## 4 Discussion  
This paper presents a novel approach to improve the physical therapy process by developing a serious game specifically designed for wrist rehabilitation. Utilizing the \"MetaQuest\" VR headset, the developed game integrates a variety of identified movement patterns that mirror those used in traditional physical therapy settings. The research included a thorough review of existing serious games aimed at wrist rehabilitation and involved close collaboration with both physical and occupational therapists throughout the different phases. The resulting prototype, developed within the Unity development platform, features an escape-the-room-style game that employs specific movements detected by the \"MetaQuest\" headset's advanced hand-tracking sensors. Technically, our results confirm that the standard \"MetaQuest\" (2 and 3) headset and its integrated sensors can effectively control serious games tailored for wrist and hand rehabilitation, offering a functional and engaging therapeutic tool.  
The game's design incorporates the engaging concept of an escape room combined with a compelling narrative to capture the interest of patients across different age groups, encouraging consistent participation in prescribed exercises at home or together with a therapist. This motivation is crucial for the effectiveness of home-based therapy. The project leveraged insights from a collaboration with five expert therapists and an extensive review of the literature on wrist injury rehabilitation, as well as six participants within an evaluation, enriching the game's content with effective therapeutic exercises. This collaboration allowed us to include a variety of precise movements, such as the complex dart-throwing motion, which enhances the game's therapeutic value and had not been adequately addressed in previous serious games.  
Moreover, the use of \"MetaQuest\" as the chosen platform enables patients to engage in therapeutic activities virtually anywhere, providing flexibility and convenience without the need for additional hardware. This adaptability makes it an excellent option for patients who may find frequent visits to therapy centers challenging. The game's development also included a detailed survey of professional therapists, whose insights were invaluable in integrating clinically relevant exercises into the game. This comprehensive approach ensures that the game not only engages patients but also effectively meets therapeutic needs, potentially transforming how wrist rehabilitation is conducted. Additionally, the versatility  
\begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Part.** & **FA** & **PU** & **AE** & **RW** & **Average** \\ \hline P06 & 4.6 & 4.3 & 5 & 5 & 4.73 \\ P07 & 3 & 4.3 & 3.6 & 4.3 & 3.80 \\ P08 & 4 & 3.3 & 4 & 5 & 4.08 \\ P09 & 3.3 & 5 & 3 & 4.3 & 3.90 \\ P10 & 5 & 4.6 & 5 & 5 & 4.90 \\ P11 & 5 & 2.3 & 4 & 5 & 4.08 \\ \hline Average & 4.15 & 3.97 & 4.1 & 4.77 & \\ \hline \hline \end{tabular}
\end{table}
Table 6: Individual UES results, including their averages (FA = Focus Attention; PU = Perceived Usability; AE = Aesthetic Appeal; RW = Reward Worthiness).  
\begin{table}
\begin{tabular}{c c c} \hline \hline
**Part.** & **SUS** & **Interpretation** \\ \hline P06 & 50 & Poor \\ P07 & 67.5 & Ok \\ P08 & 70 & Ok \\ P09 & 65 & Ok \\ P10 & 77.5 & Good \\ P11 & 85 & Excellent \\ \hline Average & 69 & Ok \\ \hline \hline \end{tabular}
\end{table}
Table 5: Individual SUS results, including overall scores and their interpretation.  
and portability of the \"MetaQuest\" system allow for a broad implementation of this therapy modality, further extending its reach and impact in the field of rehabilitation.