Experience of Virtual Help in a Simulated BCI Stroke Rehabilitation Serious Game and How to Measure It

Designers of digital rehabilitation experiences can accommodate error-prone input devices like brain-computer interfaces (BCIs) by incorporating virtual help mechanisms to adjust the difficulty, but it is unclear on what grounds users are willing to accept such help. To study users' experience of virtual help mechanisms, we used three help mechanisms in a blink-controlled game simulating a BCI-based stroke rehabilitation exercise. A mixed-method, simulated BCI study was used to evaluate game help by 19 stroke patients who rated their frustration and perceived control when experiencing moderately high input recognition. None of the help mechanisms affected ratings of frustration, which were low throughout the study, but two mechanisms affected patients' perceived control ratings positively and negatively. Patient ratings were best explained by the amount of positive feedback, including game help, which increased perceived control ratings by 8% and decreased frustration ratings by 3%. The qualitative analysis revealed appeal, interference, self-blame, and prominence as deciding experiential factors of help, but it was unclear how they affected frustration and perceived control ratings. Building upon the results, we redesigned and tested self-reported measures of help quantity, help appeal, irritation, and pacing with game-savvy adults in a follow-up study using the same game. Help quantity appeared larger when game help shielded players from negative feedback, but this did not necessarily appeal to them. Future studies should validate or control for the constructs of perceived help quantity and appeal.