Exploring Mixed-Reality Exergames for Sports Rehabilitation: Design Insights and Evaluation Findings

Area of Science:

• Sports Science
• Rehabilitation Medicine
• Game Design

Background:

• Exergaming (exercise-based gaming) provides motivating functional training.
• Anterior cruciate ligament (ACL) injuries require lengthy rehabilitation, with only 65% of athletes returning to pre-injury performance levels.
• A lack of sport-specific exergames for ACL rehabilitation limits athletes' preparation for return to sport.

Purpose of the Study:

• To develop a specialized exergame scenario for post-ACL injury sports rehabilitation.
• To employ a research-driven, user-centered, and iterative development approach.
• To structure the project into four phases: motor performance assessment, user requirement gathering, exergame development, and validation.

Main Methods:

• Assessed lower extremity kinematics in athletes (including ACL patients) during a fitness exergame using marker-based motion capture.
• Conducted focus groups with physiotherapists and patients to establish user requirements.
• Iteratively designed a new exergame scenario and movement concept based on kinematic analysis and user feedback, followed by recurrent validation with user groups.

Main Results:

• Kinematic analysis revealed significant effects of exercise on knee valgus, knee internal rotation, and hip flexion.
• Patients desired faster return to sport but feared sensory overload; therapists sought devices for independent training with novel stimuli.
• The developed exergame incorporates strength, balance, endurance, reaction, and skill training with adjustable difficulty levels, showing high motivational potential and suitability for autonomous use.

Conclusions:

• An interdisciplinary, evidence-based approach systematically developed user-centered requirements for an ACL rehabilitation exergame.
• The final exergame was validated for its motivational potential and applicability, leading to its deployment in rehabilitation settings.