## 4 Discussion
### Feasibility of Use of Serious Games for Children with Disabilities in Ukraine  
The impact of war on the population, but more specifically on children with disabilities, is profound and far-reaching, encompassing a wide range of consequences, from direct threats to life and health to a diminished quality of life, spanning immediate stress responses to enduring psychological repercussions [18]. Similarly to in other emergencies, in war, children with disabilities face heightened vulnerability and endure the effects of violence, forced displacement, and prolonged chronic stress [2]. The foremost commitment of clinicians is to uphold the right of the patients to attain the highest attainable standard of health. Responsibilities are escalating in tandem with the ongoing conflict, as extensive damage continues to mount due to attacks on medical facilities, shortages of healthcare supplies, and electrical power crises. Recognizing the need to maintain contact with patients regardless of their current locations, technologies were chosen as a means to achieve this goal. The Stassism platform may serve as a conduit, offering access to a suite of SG under the remote supervision of healthcare professionals. The key results of this study are the feasibility of implementing such solutions despite the conflict and the shortage of healthcare professionals, as indicatedby the high number (186) of patients treated and evaluated using the platform. Daily assessments of patient progress via platform analytics require only 2 to 10 min, depending on the clinical scenario, ensuring uninterrupted care delivery despite a lack of clinical staff. Despite the limited training intensity, a majority of participants have expressed their willingness to continue using the platform. Furthermore, the affordability of the platform renders it accessible to families across various income levels. An additional pivotal consideration is the fact that the population of this study are children. Every child has an innate affinity for play, and we firmly believe that incorporating SG into telerehabilitation will facilitate motor skill acquisition and cognitive training through gamification [19]. Although the current study does not provide objective measures to support this claim, there is substantiated evidence suggesting that SG interventions can effectively alleviate symptoms of post-traumatic stress disorder, a condition frequently observed in children exposed to military conflicts [20; 21]. The results of this study indicated that the use of SG alone or in combination with telerehabilitation is feasible even during war and conflicts. It is essential to acknowledge some limitations associated with this research that require careful attention. First, the study may be susceptible to sample bias due to its focus on children undergoing rehabilitation-only at the ERC. This particular sample may not comprehensively depict the heterogeneous population of children with disabilities in Ukraine, a country with vast socioeconomic and regional disparities. Specifically, children who lack access to rehabilitation services comparable to those offered at the ERC may experience different rehabilitation outcomes, influencing the generalizability of the study's findings. Moreover, the exclusion criteria, which encompass the inability to access the platform due to technical limitations, may add selection bias, potentially leading to the exclusion of children who could benefit from telerehabilitation but are limited by factors such as unreliable internet connectivity or the unavailability of the necessary devices. The applicability of the results may be restricted as the study focuses exclusively on a specific rehabilitation facility in Lviv. The circumstances, available assets, and perspectives in other areas of Ukraine, particularly those immediately impacted by the fighting, may vary dramatically.