Study on the Intention of Upper Limb Hemiplegic Patients to Use Interactive Gaming Devices for Hand Rehabilitation (Preprint)
Authors: Wu Chih-Fu , Yang Chujun , Wang Jingyan , Haoyen Chang 
Published: July 2023

BACKGROUND

For stroke patients with upper limb hemiplegia, traditional rehabilitation training often involves the repetitive execution of standardized and consistent movements, which can be a tedious and lengthy process. Furthermore, passive training methods may not effectively engage patients in the rehabilitation process. While prior research has shown that incorporating serious games into rehabilitation training can enhance patient outcomes, research on the relationship between pre-factors and the intention to use interactive gaming devices for upper limb rehabilitation training is lacking. Furthermore, discussion on the differences in the use of these gaming devices for rehabilitation training among patients with varying personal characteristics and conditions (such as age, gender, digital experience, and stroke severity) is lacking.

OBJECTIVE

The study aims to comprehensively understand whether pre-factors related to patient motivation and influence, as well as individual characteristics and conditions, affect their intention to use interactive gaming devices for hand rehabilitation. Essentially, by modifying pre-factors to align with individual characteristics and conditions, patient motivation to use interactive gaming devices for hand rehabilitation could be boosted, leading to increased patient engagement and better training outcomes.

METHODS

Examining the relationship among pre-factors (as the independent variable), individual characteristics and conditions (as the moderating variable), and patient intention to use interactive gaming devices for hand rehabilitation (as the dependent variable) was the focus. The abovementioned variables were integrated into the development of interactive gaming devices for hand rehabilitation through participatory design. Thirty-eight stroke patients with upper limb hemiplegia and diverse personal characteristics and conditions participated in the study. They completed a survey questionnaire based on an optimized and extended Unified Theory of Acceptance and Use of Technology, which was designed for analysis and research.

RESULTS

The pre-factor of hedonic motivation is an essential mediating variable that significantly influences patient engagement in hand rehabilitation training using interactive gaming devices. Furthermore, it is possible to enhance the device’s hedonic motivation by utilizing the characteristics of performance expectancy, effort expectancy, and game design constructs, thereby increasing patient willingness to use interactive gaming devices for training purposes. Additionally, the study found that stroke severity moderates the relationship between effort expectancy and behavioral intention. Therefore, designing differentiated interactive training game content to meet the needs of patients with varying stroke severity is recommended.

CONCLUSIONS

Hedonic motivation is a crucial pre-factor that significantly influences patient intention to use interactive gaming devices for hand rehabilitation, and stroke severity plays a moderating role within the individual characteristics and conditions. The UTATUT2 revised model for interactive gaming devices for hand rehabilitation developed in this study offers a practical and valuable reference for making decisions regarding the design and development of related rehabilitation training devices in the future.