What

This master’s thesis explores how Extended Reality (XR) can be designed to support engagement and detect early signs of fatigue in children undergoing rehabilitation for acquired brain injuries. The project centres on the development of an XR-based interactive game that motivates children to participate in therapeutic exercises and captures behavioural data that can help clinicians identify signs of physical or cognitive fatigue. The system aims to balance therapeutic intent with playfulness, drawing from both engagement theory and clinical rehabilitation practices. By integrating elements of game design with fatigue-sensitive interaction, the solution seeks to support therapists in tailoring interventions to the specific and fluctuating needs of each child.

How

The project followed a case study approach, combining theoretical grounding with iterative prototyping and participatory design. Multiple XR prototypes were developed and tested through co-design workshops held at Aker Hospital, involving children with brain injuries and therapists. Design decisions were guided by engagement theory and fatigue frameworks, and refined through qualitative feedback, behavioural data from integrated tracking tools, and expert reflections. Standardized instruments were used to assess engagement and fatigue, while thematic analysis of workshop discussions informed the ongoing design. This methodology ensured that the XR system evolved in close alignment with both user experience principles and therapeutic relevance.

Why

Children with acquired brain injuries often experience cognitive fatigue, attention challenges, and reduced motivation, making sustained participation in conventional therapy difficult. At the same time, clinicians lack dynamic, child friendly tools to monitor fatigue or adapt therapy based on day-to-day fluctuations in ability and engagement. Many existing XR healthcare applications overlook the unique cognitive, emotional, and sensory needs of pediatric users. This project addresses both a research gap of how fatigue manifests behaviourally in XR contexts and a practical design need for more engaging, data-informed rehabilitation tools. By blending engagement theory with clinical insights, this work contributes a new approach to pediatric rehabilitation design: one that values motivation as much as measurement and play as much as performance. The goal is to make therapy more meaningful, personalized, and responsive to the lived experiences of each child.