Hemiparesis resulting from a stroke has a direct impact on patients’ daily activities. New approaches for motor rehabilitation include Serious Games (SG) because they include (in a motivating way) the three fundamental elements for rehabilitation: intensive, repetitive and task-oriented training. This study aims to evaluate the therapeutic effects of a biomedical SG and a scoring system developed for lower limb motor rehabilitation of hemiparetic stroke patients. The SG was inspired by the classic videogame called Pong, where the goal is to control a tennis racquet, but using muscular strength. A knee extensor apparatus was adapted with a load cell and mechanical adjustments for measuring the muscular strength of the quadriceps femoris (QFG) and hamstrings (HSG). A scoring system was proposed to evaluate muscular control. Eleven hemiparetic stroke patients participated in an exercise program using the SG twice a week for ten weeks and only the paretic side was trained. Significant Effect Sizes (d) were found for QFG strength (d=0.5; p=0.021), QFG control (d=1.1; p<0.001), HSG strength (d=1.1; p=0.001), HSG control (d=1.5; p=0.003), functional mobility (d=0.3; p<0.001), gait speed (d=0.4; p=0.007) and motor recovery (d=1.0; p<0.001). Results indicate that the intervention of a SG with both proper apparatus and evaluation system may effectively promote lower limb motor rehabilitation of hemiparetic stroke patients.

Hemiparetic stroke patients can have several muscular and postural disorders which compromise their balance. Serious Games (SG) emerged as a new approach to enhance conventional treatment by making it a motivating method to meet individual needs. This paper evaluated the therapeutic effects of a biomedical SG system developed for balance evaluation and training of hemiparetic stroke patients. The system consists of a balance board with inertial sensors and a computer system that runs the game. A novel scoring system for balance evaluation which extracts metric information regarding patients’ performance while gaming was proposed. A quasi-experimental study was performed with six hemiparetic patients in an exercise program using the SG twice per week for 10 weeks. Twelve healthy subjects were recruited for determining the baseline score for balance by using the proposed system. Significant Effect Sizes (ES) were observed for dynamic balance (ES=0.9), functional mobility (ES=0.4) and center of pressure displacement of the balance board (ES=1.9). Significant correlations between game scores and clinical scales suggest that the use of the scoring system for balance evaluation is feasible. The results of this study support the clinical potential of a biomedical SG for balance rehabilitation of hemiparetic stroke patients.

Introduction The Stroke is a neurologic disturbs that leads to a serious impact to the functionality and the quality of life of the survivors. It is necessary to develop new tools with rehabilitation objectives, where the Virtual Reality (VR) is introduced as a useful therapeutic resource to the motor recovery, in an attractive and efficient way, restoring functions through adapted games. Objective Analyzing the therapeutic effects of the Virtual Reality (Serious Game) in the recovery of the upper limb in hemiparetic Stroke patients. Methods Quasi-experimental research type time series, there are three pre and three post-tests already accomplished around 20 VR sessions. In the assessments the following measurement instruments were used: Fugl-Meyer Scale – session of the upper limb (FMS - UL); Range of Motion (ROM) for flexion and abduction shoulder; Box and Block Test (BBT); Nine Holes and Peg Test (9HPT); the Nottingham Health Profile (NHP); and the Modified Ashworth Scale (MAS). Results Significant gains were observed in the FMS-UL tests, with increase of 25.6%; increase ROM of shoulder with 34.0% for abduction and 19% for flexion; BBT 25.0%; also reported improvement in quality of life by NHP; it did not occurred significant alterations for 9HPT nor in MAS. Conclusion Although the results found in this research are preliminary, they are indicative that the VR can contribute for the recovery of the upper limb in hemiparetic Stroke patients.

Game design depends not only on understanding the creation process but also the elements that lead the game to be played. Fun, one of these elements, is of important value for the players’ enjoyment as well as their experience with the game, particularly with Serious Games (SG) due to its use as an instrument to serious matters. But there is no consensus on what it is and how to create something fun in SG. This paper performs a systematic literature mapping, to answer which are the constructs and outcomes related to fun. Out of 1062 papers, 62 were selected, 19 of which proved a direct impact of some factors on fun. It was found that the research on fun is increasing but slowly, 13 constructs have been proved to yield fun and 17 outcomes were investigated as a result from fun. Along with this, a Fun Framework was created based on related work. However, it was not possible to perceive a trend as to the rationale or form of evaluation focused on fun. Also, it was found that there is no consensual author regarding the definition of fun. The need for more research and discussion about fun, its causes and consequences became clear, despite the lack of a sound definition.