Capabilities of a virtual reality-based serious game for enhancing cognitive-motor rehabilitation in stroke patients’ daily life activities
Vahid Fatehi, Zahra Salahzadeh, Zeinab Mohammadzadeh, Ayda TaghizadehBACKGROUND:
Stroke rehabilitation requires innovative approaches to address both motor and cognitive impairments in daily living activities. This study aims to identify key design specifications, critical features, and theoretical foundations necessary for developing virtual reality (VR)-based serious games tailored to support cognitive-motor rehabilitation in stroke patients during daily life activities.
MATERIALS AND METHODS:
A mixed-methods design was adopted. In the initial phase, a systematic literature review and scientometric analysis were conducted to define the clinical content. Based on these findings, a serious game was designed using the Game Design Document (GDD) framework. The development process followed the Game Development Life Cycle, including initiation, preproduction, and production phases. Patient-centered scenarios were developed and validated through expert focus groups. 3D modeling was performed using 3ds Max, and Unified Modeling Language diagrams were generated with AI-assisted tools such as GPT-4.1 and ChatUML. A prototype was implemented in a VR environment and evaluated for content validity and usability by rehabilitation specialists.
RESULTS:
A comprehensive search identified 2933 publications related to digital health in stroke rehabilitation. Scientometric analysis revealed that the most influential works were published between 1994 and 2007, with a peak in randomized trials before 2012. Findings from the scientometric review, content analysis, and expert consultations were combined into a core conceptual framework that shaped the structure and content of the GDD used to develop a VR-based cognitive-motor rehabilitation game.
CONCLUSIONS:
This VR-based serious game provides an innovative, immersive tool for enhancing motor and cognitive function in stroke patients during ADL training.