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This pilot feasibility study evaluated a therapist-configurable serious-game system in which a handle equipped with an RGB sensor, embedded processing, and wireless communication converted detections of reconfigurable colored targets into control events for 17 games. Thirteen neurological patients began six supervised sessions over three weeks alongside usual care; 11 completed them (84.6%). Including one session completed by each participant who withdrew, 68 sessions were delivered overall (approximately 34 h of scheduled time). From a sensing-operability perspective, no session ended prematurely because of a sensing or other technical failure; RGB recalibration was required in 4 sessions (5.9%). Measures included session logs, System Usability Scale, Intrinsic Motivation Inventory, In-Game Game Experience Questionnaire, Pittsburgh Rehabilitation Participation Scale, Box and Block Test, and exploratory movement analysis. Mean SUS was 76.1 \u00b1 12.6; IMI interest\/enjoyment and perceived competence were 6.47\/7 and 6.39\/7; exploratory post-activity iGEQ positive affect was 3.64\/4; and PRPS means ranged from 4.64 to 5.45\/6. BBT scores increased descriptively in 11 of 12 assessed affected limbs. The system was feasible and acceptable as a supervised adjunct, but exploratory findings do not establish clinical efficacy.<\/jats:p>","DOI":"10.3390\/s26185956","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:21:48Z","timestamp":1790072508000},"page":"5956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Therapist-Configurable Serious Game System for Upper-Limb Neurorehabilitation: A Pilot Feasibility Study"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1401-0910","authenticated-orcid":false,"given":"Juan J.","family":"S\u00e1nchez-Gil","sequence":"first","affiliation":[{"name":"Departamento de Ingenier\u00eda Electr\u00f3nica y de Computadores, Universidad de C\u00f3rdoba, Edificio Leonardo Da Vinci, Campus de Rabanales, 14071 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2555-7123","authenticated-orcid":false,"given":"Aurora","family":"S\u00e1ez","sequence":"additional","affiliation":[{"name":"Departamento de Ingenier\u00eda Electr\u00f3nica y de Computadores, Universidad de C\u00f3rdoba, Edificio Leonardo Da Vinci, Campus de Rabanales, 14071 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Juan Jos\u00e9","family":"Ochoa-Sep\u00falveda","sequence":"additional","affiliation":[{"name":"Instituto de Neurociencias, Hospital Cruz Roja, P.\u00ba de la Victoria, 14004 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Rafael","family":"L\u00f3pez-Luque","sequence":"additional","affiliation":[{"name":"Instituto de Neurociencias, Hospital Cruz Roja, P.\u00ba de la Victoria, 14004 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7076-9041","authenticated-orcid":false,"given":"Laura","family":"Mu\u00f1oz-Mill\u00e1n","sequence":"additional","affiliation":[{"name":"Departamento de Ingenier\u00eda Electr\u00f3nica y de Computadores, Universidad de C\u00f3rdoba, Edificio Leonardo Da Vinci, Campus de Rabanales, 14071 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0384-1660","authenticated-orcid":false,"given":"Eduardo","family":"Ca\u00f1ete-Carmona","sequence":"additional","affiliation":[{"name":"Departamento de Ingenier\u00eda Electr\u00f3nica y de Computadores, Universidad de C\u00f3rdoba, Edificio Leonardo Da Vinci, Campus de Rabanales, 14071 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s11910-023-01308-9","article-title":"Post-stroke Everything","volume":"23","author":"Lekoubou","year":"2023","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100152","DOI":"10.1016\/j.dscb.2024.100152","article-title":"Virtual reality intervention for improving cognitive function in post-stroke patient: A systematic review and meta-analysis","volume":"15","author":"Gunawan","year":"2024","journal-title":"Brain Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3341","DOI":"10.1109\/TNSRE.2023.3304758","article-title":"Current Topics in Technology-Enabled Stroke Rehabilitation and Reintegration: A Scoping Review and Content Analysis","volume":"31","author":"Cisek","year":"2023","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Diriba Kenea, C., Gemechu Abessa, T., Lamba, D., and Bonnech\u00e8re, B. (2024). Technological Features of Immersive Virtual Reality Systems for Upper Limb Stroke Rehabilitation: A Systematic Review. Sensors, 24.","DOI":"10.3390\/s24113546"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ganter-Argast, C., Schipper, M., Shamsrizi, M., Stein, C., and Khalil, R. (2024). The light side of gaming: Creativity and brain plasticity. Front. Hum. Neurosci., 17.","DOI":"10.3389\/fnhum.2023.1280989"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Dama\u0161evi\u010dius, R., Maskeli\u016bnas, R., and Bla\u017eauskas, T. (2023). Serious Games and Gamification in Healthcare: A Meta-Review. Information, 14.","DOI":"10.3390\/info14020105"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s11910-022-01181-y","article-title":"Gamified Neurorehabilitation Strategies for Post-stroke Motor Recovery: Challenges and Advantages","volume":"22","author":"Tabacof","year":"2022","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"108563","DOI":"10.1016\/j.cmpb.2024.108563","article-title":"Design and validation of PACTUS: A gamified electronic device for stroke rehabilitation","volume":"260","year":"2025","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Eldridge, S.M., Lancaster, G.A., Campbell, M.J., Thabane, L., Hopewell, S., Coleman, C.L., and Bond, C.M. (2016). Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0150205"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s40814-019-0499-1","article-title":"Guidelines for Reporting Non-Randomised Pilot and Feasibility Studies","volume":"5","author":"Lancaster","year":"2019","journal-title":"Pilot Feasibility Stud."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"108476","DOI":"10.1016\/j.cmpb.2024.108476","article-title":"Gamified devices for stroke rehabilitation: A systematic review","volume":"258","year":"2025","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_12","first-page":"1","article-title":"Gamified In-Home Rehabilitation for Stroke Survivors: Analytical Review","volume":"5","author":"Garbaya","year":"2018","journal-title":"Int. J. Serious Games"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s12984-019-0595-8","article-title":"Effects of virtual reality-based planar motion exercises on upper extremity function, range of motion, and health-related quality of life: A multicenter, single-blinded, randomized, controlled pilot study","volume":"16","author":"Park","year":"2019","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/15459683231222921","article-title":"Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People with Stroke (EnteRtain): A Multicenter Randomized Clinical Trial","volume":"38","author":"Ali","year":"2024","journal-title":"Neurorehabilit. Neural Repair"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1080\/10749357.2021.1943797","article-title":"A scoping review of design requirements for a home-based upper limb rehabilitation robot for stroke","volume":"29","author":"Li","year":"2022","journal-title":"Top. Stroke Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e10510","DOI":"10.2196\/10510","article-title":"Assistive Technology for the Upper Extremities After Stroke: Systematic Review of Users\u2019 Needs","volume":"5","author":"Smulders","year":"2018","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s12984-021-00853-z","article-title":"The use of game modes to promote engagement and social involvement in multi-user serious games: A within-person randomized trial with stroke survivors","volume":"18","author":"Pereira","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.rehab.2019.10.009","article-title":"Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial","volume":"63","author":"Laffont","year":"2020","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e55481","DOI":"10.2196\/55481","article-title":"Exploring the Impact of an Interactive Electronic Pegboard on Manual Dexterity and Cognitive Skills of Patients with Stroke: Preliminary Analysis","volume":"8","author":"Chien","year":"2024","journal-title":"JMIR Form. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"108164","DOI":"10.1016\/j.jstrokecerebrovasdis.2024.108164","article-title":"Feasibility, usability and engagement of a tangible interface for upper limb rehabilitation after stroke","volume":"34","author":"Pereira","year":"2025","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20552076261425481","DOI":"10.1177\/20552076261425481","article-title":"Psychometric properties and usability of a gamified digital task system for assessing attention and hand function in stroke rehabilitation","volume":"12","author":"Huang","year":"2026","journal-title":"Digit. Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e65358","DOI":"10.2196\/65358","article-title":"Evaluation of a Game-Based Mechatronic Device for Rehabilitation of Hand-Arm Function in Children with Cerebral Palsy: Feasibility Randomized Controlled Trial","volume":"12","author":"Peramalaiah","year":"2025","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bektic, M., Smith, B.E., Ridgel, A.L., and Kim, K. (2025). An Evaluation of VR Games and Haptic Feedback for Upper Limb Rehabilitation for Individuals with Parkinson\u2019s Disease. Machines, 13.","DOI":"10.3390\/machines13100930"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"112248","DOI":"10.1016\/j.engappai.2025.112248","article-title":"An online reinforcement learning method to improve control adaptability in robot-aided rehabilitation","volume":"161","author":"Molle","year":"2025","journal-title":"Eng. Appl. Artif. Intell."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3169262","DOI":"10.1155\/2023\/3169262","article-title":"DeapSea: Workflow-Supported Serious Game Design for Stroke Rehabilitation","volume":"2023","author":"Baranyi","year":"2023","journal-title":"Int. J. Comput. Games Technol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e66802","DOI":"10.2196\/66802","article-title":"Virtual Reality Enhanced Exercise Training in Upper Limb Function of Patients with Stroke: Meta-Analytic Study","volume":"27","author":"Xu","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1080\/17483107.2020.1768309","article-title":"Exploring serious games for stroke rehabilitation: A scoping review","volume":"17","author":"Mubin","year":"2022","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1037\/0003-066X.55.1.68","article-title":"Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being","volume":"55","author":"Ryan","year":"2000","journal-title":"Am. Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1145\/1077246.1077253","article-title":"GameFlow: A model for evaluating player enjoyment in games","volume":"3","author":"Sweetser","year":"2005","journal-title":"Comput. Entertain."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Cuthbert, R., Turkay, S., and Brown, R. (2019, January 2\u20135). The Effects of Customisation on Player Experiences and Motivation in a Virtual Reality Game. Proceedings of the OZCHI\u201919: 31st Australian Conference on Human-Computer-Interaction, Fremantle, WA, Australia.","DOI":"10.1145\/3369457.3369475"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/978-3-030-63464-3_15","article-title":"Motivation in Gamification: Constructing a Correlation Between Gamification Achievements and Self-determination Theory","volume":"Volume 12517","author":"Bellotti","year":"2020","journal-title":"Proceedings of the Games and Learning Alliance"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e39838","DOI":"10.2196\/39838","article-title":"Improving Adherence to Physical Therapy in the Development of Serious Games: Conceptual Framework Design Study","volume":"7","year":"2023","journal-title":"JMIR Form. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e26344","DOI":"10.2196\/26344","article-title":"Recommendations for the Design and Implementation of Virtual Reality for Acquired Brain Injury Rehabilitation: Systematic Review","volume":"23","author":"Brassel","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1177\/23969873231191304","article-title":"Motor rehabilitation after stroke: European Stroke Organisation (ESO) consensus-based definition and guiding framework","volume":"8","author":"Kwakkel","year":"2023","journal-title":"Eur. Stroke J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e21161","DOI":"10.2196\/21161","article-title":"Spanish Version of the System Usability Scale for the Assessment of Electronic Tools: Development and Validation","volume":"7","year":"2020","journal-title":"JMIR Hum. Factors"},{"key":"ref_36","unstructured":"Brooke, J. (1996). SUS: A quick and dirty usability scale. Usability Evaluation in Industry, Taylor & Francis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.apmr.2003.06.001","article-title":"The Pittsburgh Rehabilitation Participation Scale: Reliability and Validity of a Clinician-Rated Measure of Participation in Acute Rehabilitation","volume":"85","author":"Lenze","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1037\/0022-3514.43.3.450","article-title":"Control and Information in the Intrapersonal Sphere: An Extension of Cognitive Evaluation Theory","volume":"43","author":"Ryan","year":"1982","journal-title":"J. Personal. Soc. Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1080\/02701367.1989.10607413","article-title":"Psychometric Properties of the Intrinsic Motivation Inventory in a Competitive Sport Setting: A Confirmatory Factor Analysis","volume":"60","author":"McAuley","year":"1989","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"386","DOI":"10.5014\/ajot.39.6.386","article-title":"Adult Norms for the Box and Block Test of Manual Dexterity","volume":"39","author":"Mathiowetz","year":"1985","journal-title":"Am. J. Occup. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"IB24014","DOI":"10.1071\/IB24014","article-title":"Spanish translation and cross-cultural adaptation of the Box and Block Test: A pilot study in adults with chronic acquired brain injury","volume":"25","author":"Noce","year":"2024","journal-title":"Brain Impair."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1002\/1099-1166(200011)15:11<1021::AID-GPS234>3.0.CO;2-6","article-title":"The Mini-Cog: A cognitive \u2018vital signs\u2019 measure for dementia screening in multi-lingual elderly","volume":"15","author":"Borson","year":"2000","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.nrleng.2018.12.022","article-title":"Assessment of the diagnostic accuracy and discriminative validity of the Clock Drawing and Mini-Cog tests in detecting cognitive impairment","volume":"37","year":"2022","journal-title":"Neurolog\u00eda (Engl. Ed.)"},{"key":"ref_44","first-page":"6","article-title":"The Functional Independence Measure: A New Tool for Rehabilitation","volume":"1","author":"Keith","year":"1987","journal-title":"Adv. Clin. Rehabil."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"452","DOI":"10.23736\/S1973-9087.23.07841-3","article-title":"Reliability and validity of the Spanish adaptation of the Functional Independence Measure + Functional Assessment Measure","volume":"59","author":"Colomer","year":"2023","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_46","unstructured":"Poels, K., de Kort, Y., and IJsselsteijn, W. (2007). D3.3: Game Experience Questionnaire: Development of a Self-Report Measure to Assess the Psychological Impact of Digital Games, Technische Universiteit Eindhoven."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Rodrigues, L., Toda, A.M., Palomino, P.T., Oliveira, W., and Isotani, S. (2021). Personalized gamification: A literature review of outcomes, experiments, and approaches. Proceedings of the Eighth International Conference on Technological Ecosystems for Enhancing Multiculturality, TEEM\u201920, Association for Computing Machinery (ACM).","DOI":"10.1145\/3434780.3436665"},{"key":"ref_48","first-page":"158","article-title":"Item benchmarks for the system usability scale","volume":"13","author":"Lewis","year":"2018","journal-title":"J. Usability Stud."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12984-021-00889-1","article-title":"Serious games for upper limb rehabilitation after stroke: A meta-analysis","volume":"18","author":"Doumas","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11517-023-02933-9","article-title":"Post-stroke functional assessments based on rehabilitation games and their correlation with clinical scales: A scoping review","volume":"62","author":"Tannus","year":"2024","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1590\/0004-282x20190103","article-title":"Use of client-centered virtual reality in rehabilitation after stroke: A feasibility study","volume":"77","author":"Aramaki","year":"2019","journal-title":"Arq. Neuro-Psiquiatr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e13588","DOI":"10.1016\/j.heliyon.2023.e13588","article-title":"Commercial device-based hand rehabilitation systems for stroke patients: State of the art and future prospects","volume":"9","author":"Sheng","year":"2023","journal-title":"Heliyon"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s12984-024-01367-0","article-title":"Immersive VR for Upper-Extremity Rehabilitation in Patients with Neurological Disorders: A Scoping Review","volume":"21","author":"Ceradini","year":"2024","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1109\/TMRB.2021.3054462","article-title":"Affordable Robotics for Upper Limb Stroke Rehabilitation in Developing Countries: A Systematic Review","volume":"3","author":"Demofonti","year":"2021","journal-title":"IEEE Trans. Med. Robot. Bionics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1109\/THMS.2020.2976905","article-title":"State-of-the-Art Robotic Devices for Wrist Rehabilitation: Design and Control Aspects","volume":"50","author":"Hussain","year":"2020","journal-title":"IEEE Trans.-Hum.-Mach. Syst."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1109\/TNSRE.2023.3252880","article-title":"Application of Home-Based Wearable Technologies in Physical Rehabilitation for Stroke: A Scoping Review","volume":"31","author":"Toh","year":"2023","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"26470","DOI":"10.1109\/JSEN.2021.3119658","article-title":"Recent Advances in Quantitative Gait Analysis Using Wearable Sensors: A Review","volume":"21","author":"Hutabarat","year":"2021","journal-title":"IEEE Sens. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"28576","DOI":"10.1109\/JSEN.2024.3436532","article-title":"IMU-Based Systems for Upper-Limb Kinematic Analysis in Clinical Applications: A Systematic Review","volume":"24","author":"Favata","year":"2024","journal-title":"IEEE Sens. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"100247","DOI":"10.1016\/j.wnsx.2023.100247","article-title":"SmartWear body sensors for neurological and neurosurgical patients: A review of current and future technologies","volume":"21","author":"Gupta","year":"2024","journal-title":"World Neurosurg. X"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1212\/CON.0000000000001218","article-title":"Stroke Rehabilitation and Motor Recovery","volume":"29","year":"2023","journal-title":"Continuum"},{"key":"ref_61","unstructured":"Calisir, F., and Korhan, O. (2020). Gamification of Upper Limb Tangible-Wearable Rehabilitation Devices. Industrial Engineering in the Digital Disruption Era, Springer. Lecture Notes in Management and Industrial Engineering."},{"key":"ref_62","first-page":"205566832091538","article-title":"Commercial gaming devices for stroke upper limb rehabilitation: The stroke survivor experience","volume":"7","author":"Thomson","year":"2020","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_63","first-page":"263","article-title":"A review of technological and clinical aspects of robot-aided rehabilitation of upper-extremity after stroke","volume":"11","author":"Babaiasl","year":"2016","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1109\/TMRB.2023.3310086","article-title":"Mechanism Design and Control of Shoulder Rehabilitation Robots: A Review","volume":"5","author":"Shah","year":"2023","journal-title":"IEEE Trans. Med. Robot. Bionics"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Mohd Zuki, F.S., Sulaiman, S., Rambli, D.R.A., Merienne, F., and Mohamad Saad, M.N. (2021, January 13\u201315). Sensory Feedback and Interactivity: Enhancing Motivation and Engagement for VR Stroke Rehabilitation. Proceedings of the 2021 International Conference on Computer & Information Sciences (ICCOINS), Kuching, Malaysia.","DOI":"10.1109\/ICCOINS49721.2021.9497200"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/978-3-030-37639-0_4","article-title":"Virtual Reality Design for Stroke Rehabilitation","volume":"Volume 1235","author":"Rea","year":"2020","journal-title":"Biomedical Visualisation"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.infsof.2017.10.015","article-title":"How to design gamification? A method for engineering gamified software","volume":"95","author":"Morschheuser","year":"2018","journal-title":"Inf. Softw. Technol."},{"key":"ref_68","unstructured":"Senthil Kumaran, D., Swathi G, A., Riya Ashit, R., Sulfikar Ali, A., Nirmala, N., and Ashokan, A. (2021, January 7\u201310). Effects of a Novel Game-Based Arm Rehabilitation Device, the ArmAble, on Improving Upper Limb Function in People With Stroke. Proceedings of the 2021 14th International Conference on Developments in eSystems Engineering (DeSE), Sharjah, United Arab Emirates."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"105235","DOI":"10.1016\/j.ijmedinf.2023.105235","article-title":"Challenges and promises of mixed-reality interventions in acquired brain injury rehabilitation: A scoping review","volume":"179","author":"Figeys","year":"2023","journal-title":"Int. J. Med. Inform."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11257-015-9154-6","article-title":"Adaptation in serious games for upper-limb rehabilitation: An approach to improve training outcomes","volume":"25","author":"Hocine","year":"2015","journal-title":"User Model.-User-Adapt. Interact."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Wang, P., Koh, R.K.C., Boucharenc, C.G., and Yen, C.C. (2016). Lights Out: An Interactive Tangible Game for Training of Post-Stroke Reaching. Proceedings of the 2016 CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA \u201916), San Jose, CA, USA, 7\u201312 May 2016, Association for Computing Machinery.","DOI":"10.1145\/2851581.2892422"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Peng, S., and Guo, Y. (2025). Research on the Intelligent Interaction Design of Gamified Hand Rehabilitation Training for the Elderly with Stroke. Proceedings of Human Aspects of IT for the Aged Population, Springer Nature.","DOI":"10.1007\/978-3-031-92710-2_22"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1089\/g4h.2017.0138","article-title":"Proposal of an Extended Taxonomy of Serious Games for Health Rehabilitation","volume":"7","author":"Rego","year":"2018","journal-title":"Games Health J."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.entcom.2013.09.002","article-title":"Serious games for health","volume":"4","author":"Wattanasoontorn","year":"2013","journal-title":"Entertain. Comput."},{"key":"ref_75","unstructured":"Rego, P., Moreira, P.M., and Reis, L.P. (2010, January 16\u201319). Serious Games for Rehabilitation: A Survey and a Classification Towards a Taxonomy. Proceedings of the 5th Iberian Conference on Information Systems and Technologies (CISTI), Santiago de Compostela, Spain."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e11565","DOI":"10.2196\/11565","article-title":"Developing Theory-Driven, Evidence-Based Serious Games for Health: Framework Based on Research Community Insights","volume":"7","author":"Verschueren","year":"2019","journal-title":"JMIR Serious Games"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Yang, Z., Jie, S., Shiqi, L., Ping, C., and Shengjia, N. (2018, January 9\u201313). Tangible Interactive Upper Limb Training Device. Proceedings of the 2018 ACM Conference Companion Publication on Designing Interactive Systems, Hong Kong, China.","DOI":"10.1145\/3197391.3205403"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e20066","DOI":"10.2196\/20066","article-title":"Serious Game Design and Clinical Improvement in Physical Rehabilitation: Systematic Review","volume":"9","author":"Vieira","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/978-3-030-65736-9_15","article-title":"Virtual Reality Games for Stroke Rehabilitation: A Feasibility Study","volume":"Volume 12523","author":"Nunes","year":"2020","journal-title":"Entertainment Computing\u2013ICEC 2020"},{"key":"ref_80","first-page":"374","article-title":"Gamification frameworks and models for health contexts: An integrative review","volume":"9","author":"Arouca","year":"2021","journal-title":"Int. J. Innov. Educ. Res."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Tuah, N.M., Ahmedy, F., Gani, A., and Yong, L.N. (2021). A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges. Information, 12.","DOI":"10.3390\/info12020091"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/978-3-030-77857-6_4","article-title":"Towards a Unified Model of Gamification and Motivation","volume":"Volume 12792","author":"Sottilare","year":"2021","journal-title":"Adaptive Instructional Systems: Design and Evaluation"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1080\/0960085X.2020.1796531","article-title":"Capturing the complexity of gamification elements: A holistic approach for analysing existing and deriving novel gamification designs","volume":"29","author":"Janson","year":"2020","journal-title":"Eur. J. Inf. Syst."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Zuki, F.S.M., Merienne, F., Sulaiman, S., Ricca, A., Rambli, D.R.A., and Saad, M.N.M. (2022, January 1\u20132). Gamification, sensory feedback, adaptive function on virtual reality rehabilitation: A brief review. Proceedings of the 2022 International Conference on Digital Transformation and Intelligence (ICDI), Kuching, Malaysia.","DOI":"10.1109\/ICDI57181.2022.10007124"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e39019","DOI":"10.2196\/39019","article-title":"The Use of Gamification in the Self-Management of Patients With Chronic Diseases: Scoping Review","volume":"11","author":"Huang","year":"2023","journal-title":"JMIR Serious Games"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.invent.2016.10.002","article-title":"Gamification for health and wellbeing: A systematic review of the literature","volume":"6","author":"Johnson","year":"2016","journal-title":"Internet Interv."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ijhcs.2014.09.006","article-title":"Gamification in theory and action: A survey","volume":"74","author":"Seaborn","year":"2015","journal-title":"Int. J.-Hum.-Comput. Stud."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"721","DOI":"10.3233\/NRE-172183","article-title":"Application of virtual environments in a multi-disciplinary day neurorehabilitation program to improve executive functioning using the Stroop task","volume":"41","author":"Dahdah","year":"2017","journal-title":"NeuroRehabilitation"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Reiners, T., and Wood, L.C. (2015). Studying Gamification: The Effect of Rewards and Incentives on Motivation. Gamification in Education and Business, Springer.","DOI":"10.1007\/978-3-319-10208-5"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Loughrey, K., and O Broin, D. (2018, January 15\u201317). Are We Having Fun Yet? Misapplying Motivation to Gamification. Proceedings of the 2018 IEEE Games, Entertainment, Media Conference (GEM), Galway, Ireland.","DOI":"10.1109\/GEM.2018.8516535"},{"key":"ref_91","first-page":"2055668316643644","article-title":"The use and effect of video game design theory in the creation of game-based systems for upper limb stroke rehabilitation","volume":"3","author":"Barrett","year":"2016","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_92","unstructured":"B\u00f6ckle, M., Novak, J., and Bick, M. (2017, January 5\u201310). Towards Adaptive Gamification: A Synthesis of Current Developments. Proceedings of the 25th European Conference on Information Systems (ECIS), Guimar\u00e3es, Portugal. Available online: https:\/\/aisel.aisnet.org\/ecis2017_rp\/11\/ (accessed on 3 September 2026)."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/18\/5956\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:46:56Z","timestamp":1790138816000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/18\/5956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,20]]},"references-count":92,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["s26185956"],"URL":"https:\/\/doi.org\/10.3390\/s26185956","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,20]]}}}