# eJamar: A Novel Exergame Controller for Upper Limb Motor Rehabilitation
## 5 Discussion
\begin{table}
\begin{tabular}{l l c c c c c c c c c c} \hline \hline
**ID** & **Question** & **P1** & **P2** & **P3** & **P4** & **P5** & **P6** & **P7** & **P8** & **Mean** & **STD** \\ \hline \multicolumn{13}{c}{Usability} \\ \hline Q13 & Have you been able to use the Game Controller (GC) easily? & 2 & 1 & 2 & 2 & 1 & 2 & 2 & 1.8 & 0.46 \\ Q14 & In general, was it easy to control the game actions with & 2 & 2 & 1 & 2 & 2 & 1 & 2 & 2 & 1.8 & 0.46 \\ \multicolumn{13}{c}{the GC?} \\ Q15 & Was the weight of the GC suitable? & 1 & 1 & 1 & 1 & 2 & \(-1\) & 2 & 1 & 1.0 & 0.93 \\ Q16 & Were elements of the GC easy to handle? & 2 & 2 & 0 & 2 & 2 & 1 & 2 & 2 & 1.6 & 0.74 \\ Q17 & Have you felt comfort in your hand when taking the GC? & 2 & 2 & 1 & 2 & 1 & 0 & 2 & 2 & 1.5 & 0.76 \\ Q18 & There were no disconnection issues during the session (GC & 2 & 2 & 1 & 2 & 2 & 2 & 2 & 1.9 & 0.35 \\ \multicolumn{13}{c}{and PC)} \\ \multicolumn{13}{c}{Q19} & Do you find the vibration mode useful? & 2 & 2 & 0 & 1 & 1 & 2 & 2 & 0 & 1.3 & 0.89 \\ \hline \multicolumn{13}{c}{Satisfaction} \\ \hline Q20 & Have you been able to perform all the game levels & 2 & 2 & 2 & 2 & 2 & 2 & 2 & 2.0 & 0.0 \\ Q21 & successfully? & 2 & 2 & 1 & 2 & 1 & 1 & 1 & 1.4 & 0.52 \\ Q21 & Have the games taken a lot of effort from you? (fatigue) & 2 & 1 & 2 & 1 & 2 & 2 & 1 & 1.5 & 0.53 \\ Q22 & In general, the difficulty level of the games is adequate. & 2 & 1 & 1 & 2 & 1 & 2 & 2 & 1.5 & 0.53 \\ Q23 & Were you able to easily calibrate the rigidity of the device? & \(-1\) & \(-1\) & \(-1\) & 2 & 2 & \(-1\) & 0 & 2 & 0.25 & 1.49 \\ Q24 & If possible, would you like to continue using this system & 2 & 2 & 1 & 2 & 1 & 2 & 2 & 1 & 1.6 & 0.52 \\  & (GC + games)? & & & & & & & & & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 4: \(Cont.\)level. This also brings a subtle shift to the game mechanics, ensuring a pleasant experience in each session and promoting adherence to the game [47]. As previously mentioned, this feature, particularly in Peter Jumper, will be further enhanced in future work. The wireless and portable design of the ejamar, combined with the ability to measure and store data about motor functionality and grip strength, will facilitate the integration of this system into remote rehabilitation treatments. These treatments are particularly needed by patients with neurological conditions who face challenges in attending medical centers for rehabilitation. As such, the development of new systems like this is always essential [50]. Hence, the novel ejamar can contribute to design new tele-rehabilitation strategies in complementing and enhancing the effects of conventional physical therapy. Additionally, in the holistic context of rehabilitation, it is important to not only exercise motor function but also to assess the patients' functional status and the effects of treatments [51]. This assessment-rehabilitation dichotomy should be considered, especially when designing tools intended for neurological rehabilitation. Thus, the proposed exergame controller could serve also for the assessment of UL motor function and hand-grip strength and provide relevant information about the patient's evolution. For that purpose, outcome measures given by the ejamar must be correlated with the golden standard metrics (ARAT, FMA, Jamar, etc.) for clinical validation. Future studies will focus on data gathering for outcome measurement correlation, similarly to other validation studies [52; 53]. Finally, we identified some areas for improvement. For instance, some participants considered the device to be somewhat heavy. To address this, we plan to modify the protocol in future studies, allowing participants to rest their arm on a table, as has been done in other studies [20; 48]. Additionally, although the vibration system was designed to enhance the gaming experience and provide haptic feedback [45], participants found it difficult to detect. This suggests that the vibration system may need to be improved, or that alternative forms of haptic feedback should be explored.