A Compact Dynamic Driving Simulator for Rehabilitation-Oriented Exergames: System Design and Experimental Evaluation in Healthy Partic

Many neurological conditions, including stroke, Parkinson’s disease, amyotrophic lateralsclerosis, and mild cognitive impairment, compromise cognitive and motor functions andmay threaten autonomy in complex daily activities. Rehabilitation can therefore benefitfrom tasks that simultaneously engage these domains. Driving is a representative example,as it combines continuous motor control, visual processing, attention, decision making,and reaction to unexpected events. Driving simulators can provide a controlled and repeatableenvironment in which these cognitive and motor functions can be jointly trained,while also supporting the assessment and recovery of driving-related abilities when returnto driving is clinically relevant. However, rehabilitation-oriented simulators oftenprovide limited multisensory feedback compared with professional systems, whose size,cost, and complexity limit their transfer to clinical settings. This study presents a compact,three-degree-of-freedom dynamic driving simulator developed for rehabilitation-orientedexergames with adjustable difficulty and measurable in-game metrics. It combines a parallelmotion platform, haptic steering, instrumented pedals, and a modular software architecturebased on a multibody simulation engine and a graphics engine, with automated sessionreports. Four exergames were evaluated in 62 healthy licensed adults aged 19–30 years, witheach exergame scheduled twice. Traffic Mode was assessed in a separate data-collectioncampaign involving 38 participants, with partial participant overlap between campaigns.Slalom showed a marked ceiling effect, whereas Linekeeping showed a graded distributionof performance. Reaction Test outcomes varied widely between participants and werestrongly associated with approach speed. Participant rank order was moderately preservedacross executions. The results characterize the proposed measures in a homogeneoushealthy population and identify the most informative metrics and the task configurationsrequiring refinement. Their suitability for longitudinal monitoring in patients remains tobe established.