Move On is a graduation project which is focused on redesigning the HandsOn game, a therapeutic game for arm-hand rehabilitation which is developed at Roessingh Research and Development (RRD). The HandOn game is a ‘mixed reality’, i.e. a video game played by interacting with physical objects. It trains grasping and horizontal reaching movements in a rehabilitation context. The game is mostly used by adults aged 50+ with hemiparesis, weakness at one side of the body, due to stroke. Design Assignment:
The goal of the HandsOn redesign is to include training vertical reaching movement and motivate stroke patients in starting, enduring and repeating the game.Design method:
The Persuasive Design Method is used to structure the redesign process (Siriaraya, n.d.). First the “transfer effect’ is determined, being the therapeutic effect to be aimed for by the game. Second, the “user real world” is analyzed involving the user, its motives and values and its context. Thirdly, in the game design phase the persuasive game will be iteratively designed with the aim to increase an experience of a game world in the player. Subsequently, this game world experience is designed in such a way that it facilitated realization of the transfer effect (phase 1). Finally, an ‘evaluation’ is conducted on whether the game design causes the ‘transfer effect’.Transfer effect:
To determine the transfer effect regular arm and hand therapy exercises are analyzed, therapists are interviewed and a literature study is conducted. It can be concluded that arm and hand rehabilitation exercises can be decomposed in various elements. Every rehabilitant needs a unique combination of these elements, which a therapist is able to estimate.
-An optimal rehabilitation effect can be reached through tailoring the game for the abilities of the player.
Long term motivation, for about three months, can be reached by:
-Communicating to the rehabilitant what he has reached within therapy through progress feedback
-Showing the relevance of exercises by real life simulation
Motivation during play can be reached by:
-A challenging, but not too challenging, task
-Multi-sensory feedback
-A clear start and end of the task, to work towards to

User real world:
The user real world, i.e. the user-experienced rehabilitation context, is analyzed through interviews with rehabilitants, which confirmed the motivational factors exposed in the research for the transfer effect.
The greatest wish of all rehabilitants is to live independently again.
This inspired a game theme focused on daily life tasks that rehabilitants were used to do at home.

Game design:
An effective, motivating game for arm and hand rehabilitation broadly exists of three steps: 1. Tailoring trough game settings, 2. game play which includes moving physical objects and 3. Reflection through progress feedback.
Based on these steps, three design directions were developed: gamifying daily chores, a game revolving around tea and a game about chores in- and outside the house. These design directions were evaluated with healthcare professionals, and two were chosen to elaborate into concepts.
In the ‘Tea Time’concept, the player runs a teahouse and should serve orders, physical objects, to his customer, being coasters placed on a table.
In the ‘Joblocks’concept, the player simulates different chores in- and outside the house with the use of ambiguous objects.
Both concepts are evaluated on their therapeutic and motivational effect and feasibility. Tea Time was choosen, since it is indicated to be most feasable.
A prototype of Tea Time was created for testing.

Evaluation:
The prototype’s game experience and motivation towards therapy were tested by four rehabalilitants. They played the game three times in three weeks and filled in questionnaires and were interviewed about motivation and game experience.
Two therapists reviewed the prototype for points of improvement.
It can be concluded that the game creates motivation towards arm and hand rehabilitation. Game experience stayed almost the same over three weeks, which indicates players can play the game for weeks without getting bored.
Game experience itself was ranked neutral. Game experience can be increased by more accurately tailoring the game’s challenge for the individual rehabilitant.
Recommendations are made for an improved game, which has main focus on better tailoring physical challenge by:
-objects that vary in shape and weight
-more placement possibilities of coasters
-more variety in time limit
And better tailoring cognitive challenge by:
-Multisensory cues for playing
-Possibility to reduce sensory stimuli
-Adding an easier level

It is expected that the new recommended prototype will meet the therapeutic requirements and motivates and challenges rehabilitants.