Interactive technology and games provide promising methods for wheelchair skills training. This paper introduces RollAbility, a rehabilitative game for powered wheelchair skills training aimed at children and teenagers with complex movement disorders. The game combines clinical best practices and standardized training protocols with player experience goals. Developed through an iterative process with rehabilitation experts and game designers, RollAbility utilizes the Wheelchair Skills Training Program [Kirby et al. '23] and integrates key insights from Aufheimer's [CHI '23] motivation studies in physical therapy to ensure both therapeutic and engaging gameplay. Evaluated through exploratory sessions with children, therapists, and clinical experts, results show that RollAbility effectively merges clinical protocols with an engaging game format. However, balancing player autonomy and therapist guidance remains a critical consideration. This work offers a blueprint for designing therapeutic games that align clinical protocols with engaging player experiences.

Wheelchair skills training is key for achieving greater personal mobility, and interactive solutions offer the potential for a more engaging training experience. In this paper, we examine the tensions between therapeutic requirements and player engagement, through the prototypical development of a wheelchair skills training game for children with Cerebral Palsy. Using an iterative and interdisciplinary design process, exercises from the Wheelchair Skills Program manual are implemented as interactive missions in an open-world, medieval-themed game. The game contains a custom input system that directly uses the player’s wheelchair input peripherals. In bridging the gap between clinical requirements and player engagement, we discuss the challenge of repetition and feedback in therapy, and implications for future work in game design.

While it is widely assumed that games can engage patients in therapy through their inherent ‘motivational pull’, relatively little attention has been paid to what HCI games research can learn from strategies employed by therapists. We address this gap by leveraging Self-Determination Theory (SDT) and its mini-theories Basic Psychological Needs Theory and Organismic Integration Theory as a theoretical lens on physical therapy for children and adolescents. Results from in-depth interviews with twelve therapists show that they carefully adjust sessions to allow patients to experience competence, making more comprehensive adjustments than currently offered by games. Additionally, we highlight how therapists leverage their relationship with patients to support motivation, but struggle to reconcile meaningful experiences of autonomy with therapeutic goals. On this basis, we reflect on implications for researchers and designers who create games for physical therapy, and the potential of SDT to provide a foundation for game design and therapeutic practice.