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Updated: May 24, 2026

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Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation
Published on: March 8, 2018
User-Centered Design of a Replayable VR Game for Children with HCP
Susanne Werking1, Tung Khau1, David Flaig1
1UniTyLab, Heilbronn University of Applied Sciences.
Studies in Health Technology and Informatics
|May 23, 2026
Summary
This study introduces Procedural Content Generation in immersive Virtual Reality (VR) games to boost engagement for children with hemiparetic Cerebral Palsy (CP). The VR game enhances upper-limb mobility and physical activity through dynamic content creation.
Area of Science:
- Rehabilitation Medicine
- Human-Computer Interaction
- Game Design
Background:
- Hemiparetic Cerebral Palsy (CP) affects one side of the body, leading to reduced physical activity and increased long-term health risks.
- Current immersive Virtual Reality (VR) games show promise for mobility improvement but often lack sustained engagement and varied stimuli.
- Procedural Content Generation (PCG) offers a potential solution to enhance replayability and user engagement in therapeutic VR applications.
Purpose of the Study:
- To explore the use of PCG in immersive VR games to enhance engagement and promote physical activity and upper-limb mobility in children with hemiparetic CP.
- To develop a user-centered VR game prototype incorporating PCG techniques.
- To evaluate the usability and user experience of the VR game prototype.
Main Methods:
- A user-centered design process, including expert interviews, informed the VR game development.
- Procedural Content Generation techniques, specifically Pseudo-Random Number Generators and Markov chains, were integrated for dynamic content adaptation.
- A pilot study with 24 healthy participants assessed usability, user experience, enjoyment, and ease of use.
Main Results:
- The VR game prototype demonstrated high enjoyment and ease of use among healthy participants.
- The integration of PCG successfully adapted object spawning and maintained content variety.
- Participants identified a need for clearer goals, social interaction, and achievement elements to enhance replayability.
Conclusions:
- Procedural Content Generation is a viable approach to enhance engagement and replayability in immersive VR games for rehabilitation.
- The developed VR game prototype shows potential for improving upper-limb mobility and physical activity.
- Future iterations should incorporate social and achievement features to further optimize user engagement and therapeutic outcomes.