A participatory design framework for the gamification of rehabilitation systems

Headnote

Abstract

In recent years games and game technology have been used quite widely to investigate if they can help make rehabilitation more engaging for users. The underlying hypothesis is that the motivating qualities of games may be harnessed and embedded into a game-based rehabilitation system to improve the quality of user participation. We present here the PACT framework which has been created to guide the design of gamified rehabilitation systems; placing emphasis on people, aesthetics, context, and technology from the beginning of a design and development process. We discuss the evolution of PACT from our previous GAMER framework, which was used to develop a range of games for upper arm stroke rehabilitation with natural user interfaces. GAMER was established to guide the design of rehabilitation games from the viewpoint of a designer, whereas with PACT greater emphasis has been placed on an inclusive design process. We provide a detailed work flow illustration for the use of PACT in the development of rehabilitation systems and provide examples of practical design and analysis tools that improve the quality of workflow in PACT.

Keywords: gamification, rehabilitation, games, design framework

Introduction

PACT (People, Aesthetics, Context, and Technology) may be described as a participatory design framework for the gamification of rehabilitation systems. Inclusive participation from the beginning of a rehabilitation design process has been raised as an increasingly important experimental methodology (1). Influence from games in the design of engaging rehabilitation software has also received a lot of recent attention (2). Though only a few papers make explicit reference to gamification, e.g., (3), there is often an implicit application of simple gamification techniques in the design of bespoke rehabilitation.

The focus is often on inclusion of fun user feedback for the completion of tasks, with points, badges, high score tables, and leader boards being typical design patterns used. There is a danger, however, in taking too narrow a focus in the application of gamification to the design of systems. If the design focuses too much on task completion and rewards then there may be an over emphasis on extrinsic motivation, which may have less impact on long term behaviour and attitude change. Behavioural change is central to the goals of a well-designed rehabilitation system (4).

There are several definitions...