Current serious game genres for stroke neurorehabilitation: A scoping review of randomized controlled trials

Stroke rehabilitation increasingly leverages serious games to enhance patient motivation and recovery, yet the diversity of genres applied in neurorehabilitation remains poorly systematized. This scoping review, aligned with PRISMA-ScR guidelines, analyzed 87 randomized controlled trials (2019–2025) published in Q1–Q2 journals to map the genres and subgenres of serious games used in post-stroke therapy. Both commercial systems (71%) and custom-made prototypes (29%) were examined, finding that action, puzzle, and simulation were the most prevalent Tier 1 (main) genres. Arcade-style mechanics and instruction-focused contexts were the most common, while cognitive and socio-affective domains were underrepresented. Popular entertainment genres such as Match-3, Tower Defense, and Turn-Based Tactical were absent, underscoring design gaps and opportunities for innovation. A multilayer labeling map was developed to classify narrative and mechanical dimensions, offering a structured lens to align game choice with therapeutic objectives. This review highlights the importance of genre diversity, personalization, and clearer reporting of game mechanics to advance gamified rehabilitation. Future research should explore neglected genres, incorporate multidomain outcomes, and establish standardized descriptors to more effectively connect gameplay features with clinical outcomes. • First detailed map of serious game genres in stroke rehabilitation. • Multi-label mapping distinguishes Tier 1 genres and Tier 2 subgenres. • Action, puzzle, and simulation account for 60% of identified game genres. • 71% of RCTs use commercial devices; 29% employ custom gamified systems. • Provides design guidelines for integrating genres into therapy development.