Bootle Rumble: Gamifying Rehabilitation Exercise for Youth with Cerebral Palsy
Youth with cerebral palsy (CP) may be prescribed rehabilitation exercises by physiotherapists in order to improve or maintain motor function as they grow into adolescence. However, in the field of physiotherapeutic medicine, adherence to exercise prescriptions has been shown to be low. Motivation and enjoyment have been identified as important factors of adherence to prescribed exercise, and gamification of rehabilitation exercise has been shown in some cases to improve motivation, enjoyment, and exercise adherence for youth with cerebral palsy. In this thesis, we present Bootle Rumble, an exercise video game for youth with cerebral palsy which intends to motivate high-quality rehabilitation exercise without sacrificing enjoyable gameplay. Bootle Rumble’s design balances four distinct constraints: (1) it must motivate high-quality exercise; (2) it must be balanced for effort rather than individual ability; (3) it must be accessible to youth with CP; and (4) it must be fun. These constraints led to several unique game design decisions, which we describe in this thesis. To gain early evaluation of the design decisions that underly Bootle Rumble, we conducted a pilot study involving three participating youth with CP, their parent/guardians, and a participating physiotherapy assistant (PTA) who works with youth with CP. This pilot study focused on evaluating (1) our form-tracking mechanic, in which players’ quality of exercise influences the outcomes of in-game choices, (2) player enjoyment while playing Bootle Rumble, and (3) the effectiveness of Bootle Rumble’s design. The results gathered from our pilot study show promise for Bootle Rumble as an enjoyable adjunct to rehabilitative exercise for youth with CP. Our PTA’s observations suggest that Bootle Rumble incentivizes high-quality exercise. Responses from our participating youth with CP suggest that Bootle Rumble is enjoyable. We further leverage our results to evaluate several of Bootle Rumble’s design decisions. These design decisions may be useful to future developers intending to gamify rehabilitation for youth with CP and other motor disorders.
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