Upper-limb impairments due to stroke can severely affect the quality of life in patients. Scientific evidence supports that repetitive rehabilitation exercises can improve motor ability in stroke patients. Rehabilitation games gained tremendous interest among researchers and clinicians because of their potential to make the seemingly mundane, enduring rehabilitation therapies more engaging. However, routine and longitudinal use of rehabilitation games in real-world clinical settings has not been investigated in depth. Particularly, we know little about current practices, challenges, and their potential impacts on therapeutic outcomes. To address this gap, we established a partnership with a rehabilitation hospital where game-assisted rehabilitation was routinely employed over a 2-year period. We then conducted an observational study, in which we observed 11 game-assisted therapy sessions and interviewed 15 therapists who moderated the therapy. Significant findings include (1) different engagement patterns of stroke patients in game-assisted therapy, (2) imperative roles of therapists in moderating games and challenges that therapists face during game-assisted therapy, and (3) lack of support for therapists in delivering patient-centered, personalized therapy to individual stroke patients. Furthermore, we discuss design implications for more effective rehabilitation game therapies that take into consideration both patients and therapists and their specific needs.

中文翻译：

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现实世界临床环境中的康复游戏

中风引起的上肢损伤会严重影响患者的生活质量。科学证据支持重复性康复锻炼可以提高中风患者的运动能力。康复游戏引起了研究人员和临床医生的极大兴趣，因为它们有可能使看似平凡、持久的康复疗法更具吸引力。然而，在现实世界的临床环境中，康复游戏的常规和纵向使用尚未得到深入研究。特别是，我们对当前的实践、挑战及其对治疗结果的潜在影响知之甚少。为了解决这一差距，我们与一家康复医院建立了合作伙伴关系，该医院在 2 年的时间里定期使用游戏辅助康复。然后我们进行了一项观察性研究，其中，我们观察了 11 次游戏辅助治疗，并采访了 15 名主持治疗的治疗师。重要发现包括（1）中风患者在游戏辅助治疗中的不同参与模式，（2）治疗师在调节游戏中的必要角色以及治疗师在游戏辅助治疗中面临的挑战，以及（3）缺乏对治疗师提供的支持以患者为中心的个性化治疗个体中风患者。此外，我们讨论了考虑患者和治疗师及其特定需求的更有效的康复游戏疗法的设计含义。(2) 治疗师在调节游戏和治疗师在游戏辅助治疗过程中面临的挑战方面的必要作用，以及 (3) 治疗师在为个体中风患者提供以患者为中心的个性化治疗方面缺乏支持。此外，我们讨论了考虑患者和治疗师及其特定需求的更有效的康复游戏疗法的设计含义。(2) 治疗师在调节游戏和治疗师在游戏辅助治疗过程中面临的挑战方面的必要作用，以及 (3) 治疗师在为个体中风患者提供以患者为中心的个性化治疗方面缺乏支持。此外，我们讨论了考虑患者和治疗师及其特定需求的更有效的康复游戏疗法的设计含义。