The design choices for the development of an Augmented Reality game for people with visuospatial neglect

Introduction: Visuospatial neglect (VSN) is common after stroke and can seriously hamper everyday life. One of the most commonly used and highly recommended rehabilitation methods is Visual Scanning Training (VST) which requires a lot of repetition which makes the treatment intensive and less appealing for the patient. The use of eHealth in healthcare can increase options regarding improved treatment in the areas of patient satisfaction, treatment efficacy and effectiveness. One solution to motivational issues might be Augmented Reality (AR), which offers new opportunities for increasing natural interactions with the environment during treatment of VSN. Aim: The development of an AR-based scanning training program that will improve visuospatial search strategies in individuals affected by VSN. Method: We used a Design Research approach, which is characterized by the iterative and incremental use of prototypes as research instruments together with a strong human-centered focus. Several design thinking methods were used to explore which design elements the AR game should comply with. Seven patients with visuospatial neglect, eight occupational therapists, a game design professional and seven other healthcare professionals participated in this research by means of co-creation based on their own perspectives. Results: Fundamental design choices for an AR game for VSN patients included the factors extrinsic motivation, nostalgia, metaphors, direct feedback, independent movement, object contrast, search elements and competition. Designing for extrinsic motivation was considered the most important design choice, because due to less self-awareness the target group often does not fully understand and accept the consequences of VSN. Conclusion: This study produced a prototype AR game for people with VSN after stroke. The AR game and method used illustrate the promising role of AR tools in geriatric rehabilitation, specifically those aimed at increasing the independence of patients with VSN after stroke. 2020 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).