Virtual reality (VR) is increasingly used in dementia care, yet most applications focus on recreation or cognitive stimulation rather than supporting the everyday activities that matter for independent living. To understand what makes VR practice feel realistic and useful for people with dementia (PwD), we conducted semi-structured interviews with PwD, caregivers, and therapists using visual probes grounded in daily living contexts. We examine how stakeholders define realism and usefulness in VR-based support for instrumental activities of daily living (IADLs) and how these judgments relate to the concept of ecological validity. Our findings show that realistic IADL-based VR is characterized by environments and task flows that align with the cognitive and functional demands of real-world activities, while useful VR evokes behavior that meaningfully reflects everyday performance and supports rehabilitation practice. We translate these insights into design implications for at-home IADL-focused VR systems that emphasize functional fidelity, adaptability, and collaborative use, grounding real-world relevance in the lived routines and caregiving ecosystems of PwD.

Serious games are an effective means to help children with ADHD improve their attention and impulse control. As prior works primarily focused on clinical benefits, the relationship among serious games, children, and their caregivers remains underexplored. To bridge this knowledge gap, we conducted a two-stage study: (1) with nine educators specialized in ADHD in clinical settings and (2) with seven dyads of children and their caregivers in home settings. To facilitate the study, we developed and deployed NeuroWorld DTx v1.0 , a suite of five games that train children to improve their attention capacity. Our analysis found that children demonstrated self-efficacy, engagement, and adherence despite NeuroWorld being less fun than entertainment games. Additionally, most caregivers emphasized the importance of educational aspects over entertainment aspects. Collectively, our findings provide novel insights into how serious games could be developed and deployed for at-home use among children with ADHD.

This paper examines the complex dynamics of shift assignment in agency-based home care settings, emphasizing the essential but overlooked role of care coordinators. Drawing on 18 qualitative interviews with home care aides and coordinators from three U.S. agencies, our findings reveal the work coordinators do to enable the aide-client relationships at the heart of home care. Coordinators act as both logisticians and matchmakers, trying to meet the needs of their clients with a limited and ever-changing pool of aides, all of whom have their own unique identities and needs. To do so, they draw on their own relationships with aides and other coordinators. Home care management software assists coordinators, but it cannot function without the social infrastructure they help to maintain. This study challenges the current focus of both technology designers and researchers, advocating for a perspective that recognizes the importance of relationships in home care and the interdependence of aides, clients, and coordinators.

Dog guides are favored by blind and low-vision (BLV) individuals for their ability to enhance independence and confidence by reducing safety concerns and increasing navigation efficiency compared to traditional mobility aids. However, only a relatively small proportion of BLV individuals work with dog guides due to their limited availability and associated maintenance responsibilities. There is considerable recent interest in addressing this challenge by developing legged guide dog robots. This study was designed to determine critical aspects of the handler-guide dog interaction and better understand handler needs to inform guide dog robot development. We conducted semi-structured interviews and observation sessions with 23 dog guide handlers and 5 trainers. Thematic analysis revealed critical limitations in guide dog work, desired personalization in handler-guide dog interaction, and important perspectives on future guide dog robots. Grounded on these findings, we discuss pivotal design insights for guide dog robots aimed for adoption within the BLV community.

Upper-limb impairments due to stroke can severely affect the quality of life in patients. Scientific evidence supports that repetitive rehabilitation exercises can improve motor ability in stroke patients. Rehabilitation games gained tremendous interest among researchers and clinicians because of their potential to make the seemingly mundane, enduring rehabilitation therapies more engaging. However, routine and longitudinal use of rehabilitation games in real-world clinical settings has not been investigated in depth. Particularly, we know little about current practices, challenges, and their potential impacts on therapeutic outcomes. To address this gap, we established a partnership with a rehabilitation hospital where game-assisted rehabilitation was routinely employed over a 2-year period. We then conducted an observational study, in which we observed 11 game-assisted therapy sessions and interviewed 15 therapists who moderated the therapy. Significant findings include (1) different engagement patterns of stroke patients in game-assisted therapy, (2) imperative roles of therapists in moderating games and challenges that therapists face during game-assisted therapy, and (3) lack of support for therapists in delivering patient-centered, personalized therapy to individual stroke patients. Furthermore, we discuss design implications for more effective rehabilitation game therapies that take into consideration both patients and therapists and their specific needs.

Individuals with cognitive impairments are evaluated using clinically validated cognitive assessment tools, which need to be administered by trained therapists. This serves as a major barrier for frequent and longitudinal monitoring of patients' cognitive impairment level. We introduce Neuro-World, a set of six mobile games designed to challenge visuospatial short-term memory and selective attention, which allows one to self-administer the assessment of his/her cognitive impairment level. Game performance is analyzed to estimate a widely accepted clinical measure, the mini mental state examination (MMSE), which highlights the translational impact of the system in real-world settings. We collected game-specific performance data from 12 post-stroke patients at baseline and a three-month follow-up, which were used to train supervised machine learning models to estimate the corresponding MMSE scores. The results presented herein show that the proposed approach can estimate the MMSE scores with a normalized root mean square error of 5.75%. We also validate the system's responsiveness to longitudinal changes in cognitive impairment level and demonstrate the system's positive usability in cognitively impaired individuals and their willingness to adhere to the longitudinal use. This study demonstrates that Neuro-world has great potential to be used to evaluate the cognitive impairment level and monitor its long-term change. This study enables new clinical and research opportunities for accurate, longitudinal assessment of cognitive function via mobile games.

The use of robots in stroke rehabilitation has become a popular trend in rehabilitation robotics. However, despite the acknowledged value of customized service for individual patients, research on programming adaptive therapy for individual patients has received little attention. The goal of the current study is to model teletherapy sessions in the form of a generative process for autonomous therapy that approximate the demonstrations of the therapist. The resulting autonomous programs for therapy may imitate the strategy that the therapist might have employed and reinforce therapeutic exercises between teletherapy sessions. We propose to encode the therapist's decision criteria in terms of the patient's motor performance features. Specifically, in this work, we apply Latent Dirichlet Allocation on the batch data collected during teletherapy sessions between a single stroke patient and a single therapist. Using the resulting models, the therapeutic exercise targets are generated and are verified with the same therapist who generated the data.

We report the results of standardized tests on a single subject with a stroke at 4, 20 and 28 weeks after completion of the study. These results follow from previous work[1]. The subject demonstrated sustained improvement in motor function 28 weeks after completing the study. In addition to quantitative results, the questionnaire results by the subject and the spouse testify that the subjective user experience was also positive. This further advocates the use of general purpose robots to complement human therapists.

In this case study, we examine the functional utility of an embodied agent as an interactive medium in stroke rehab. A set of physical rehab exercises is conducted through the direct engagement of an embodied agent, the uBot-5. Based on the preliminary data, we argue that a general-purpose embodied agent has a potential to functionally complement human therapists in providing rehab to stroke patients.

In recent years, the potential of robot-mediated upper extremity therapy has been widely acknowledged in stroke rehabilitation. The primary focus of rehabilitation robotics has been on building exoskeleton robots as well as devising control strategies that leverage robotic forces to adaptively assist and resist the movements of patients' impaired arms during repetitive reach-touch exercises. In our single subject case study, a robot presents exercise target positions that are successively more difficult to the patient. This serves to adaptively challenge the patient, while inducing voluntary reach-touch movements. Through data collected during 12 weeks of therapy with a single subject, we demonstrate that a general purpose robot can induce desired therapeutic exercise movements from a patient. In addition, we have observed that the challenge level can be adapted as the patient improves his motor function, which leads to observable improvements in the motor function of the patient.