Stroke is affecting different age groups worldwide with tremendous consequences. Most stroke survivors suffer from motor impairment, where rehabilitation helps to regain lost abilities. Rehabilitation is a long process that focuses on repeating exercises, which are monotonous and time-consuming. As a consequence, patients loose interest and motivation. Serious games offer the possibility to deliver rehabilitation exercises in combination with entertaining and motivating aspects. A variety of serious games using additional hardware is available to support stroke patients. The authors propose a new and innovative serious game, which rely only on integrated sensors of a smartphone. Development was based on a user-centred design approach divided into 2 phases. In phase 1 requirements were identified in cooperation with a therapist and 13 stroke patients. The developed serious game included different levels of difficulty for movement, gesture and touch exercises. Additional feedback and requirements from therapists and medical doctors were included in phase 2, which resulted in an advanced solution with additional levels. Gathered feedback showed a positive attitude towards the proposed solution.

Ankle injuries are amongst the most common musculoskeletal injuries. The necessity of prevention measurements before or an early rehabilitation start after an injury, is essential for (semi-) professional sports like soccer to decrease healing duration. Sensor-supported serious games could complement a therapeutic program to support resilience and motivation during the prevention or rehabilitation process. Therefore, the aim of this study is to develop and evaluate a user-centered prototype of a serious game using a commercial Off-The-Shelf MetaMotion IMU sensor. A semi-structured interview with a soccer club therapist, followed by an online questionnaire containing 48 questions (n = 91), was performed to ensure a user-centered approach. Based on this, a prototype, including five identified functional requirements and seven exercises (comprising: horizontal/vertical in- and eversion, dorsi- and plantarflexion, knee bend and squat, and toe and heel rise), was developed in an iterative process and evaluated by two participants with an acute ankle injury. The questionnaire outcomes showed averages of 3.3 ankle injuries per participant and 40 absence days per incident. Additionally, 85% of the participants reported needing more prevention time for such injuries. The evaluation phase (total training duration: 2 h 52 min) consisted of playing two different game types (1 and 2 degrees of freedom) and three different levels, where an avatar needs to be controlled while running and avoiding obstacles or collecting trophies. Both range of motion (ROM) and scores, which are directly measured by the game, showed significant improvements (ROM: t = 5.71; p < 0.01; Score: t = 3.98; p < 0.01) between the first and last session in both participants (P1: ROM +3.56°; Score +7.00%, P2: ROM +6.59°; Score +9.53%), indicating high effectiveness, despite a short training period (1 and 2 weeks). ROM improvement results and athlete feedback coincide in that the sensor-assisted serious game might be beneficial for ankle prevention and rehabilitation. At the same time, the increased scores indicate substantial motivation over several training sessions.

Wrist injuries, driven by factors such as an aging population and the popularity of high-impact sports, have become increasingly prevalent. In response, this study focuses on developing a serious game for wrist injury rehabilitation within a virtual environment, aiming to enhance motivation and therapeutic adherence while highlighting the potential of virtual rehabilitation. Extensive literature research and the involvement of five experts during the game’s design led to the creation of “WristBreakout”, which successfully integrated 13 out of 15 recommended movements into gameplay. In addition, the technical feasibility of the VR headset “MetaQuest” within the domain of wrist rehabilitation was shown. A preliminary evaluation with six healthy participants showed positive results in terms of usability and acceptance (SUS average was 69; UES categories were between 3.97 and 4.77). This work contributes to the broader context of serious games and virtual reality (VR) applications in healthcare, exemplifying how technology can positively impact the rehabilitation experience.

Smoking is still a worldwide phenomenon and a big health issue that needs to be combated. Smoking cigarettes is linked to many serious illnesses and causes an estimated six million deaths per year. Tobacco users are more likely to quit if they have better knowledge of specific health risks caused by their tobacco consumption. Overcoming this addiction caused by nicotine is often very difficult both on a physical as well as a psychological level and most smokers fail to stop, especially on a long-term basis. It has been shown that the success rate to stop smoking increases when smokers use some form of further assistance. Therefore, the authors of this paper suggest a novel serious game to support the process of smoking cessation called “BreathIn”. After a comprehensive literature review and a state-of-the-art analysis, an iterative design study was conducted. During a total of three iterations, responses from 304 participants with the help of an online questionnaire and 9 additional interview partners were collected and ended up in the definition of 12 final requirements which were used for the definition and design of the serious game (low-fidelity prototype). The prototype was then subsequently evaluated by 6 users and one psychiatrist in the third and final iteration.