Physical rehabilitation has been widely used to restore or maintain motor capabilities of patients with upper-limb mobility limitations. Despite its effectiveness, physical rehabilitation has several difficulties in engaging patients with the multiple therapeutical sessions required to obtain measurable benefits. Novel technologies incorporate gamification strategies to encourage participants to play during the rehabilitation sessions (instead of counting repetitions), providing benefits for therapy adherence. “Serious” or also called applied games have been used as a complementary therapy for neuromuscular disorders. However, the therapy effectiveness of several serious games for health has been questioned by the clinical experts since crucial factors associated with the physical rehabilitation are not commonly included in the gameplay. This study reports the use of a physiologically aware serious game developed using surface electromyography (sEMG) to capture upper-limb muscular fatigue levels of participants. We carried out a pilot study lasting four weeks with five participants diagnosed with monoparesis/hemiparesis to evaluate the feasibility of using the fatigue-adaptive game called Force Defense as a complementary tool for physical rehabilitation in a local community-based rehabilitation center. Preliminary results suggest a positive user gameplay experience as well as good usability of the system reported by participants after the first intervention session. Moreover, we showed how the physiological adaptation was able to encourage participants to maintain exertion in the therapeutically desired zone, thus improving the system’s effectiveness. Participants also improved in their functional abilities of the upper limbs and the game performance measured in pre- and post-moments and reported reduced levels of perceived fatigue after the end of the training program.

身体康复已被广泛用于恢复或维持上肢活动受限患者的运动能力。尽管它很有效，但物理康复在让患者参与获得可衡量的益处所需的多个治疗过程方面存在一些困难。新技术结合了游戏化策略，以鼓励参与者在康复过程中玩耍（而不是计算重复次数），从而为治疗依从性提供好处。“严肃”或也称为应用游戏已被用作神经肌肉疾病的补充疗法。然而，由于与身体康复相关的关键因素通常不包含在游戏中，因此临床专家质疑了几种严肃游戏的治疗效果。本研究报告了使用表面肌电图 (sEMG) 开发的具有生理意识的严肃游戏来捕捉参与者的上肢肌肉疲劳水平。我们对五名被诊断患有偏瘫/偏瘫的参与者进行了为期 4 周的试点研究，以评估在当地社区康复中心使用名为 Force Defense 的适应疲劳的游戏作为身体康复补充工具的可行性。初步结果表明，参与者在第一次干预会议后报告了积极的用户游戏体验以及系统的良好可用性。此外，我们展示了生理适应如何能够鼓励参与者在治疗所需的区域内保持用力，从而提高系统的有效性。