Key Design Considerations and Assessment of a Serious Game for Hand and Wrist Rehabilitation Using a Leap Motion Controller

Serious games are increasingly explored as tools to enhance rehabilitation, yet their effectiveness in medical applications is often insufficiently evaluated. Many studies do not use standardized methods to check if these games are truly effective. However, in medical settings, for example for stroke rehabilitation, it is important to know if a game is engaging, easy to use and actually supports therapy. Without proper assessment, serious games might be used without understanding their benefits or limitations. A major issue is that serious games are tested informally without using standardized methods for evaluation. This makes it difficult to compare results or improve the game based on feedback. In the medical field, where reliable and effective tools are essential, this is a serious problem. To address this, an existing serious game, RehaFox, designed for hand and stroke rehabilitation using the Leap Motion Controller, was selected. A structured evaluation method was developed, combining both qualitative and quantitative approaches. Overall, 15 participants evaluated the serious game during play sessions in the context of a System Usability Scale (SUS), the short form of the User Engagement Scale (UES), a Game Experience Questionnaire (GEQ), and interviews. These findings have provided initial insights into the strengths and challenges of RehaFox from various perspectives. The game excelled in several dimensions of the GEQ, particularly in terms of positive affect (average score of 4.2/5.0) and low levels of tension and anger (average score of 1.4/5.0). The UES results indicate a high level of user engagement, with an overall engagement score of 4.0/5.0, while an average SUS score of 78.0 suggests the game has good usability. In addition 9 different requirements were derived, which should be used within a serious game utilizing a LMC in the context of hand and wrist rehabilitation. These findings highlight the importance of structured evaluations for serious games in medical rehabilitation and provide a foundation for future improvements in this field.