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Psychometric properties and usabilityof a gamified digital task system for assessing attention and hand functionin stroke rehabilitation
n
DIGITAL HEALTH
Volume 12: 1–14
© The Author(s) 2026
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/20552076261425481
journals.sagepub.com/home/dhj
Shu-Chun Huang 1,2,*,
Chieh-Yu Li 1,
Watson Hua-Sheng Tseng 3,
Ching-Yi Wu 2,4,
Lan-Yan Yang 5,
Chiu-Wen Chen 2 and
Shih-Ying Chien 2,6,7,*
Abstract
Objective:
Conventional occupational therapy for stroke rehabilitation often relies on pegboards and paper-based tasks,
which lack digital, objective, and gamified assessment capabilities. To address this gap, we developed a gamified digital
randomized target pressing task (RTPT) system as a user-centered digital platform for assessing attention and hand function, and evaluated its reliability, validity, and usability in patients with stroke. A previous pilot study was conducted to
refine the system design and assessment protocol.
Methods: A total of 33 stroke patients completed the RTPT alongside established measures, including the Box and Block
Test (BBT), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Chu’s Attention Test (CAT).
Twenty-six participants repeated the RTPT to evaluate test–retest reliability. Usability and acceptance were assessed
in 30 patients and 16 healthcare professionals using the System Usability Scale (SUS) and Technology Acceptance
Model (TAM), capturing both user engagement and perceived system usefulness.
Results:
Performance with the non-paretic hand (sound side correct count (SCC)) correlated strongly with attention
scores (CAT, r=.649, p<.001) and visual perception/construction (LOTCA). Paretic hand performance (affected side
correct count (ACC)) correlated with manual dexterity (BBT, r=.67, p<.001) and functional abilities in self-care.
Test–retest reliability was high (intraclass correlation coefficients: SCC=0.937, ACC=0.804). SUS scores indicated
above-average usability (median 86.3), with strong internal consistency (Cronbach’s α: TAM=.959) and high SUS
TAM correlations. Participants reported high engagement and satisfaction with the digital platform.
Conclusion:
The RTPT provides a reliable, valid, and user-friendly digital assessment of attention and hand function in
stroke rehabilitation. By integrating cognitive and motor evaluation within a gamified digital platform, it demonstrates
potential as a tool to support individualized therapy planning, monitor rehabilitation progress, and enhance patient
engagement in clinical practice.
Keywords
Digital health, stroke rehabilitation, gamified assessment, cognition, hand function, usability, machine learning
Received: 22 October 2025; accepted: 2 February 2026
1 Department of Physical Medicine and Rehabilitation, New Taipei
Municipal Tucheng Hospital, New Taipei City, Taiwan
2 Department of Physical Medicine and Rehabilitation, Linkou Chang Gung
Memorial Hospital, Taoyuan City, Taiwan
3 Department of Medical Education, Linkou Chang Gung Memorial
Hospital, Taoyuan City, Taiwan
4 Department of Occupational Therapy, Chang Gung University, Taoyuan
City, Taiwan
5 Department of Medical Research, Taichung Veterans General Hospital,
Taichung, Taiwan
6 Department of Industrial Design, Chang Gung University, Taoyuan City,
Taiwan
7 Department of Public Health and Medical Humanities, School of
Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
*Shu-Chun Huang and Shih-Ying Chien contributed equally to this work
and should be considered co-first authors.
Corresponding author:
Shih-Ying Chien, Department of Industrial Design, 6th Floor, Building A,
Management Building No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan
City 33302, Taiwan (R.O.C.).
Email: shihying@mail.cgu.edu.tw
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons At
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