Beyond Fun

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After the accessibility study concluded, participants had more to say. The interviews had touched on something beyond whether the games worked — participants were describing what the experience of playing meant to them within the context of rehabilitation. This paper reports that data.

Spinal cord injury rehabilitation is physically and psychologically demanding. Patients must perform repetitive exercises with uncertain outcomes while processing a sudden and severe change to their identity, their capabilities, and their sense of future. Passive cycling exercises, required for range-of-motion maintenance, provide no cognitive engagement. Some participants described this time as an opening for the kind of rumination that deepens psychological distress.

Gaming during rehabilitation changed this. Analysis identified three categories of benefit, organised around self-determination theory's dimensions of autonomy, competence, and relatedness. Games gave participants something to do with their attention — active engagement in place of passive endurance. Competition and goal-achievement produced feelings of accomplishment that injury had made unavailable in other contexts. And games introduced a common ground for social interaction with other patients.

Two participant statements capture the scope of what participants described. One: "It's not only healing the body — it's also healing the mind." Another, on what games could show patients about their futures with injury: "There's still lots to do in life."

These findings reframe what it means for an AI-assisted system to succeed. Task performance is one measure. Whether the system gave someone access to something that mattered to them is another. Both are real, and both are worth measuring.

Read the paper →