It Depends: ReAuthoring Play Through Clinical Reasoning in Wearable AR Rehab Games

Abstract

Augmented reality games hold promise for rehabilitation, yet most remain confined to laboratory studies with limited clinical uptake. Recent advances in spatial computing, especially lightweight, glassesformfactor AR, create a timely opportunity to embed rehabilitative play into clinical practice and daily contexts. To investigate this potential, we systematically reviewed 132 applications and conducted playtesting with 14 licensed physical therapists. Our analysis revealed three ways therapists reauthored AR games: coauthored play (reshaping movements, progressions, and difficulty), situated play (adapting across specialties, conditions, and contexts), and dual play (mediating both physical recovery and psychological support). We reframe therapists' frequent phraseIt dependsas a generative design principle. This study contributes a clinical reasoningbased framework and design principles and guidelines for creating personalized, situated forms of play that align with therapists' everyday workflows and inform future labtoclinic translation.

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