Gamifying Hand Therapy: Development of a Mixed Reality Rhythm Game to Reduce Pain and Improve Motivation

The hand is one of the most functional and frequently injured parts of the body. Without proper recovery, patients can face significant impairments performing everyday tasks. Hand therapy is the cornerstone of hand rehabilitation, but the painful, repetitive, and monotonous nature of prescribed exercises leads to poor patient motivation and adherence, ultimately compromising long-term recovery outcomes. New technologies such as virtual reality (VR) and augmented reality (AR) have emerged as interactive and engaging modalities for rehabilitation, and can even reduce pain by distracting patients during exercises. However, mixed reality (MR), which is a new modality combining VR and AR has not been well studied for its ability to reduce pain in hand rehabilitation. Therefore, we developed HoloRehab, a mixed reality video game for hand rehabilitation, built for the Microsoft HoloLens 2 headset. This device allow users to see and interact with realistic 3D holograms projected into their physical environment. This pilot study will evaluate whether using HoloRehab can reduce discomfort and improve the exercise experience compared to traditional self-guided hand therapy exercises. After development of a prototyped game, we will run a pilot study involving 20 healthy participants assigned to either the mixed reality intervention or a traditional exercise group. Outcomes will include measures of discomfort, fatigue, and user experience. Findings from this study will inform further development of the HoloRehab system.

Inclusion Criteria: * Adult (≥18 years old) medical students at Western University * English-speaking * No existing hand pathology * Able and willing to provide informed consent Exclusion Criteria: * Musculoskeletal conditions * Neurological conditions * Chronic pain conditions * Previous hand surgeries * Function-altering hand injuries * History of motion sickness * History of seizures or epilepsy * Cold sensitivity or cold intolerance * Current use of analgesic medications (e.g., NSAIDs, acetaminophen, opioids)