developed and evaluated with 20 patients who were divided into an investigation group and a control group. Based on these findings, Version 2 was developed and evaluated with 20 patients divided into an investigation and a control group. Motivation was assessed using the Intrinsic Motivation Inventory (IMI) while the application’s quality was rated using the Mobile Application Rating Scale (MARS) and the System Usability Scale (SUS). User feedback was gathered using semi-structured interviews.

Results:

The prototype evaluation confirmed the acceptance and feasibility of the game design. Version 1 significantly increased motivation in two IMI subscales, effort (p<.001) and usefulness (p=.015). In Version 2, a significant increase in daily performed exercises was achieved (p=.008) compared to Version 1, with significantly higher motivation in the IMI subscale effort (p=.022). High MARS scores were obtained for both Versions 1 and 2, with Version 2 scoring 86.9 on the SUS, indicating excellent acceptability. User feedback provided by the semi-structured interviews was instrumental in the iterative development regarding improvements and the expansion of the playable content.

Conclusions:

This study presented a virtual reality serious game designed for hand and finger rehabilitation. The game was well received and provided an environment that effectively motivated the users. The iterative development process incorporated user feedback confirming the game’s ease of use and feasibility, even for patients with severely limited hand function.