Software Engineering Frameworks Used for Serious Games Development in Physical Rehabilitation: Systematic Review

Abstract

Background Serious games are a support in the rehabilitation process for treating people with physical disabilities. However, many of these serious games are not adapted to the patient’s needs because they are not developed with a software engineering framework with a set of activities, actions, and tasks that must be executed when creating a software product. Better serious games for rehabilitation will be developed if the patient and therapist requirements are identified, the development is planned, and system improvements and feedback are involved. The goal is that the serious game must offer a more attractive environment, while maintaining patient interest in the rehabilitation process. Objective This paper submits the results of a systematic review of serious games in physical rehabilitation identifying the benefits of using a software engineering framework. Methods A systematic research was conducted using PubMed, PEDro (Physiotherapy Evidence Database), IEEE Xplore, ScienceDirect, ACM Digital Library, Mary Ann Liebert, Taylor & Francis Online, Wiley Online Library, and Springer databases. The initial search resulted in 701 papers. After assessing the results according to the inclusion criteria, 83 papers were selected for this study. Results From the 83 papers reviewed, 8 used a software engineering framework for its development. Most of them focused their efforts on 1 or more aspects, such as data acquisition and processing, game levels, motivation, therapist supervision. Conclusions This systematic review proves that most of the serious games do not use a software engineering framework for their development. As a result, development systems overlook several aspects and do not have a standardized process, eventually omitting important implementation aspects, which impact the patient’s recovery time.

Serious Games and Gamification in Healthcare: A Meta-Review

“…Study [23] reviewed the benefits of utilizing a software engineering methodology in serious games for physical rehabilitation. For this investigation, 83 publications were chosen.…”

“…Lack of standardization [23,25,59] in the development and evaluation of serious games and gamification applications for health, making it difficult to compare and replicate studies and leading to inconsistent results and conclusions.…”

“…One major challenge is the lack of standardization in the field [23,25,59]. There are currently no widely accepted guidelines or standards for the development and evaluation of serious games and gamification applications for health.…”

“…Studies have also shown that serious games and gamification techniques can be effective in promoting medication adherence [21], the self-management of chronic conditions [67], and rehabilitation outcomes [22][23][24][25]27,30,35,41,42,56,60,61,65,69].…”

Health Care Professional–Supported Co-Design of a Mime Therapy–Based Serious Game for Facial Rehabilitation

“…In motor rehabilitation, exergames—serious games that require physical exercise to play—add fun to exercises and allow patients to forget about their condition and focus on the game [ 4 ]. Studies conducted with games for motor rehabilitation have achieved promising results [ 5 ] on patient motivation and engagement [ 4 ]. This study aimed to co-design RG4Face —an exergame for facial rehabilitation.…”