Personalized Daily Hand Movement Training Methods and Effects: A Case Study

Abstract

This study proposes a method for personalized daily hand exercise training to address the lack of personalization in rehabilitation training and its disconnect from daily life. This research aims to evaluate the impact of Happiness Memory Therapy on patients’ hand function through gamified daily life training. The methodology integrates Happiness Memory Therapy and Positive Mirror Theory to assist in life game design. Patient interviews and empathy are used to gather life experiences, interests, hobbies, and challenges, which are then incorporated into personalized rehabilitation training. The experimental process includes pre- and post-intervention tests to assess changes in subjective well-being (SWLS), happiness (SHS), positive and negative emotions (PANAS), psychological well-being (PWB), and hand function impairment (DASH). The results show that the intervention significantly enhances patients’ subjective well-being, happiness, positive emotions, and reduces negative emotions and hand function impairments. In conclusion, Happiness Memory Therapy and Positive Mirror Theory are effective in developing personalized daily hand exercise training methods and have a significant impact on improving the psychological health and quality of life of stroke patients, offering new ideas and methods for personalized rehabilitation training.

1. Introduction

The number of stroke patients is increasing annually and showing a trend towards younger individuals, bringing negative impacts to both individuals and society [1,2,3]. Among the common sequelae following a stroke, hand movement disorders are frequently observed [4,5,6]. Due to the large cortical area dedicated to hand function, rehabilitation for fine motor skills is more challenging than for gross motor skills [7,8,9,10]. However, the recovery of fine motor skills is crucial for patients to regain independent living ability, and rehabilitation training is widely believed to be effective in improving both upper and lower limb function [11,12,13]. For young and middle-aged stroke patients, hand rehabilitation training plays a significant role in returning to work and normal life [14].

Traditional rehabilitation strategies mainly encompass three aspects: generic motor methods for physiological range of motion, intervention strategies for patients’ psychological and behavioral aspects, and task outcome-based strategies. In the early stages, traditional hand rehabilitation training usually involves cooperation between therapists and rehabilitation equipment to help patients alleviate or eliminate hand movement disorders. For example, low-frequency and medium-frequency electrical stimulation techniques are used for muscle training [15], aiming to prevent muscle spasms in the fingers. Rehabilitation devices such as exoskeletons, end-effector machines, and wearable gloves [16,17,18] are used to assist in the flexion and extension movements of the fingers, which help in restoring the physiological range of motion of the affected hand [19,20,21,22].

With the continuous development of technologies such as sensors [23], virtual reality [24], and brain–computer interfaces [25], rehabilitation training methods are also advancing. For instance, mirror therapy utilizes the unaffected hand and visual stimuli to promote sensorimotor recovery in the affected hand, fostering rehabilitation training [26]. Some researchers use movement data from the unaffected hand to model passive movement in the affected hand, allowing it to be exercised within its range of motion [27,28,29]. Other researchers promote training of the affected hand through games, virtual reality [30], and interactive methods to enhance participation and interest in training. For example, games might guide the affected hand along a specified trajectory to improve overall movement stability [18,26]. Through multiple comparisons of movement trajectories and assessments of training effects, rehabilitation training methods are continually optimized. Additionally, some researchers focus on localized factors for rehabilitation training, including finger muscle strength training, prediction and assessment of finger movement angles, and gesture classification for finger movement classification, helping patients develop personalized rehabilitation training plans [16,31,32,33].

In hand rehabilitation training, the demand for personalized activities of daily living is often overlooked. This oversight is mainly manifested in the following aspects:

Firstly, current rehabilitation practices do not fully relate training content to the actual daily activities of patients. Most rehabilitation training targets common impairments but lacks the development of personalized training content tailored to the daily lives of individual patients. This results in training content that lacks individual practicality and fails to effectively meet specific patient needs.

Secondly, there is a lack of exploration into the intrinsic motivational drivers of patients within rehabilitation training content. Current rehabilitation training mainly stimulates patient participation through interests and technical means. However, the participation engendered by this approach often lacks long-term sustainment and durability.

Lastly, the update and iteration of rehabilitation training content pose a significant challenge. Existing training content fails to promptly adapt to and reflect the changing rehabilitation needs of patients, resulting in suboptimal training outcomes.

Therefore, it is essential to propose a method for generating personalized daily living hand movement training to address the personalization and motivational deficiencies in current rehabilitation training. Enhancing patient engagement and psychological health to better meet their rehabilitation needs is of paramount importance.

Traditional training content is relatively fixed; long-term formulaic training engenders anxiety and self-depreciation in patients, amplifying the impact of their misfortune due to illness. This leads to training aversion and neglects the positive influence of patient well-being on hand movement training. Stroke patients face numerous challenges during rehabilitation, including physical disabilities, emotional downturns, and psychological health issues. Research in psychology and neuroscience indicates that emotions and psychological states have a profound impact on the rehabilitation process [34].

Reminiscence Therapy (RT), also known as nostalgia therapy, originates from the theory of self-transcendence [35] and was introduced in China in 2003, primarily targeted at the elderly population. Reminiscence Therapy believes that elderly individuals can gain self-awareness and envision their future by reflecting on fragments of their past lives. Its principle is to activate the posterior hippocampus by triggering memories of early autobiographical events or collective historical highlights, thereby reducing anxiety, loneliness, and stress. This, in turn, evokes positive emotions, self-esteem, social interaction, a sense of achievement, and happiness, ultimately enhancing life satisfaction and having a positive impact on physical health [36,37]. Reminiscence Therapy has been widely applied in the treatment of dementia, depression, and cognitive disorders in the elderly. It can be conducted one-on-one or in group sharing sessions and may even be combined with structured intervention plans and auxiliary tools such as old photographs or music to facilitate the reminiscing process, which has positive effects on patients’ mental health, quality of life, and coping mechanisms [38].

Happiness Therapy (HT) is a branch of RT that primarily focuses on recalling happy moments from patients’ early experiences to promote self-esteem and self-efficacy and to enhance adaptive ability. For example, when elderly individuals reminisce about their travel experiences, these memories are often very vivid, and the process of recollection can bring about excitement and joy [39]. Happiness Therapy has been validated for its effectiveness in various psychological clinical fields [40].

However, RT mainly focuses on recollection of past experiences and lacks attention to future expectations and goals, which may limit the brain’s ability to reprocess and reorganize memories. Additionally, RT does not provide mechanisms for creating new memory images through the input of others’ life experiences, which could bring new experiential influences.

For example, when we read literary works, the images constructed by the text can generate new memories, particularly those deeply moving characters who can influence our perceptions and cognition about life. This process, known as embodying others’ life experiences, can help us gain a deeper understanding of ourselves.

To optimize Happiness Therapy, the following points can be considered:

• Future Orientation: In addition to recalling happy moments, incorporate discussions about future expectations and goals to help patients connect past positive experiences with future objectives.
• Diverse Experiences: Introduce the life experiences of others, such as reading literary works or watching movies, to help patients form new memory images and enrich their psychological experience.
• Cognitive Restructuring: Combine cognitive behavioral techniques to restructure patients’ thoughts and behaviors, aiding them in better coping with life’s challenges.

By implementing these optimization measures, Happiness Therapy can more comprehensively enhance patients’ mental health and well-being.

The Positive Creation Mirror Theory (PCMT) [41], proposed by Lu Dingbang, is an innovative design thinking method aimed at guiding technological development and industry vision through reverse thinking and humanistic logic. The core of this theory lies in the concept of the “mirror”, which transforms problems and complaints in the current state into future wishes and ideals, thereby achieving innovation and value creation.

The basic principle of the Mirror Theory utilizes the interaction of three roles: “Current Self”, “Reflected Self”, and “Aspirational Self ”. Specifically, “Current Self” represents the current state and problems, “Reflected Self” presents a scenario opposite to “Current Self” through the reflection of the mirror, encompassing two mechanisms: complaint elimination (M[−1]) and the creation of unexpectedly positive experiences (M[~1]). “Aspirational Self”, on the other hand, is the ideal state projected by “Reflected Self”. Through this process, designers can find feasible paths to realize the ideal state from existing resources and conditions.

The operational steps of PCMT include:

• Establish a complete customer journey.
• Confirm key content of the journey.
• Formulate negative customer journey propositions.
• Propose binary flip models.
• Extract positive customer values.
• Depict the desired customer journey: Design and realize the entire process of the desired customer experience based on positive customer values.

Steps 1 and 2 represent the “Current Self”, steps 3 and 4 represent the “Reflected Self”, and steps 5 and 6 represent the “Aspirational Self”.

It should be noted that the Mirror Theory mentions two types of mirror transitions:

Negative-One (M[−1]) Mirror Transition: This method starts from existing complaints or problems and, through reverse thinking, converts them into solutions. The specific calculation method involves logically negating or reversing the complaint or problem proposition to obtain the opposite result, which serves as the solution. For example, if the complaint is “train schedule cannot be found”, the solution after a negative-one mirror transition would be “train schedule can be found”.

Non-One (M[~1]) Mirror Transition: Unlike the simple negation of complaints or problems, this approach fundamentally redefines the problem to create a completely new solution that exceeds expectations. The specific calculation method involves expanding the premises and limitations of the complaint or problem, thereby stepping out of the original thinking framework to achieve an innovative solution. For example, if the complaint is “train schedule cannot be found”, after a Non-One Mirror Transition, the solution might be “access real-time train schedules anytime via a mobile app”.

The distinction between these two mirror transitions lies in their approach: the Negative-One merely makes partial improvements within the existing framework, whereas the Non-One fundamentally redefines the problem to create entirely new solutions. By combining both methods, one can generate incremental and radical innovation ideas.

The theory emphasizes the distinction between technology and value, pointing out that technology can deliver functions but may not necessarily create value. Value is derived from the significance it holds for the adopter’s situation, which in turn triggers motivation and demand. Therefore, the PCMT focuses not only on the realization of technology but also on creating value by assigning specific meanings to the technology.

The PCMT also advocates for the concepts of “benevolent wisdom” and “benevolent culture”, stressing that an individual’s value lies in the value they can create for others. By promoting a virtuous cycle and benevolent culture, the Mirror Theory addresses not only individual innovation and development but also the overall progress and well-being of society [42].

In essence, PCMT provides business leaders and managers with a novel thinking tool, helping them find directions for innovation and development in complex and ever-changing market environments through reverse thinking and humanistic logic.

The PCMT has been effectively validated in fields such as designing ticketing services in train stations, product innovation, management models, and program production [43,44,45,46]. Therefore, it will continue to have a beneficial impact in the gamification design within the field of stroke rehabilitation.

Home rehabilitation is crucial for chronic stroke patients, as personalized rehabilitation training plans are essential due to the varying hand conditions and needs of each patient. Personalized rehabilitation training is the key to patient recovery, and thus the training plans should be designed based on individual needs rather than seeking a one-size-fits-all solution.

Through field research, we found that patients exhibit significant differences in hand conditions, including ataxia, coordination disorders, sensory disturbances, decreased muscle strength, spasticity, limited joint mobility, proprioceptive loss, cognitive dysfunction, finger extension difficulties, and lack of hand flexibility. Therefore, hand rehabilitation training needs to be personalized according to these specific issues to meet the unique needs of each patient. When optimizing rehabilitation training strategies, it is essential to consider all these aspects comprehensively and pay special attention to the unique needs of patients undergoing home rehabilitation. Personalized design can not only improve the effectiveness of rehabilitation training but also enhance patients’ motivation and participation, making the rehabilitation process more aligned with actual needs. Through such optimization, we can better assist chronic stroke patients in their hand rehabilitation, improving their quality of life and rehabilitation outcomes.

This paper proposes a method for generating personalized daily living hand movement training, aimed at addressing the issue of individual patients’ personalized training to meet their hand use impairments in daily life and to stimulate active training. This method integrates interesting experiences from others into Reminiscence Therapy, forming a Happiness Memory Therapy by integrating and reshaping these experiences. This therapy, based on traditional hand training, incorporates memory, expectation, and life tasks to create a rehabilitation training method unique to each patient. It promotes self-acceptance, life re-planning, happiness, and effective rehabilitation training. Moreover, this study translates this Happiness Memory Therapy into practical life games through design theoretical methods, breaking the complete dependence on therapists and rehabilitation equipment, and providing patients with a more natural way to achieve active rehabilitation training in their daily lives. This research contributes to the personalization and diversification of rehabilitation training content, positively impacting patients’ daily hand use training, psychological health, and quality of life.

2. Methods

2.1. Theoretical Innovation

Personalized daily living hand movement training builds upon traditional training by incorporating Happiness Memory Therapy. This approach is based on “personal memories and life experiences” and integrates “individual rehabilitation expectations and goals” into “life game design”. While enhancing the sense of happiness, it simultaneously accomplishes personalized daily hand function movement training. The core concept is to transform happiness memories into daily life games through the Positive Creation Mirror Theory, helping patients to complete life tasks using both the affected and unaffected hands, fostering self-acceptance and the ability to independently complete daily tasks.

The research begins by conducting interviews to gather patients’ sense of happiness and needs, then analyzes and quantifies core needs using the Positive Creation Mirror Theory. It explores the details of these needs from the dimensions of memory and expectation, integrating them into rehabilitation training. The rehabilitation training content adopts a gamified design to enhance the patients’ sense of happiness. Through pre- and post-training tests and analysis, the study evaluates the effectiveness of Happiness Memory Therapy and the Positive Creation Mirror Theory in personalized daily living hand movement training for stroke patients. The research framework is illustrated in Figure 1, where M[−1] represents the Negative-One Mirror Transition, and M[~1] represents the Non-One Mirror Transition.

2.1.1. Happiness Memory Therapy (HMT) and Implementation

Happiness Memory Therapy (HMT) is an innovative development of traditional Reminiscence Therapy (RT). It is based on the theoretical foundations of memory reactivation (reproducing happy moments to activate neural networks related to positive emotions in the brain and improve emotional state) and emotional enhancement (using the recall of positive memories to augment emotional experiences and alleviate negative emotions). The implementation pathway of Happiness Memory Therapy is shown in Figure 2.

Considering the insufficient correlation between patients’ individual life experiences and their current psychological intervention needs, this method introduces specific memories and life experiences of others as new memory sources. By conveying these related experiences through dialogue, it helps patients understand and form new memories on a psychological level. This method simultaneously encompasses the influence of both past and future on the current emotional state.

By integrating the memories of others, patients’ expectations and rehabilitation goals may shift, inspiring new visions. Through joint efforts between patients and others, happy memories can be established, achieving therapeutic effects. These others can include not only therapists but also family members, friends, and trusted individuals who are willing to help and events from patients’ social relationships.

Current scales for evaluating happiness primarily include Subjective Well-Being (SWLS), Sense of Happiness (SHS), Positive and Negative Affect Schedule (PANAS), and Psychological Well-Being (PWB). Since happiness is a subjective and multi-dimensional concept that generally refers to an individual’s positive evaluation of their quality of life and satisfaction with their current state of living, it involves multiple aspects, including emotions, cognition, and behavior. Different academic disciplines have different definitions and understandings of it. Moreover, happiness is dynamic and influenced by various factors such as personal experiences, environmental factors, psychological state, and physiological conditions.

Therefore, this study does not redefine happiness but rather explores the sense of happiness from memories and uses existing happiness scales to assess the patients’ level of happiness and its changes.

Before starting, collect information about the patient’s life experiences, hobbies, and current difficulties through interview and communication. Assess the patient’s mental health status, such as anxiety and depression, to obtain an initial evaluation. Understand the patient’s feelings and needs through listening and empathy. Maintain an open and respectful attitude to ensure the patient feels safe and supported, thereby gaining trust.

The implementation steps of HMT are as follows:

• Memory Recollection: Guide participants to recall a happy moment, focusing on helping the patient construct happy memories. If the patient’s own memories are highly unrelated to the training, relevant happy memories can be constructed through others’ experiences. Enhance the vividness and realism of the recall by engaging multiple senses and motor stimuli such as visual, auditory, olfactory, and movement. Describe the scene, people, and emotional experiences of that moment in detail.
• Happiness Reenactment: Recreate the happy moment in daily life by converting the happy memory into a daily life activity, enhancing the emotional experience of the memory, and promoting hand movement participation. Focus on the operability of reenacting it in a daily life context. This process requires the collaboration of PCMT.
• Recording and Reflection: Participants record their daily emotional experiences and training-related data, forming a log for subsequent analysis and adjustment of the training program.

These steps ensure that HMT is systematically integrated with the patient’s rehabilitation process, leveraging positive memories to enhance emotional well-being and support functional improvement.

2.1.2. Positive Creation Mirror Theory (PCMT) and Implementation

PCMT through the stages of “Current Self”, “Reflective Self”, and “Aspirational Self”, helps patients find directions and goals for rehabilitation from complaints and difficulties:

• Current Self: Based on the memory recollection, obtain situational fragments of the patient’s happy memories, evaluate the patient’s current hand function status, and identify specific difficulties related to happy memories in daily life.
• Reflective Self: Through the reverse thinking of Mirror Theory, highly relevant segments obtained at the current stage are filtered. These core segments are identified by researchers who analyze their importance through scoring after communicating with the patient, envisioning a more ideal situation than the current state (in this case, using the Non-One Mirror Transition M[~1]). Typically, one of the two types of mirror transition mechanisms is selected to analyze the problem based on the specific circumstances.
• Aspirational Self: Based on the ideal situation obtained in the Reflective Self stage, combine the patient’s personal needs and life background to achieve specific rehabilitation goals and training plans in the form of a game.

This theory helps patients systematically move from identifying their current state to envisioning and working towards an improved state, integrating their personal context and needs into the rehabilitation process.

2.1.3. Life Game Design

Incorporate happy memories and rehabilitation goals into daily life game design, making the training process more enjoyable and meaningful. Personalized game design is based on the patient’s happy memories and rehabilitation plans obtained in the Aspirational Self stage; design personalized daily life games and draw a happiness memory experience journey map for training key point design analysis.

In the case study of this research, the following two points need to be considered:

• Bilateral Coordination Training: Design tasks in the game that require cooperation between both hands, helping the affected hand to work together with the healthy hand to complete daily life tasks, thereby enhancing hand function.
• Self-completion of Tasks: Through game design, cultivate the patient’s ability to independently complete daily life tasks, thereby boosting confidence and self-acceptance awareness.

Through communication with the patient, it was discovered that at the age of 20, the patient had a habit of making bookmarks from leaves, which helped him relax and allowed him to write poems on the bookmarks, which he called “The Poetry of Life”. Cooking potato chicken nuggets made his wife praise him highly, making him happy. With his wife’s assistance, the patient hopes to contribute more to household chores in the future, making him feel that he can provide value to the family and that he is useful. Based on Happiness Memory Therapy and Positive Creation Mirror Theory, the patient’s journey map was obtained, as shown in Figure 3. The specific process involves obtaining key behaviors through core segments of happy memories, and the emotional value driven by these key behaviors is recorded in the emotional state. However, there are pain points in the current process of reactivating these original memories, which are the difficulties that patients encounter in completing tasks. Improvement opportunities are provided through the Positive Creation Mirror Theory using the Non-One Mirror Transition M[~1].

2.2. Experiment-Related Information

This experiment is related to the National Natural Science Foundation project titled “Research on the Mechanisms of Achieving Rehabilitation Effectiveness of Finger Rehabilitation Training Equipment”. Our current study is part of this project, primarily employing related questionnaires and scales to collect data using Likert 5–7 point ratings. The project has passed the ethical review by the Ethics Committee of Guangdong University of Technology, with the ethical approval code GDUTXS2024035. Participants were informed beforehand about the purpose, procedures, and risks of the study, and voluntary participation was obtained with signed informed consent forms.

The case study involves a 33-year-old patient, with a height of 185 cm and a weight of 75 kg, who suffered a stroke nearly 3 years ago. The stroke resulted in a cerebral hemorrhage of 98.5 mm, and despite ongoing rehabilitation training, the patient still experiences unilateral hand motor impairment. The experimenter will conduct continuous experimental activities over 30 days.

The treatment mechanism in this study integrates Happiness Memory Therapy, the Positive Creation Mirror Theory, and gamification design. Through interviews, positive memories and life experiences of the patient are obtained, rehabilitation needs are quantified, and personal expectations and goals are incorporated into the rehabilitation training. Training tasks are designed as life-like games, requiring cooperation between the affected and unaffected hands to enhance the patient’s sense of happiness and motivation for rehabilitation. This approach aims to help patients develop self-acceptance and independent living skills, actively participate in hand movements, and improve psychological and hand functional recovery.

The experiment is mainly conducted indoors and around the residential community. After the experiment, data are collected by administering the SWLS, SHS, PANAS, PWB, and DASH scales. For specific methods, refer to the literature [47,48,49,50,51].

2.3. Experimental Design

This experiment aims to improve the patient’s hand function, happiness, confidence, and independent living abilities through Happiness Memory Therapy and Positive Creation Mirror Theory. The experiment includes the following three main activities: Leaf Collecting Game, Cooking Potato Chicken Nuggets, and Family Assistance Activity Game. The objectives, detailed process, and expected future impacts of the experiment were explained to the patient, and the experiment commenced after obtaining the patient’s consent and cooperation.

Experiment 1: Leaf Collecting Game

Objective: Train the hand’s pinching ability and improve fine motor skills.

Activities:

• Finding Leaves: The patient searches for leaves from different trees outdoors, especially leaves with insect bites.
• Picking Leaves: Use fingers to pinch and pick the leaves, placing them into a basket.
• Making Bookmarks: After air-drying the collected leaves, make them into bookmarks.
• Criteria for Success: Successfully picking a complete leaf (the affected thumb pad and the pad of the same-side index finger are able to perform a pinching action).

Experiment 2: Cooking Potato Chicken Nuggets

Objective: Train hand pressing and bilateral coordination abilities and boost the patient’s confidence.

Activities:

• Pressing Potatoes: The patient uses the affected hand to press potatoes.
• Cutting: Use the healthy hand to cut the potatoes into pieces.
• Cooking: Follow the patient’s favorite recipe to make potato chicken nuggets.
• Criteria for Success: Successfully preparing a complete dish.

Experiment 3: Family Assistance Activity Game

Objective: Train fine motor skills through daily life activities, enhance confidence, and promote independence.

Activities:

• Household Activities: Actively identify and perform household chores, such as mopping, sweeping, drawing curtains, pouring tea, delivering napkins, distributing utensils, charging mobile phones, cleaning tables, etc.
• Scoring System: Successfully helping earns 5 points, and being helped deducts 5 points, with each person starting at 100 points.
• Game Rewards: At the end of the game, the person with the highest score can make a small, realizable request from the other participants.
• Criteria for Success: Achieving a final score of over 50 points by the tester.

Over a 30-day period, Experiments 1 and 3 were performed daily, with Experiment 3 continuing all day at the patient’s request. Experiment 2 was conducted once a week, totaling four times.

2.4. Data Process

Systematic data collection and analysis of the patient’s training effects ensure the effectiveness and applicability of the training program:

2.4.1. Pre-Test and Post-Test Data Collection

Pre-test: Collect baseline data before the start of the first game session. Daily Measurements: After starting the game experiment, measure data daily and use the average and standard deviation as the final post-test data.

Assessments:

Hand Function: Evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.

Psychological Health and Well-Being: Initially assessed with the Satisfaction with Life Scale (SWLS) [47] and the Subjective Happiness Scale (SHS) [48] to understand the patient’s overall life satisfaction and subjective well-being.

Emotional Experience: Evaluated using the Positive and Negative Affect Schedule (PANAS) [49] to assess changes in positive and negative emotions.

Psychological Well-Being: Evaluated in-depth using the Psychological Well-Being Scale (PWB) [50], with a particular focus on dimensions such as self-acceptance and personal growth.

Hand function was evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire [51].

2.4.2. Data Analysis

The data collected during the experiment were rated based on Likert scale values assigned to questionnaire items. Each questionnaire scale comes with its corresponding score evaluation interpretations. Data analysis was performed using Python 3.12.1.

Descriptive statistical analysis was used to observe the distribution and overall trends of the patient’s mental health. Means, variances, and box plots were utilized to examine data characteristics and differences. Regression analysis employed a linear regression method, with the dependent variable being hand function impairment (DASH), and independent variables being subjective well-being (SWLS), happiness (SHS), positive and negative emotions (PANAS), and psychological well-being (PWB). The regression model was constructed using Ordinary Least Squares (OLS) from Statsmodels to examine the influence of these independent variables on the DASH scores.

The primary aim of the regression analysis was to explore the effect of happiness therapy on hand function within personalized daily gaming contexts by evaluating the impact of each independent variable through regression coefficients (β values) and significance levels (p values). Graphs of residuals, fitted values, and actual values were plotted to visually analyze the impact of the independent variables on the dependent variable.

3. Results

As Experiment 1 progressed, the patient’s grip strength significantly improved, as shown in Figure 4. In Experiment 2, the patient progressed from initially struggling to slice a potato to ultimately successfully preparing potato chicken nuggets. On the 30th day of the third experiment, the patient scored 130 points, the spouse scored 70 points, and the patient was granted an opportunity to make a wish come true.

During the game process, the indicators of well-being and hand function were analyzed using paired t-tests (

Table 1. Pre- and post-data of test.

CATEGORIES	SWLS	SHS	PANAS	PWB	DASH
Pre	10	3	18–41	21	55
Post_Mean (Standard Deviation)	22 (6)	4 (1)	33–26 (8–6)	43 (14)	33 (15)
t	5.12	4.23	5.51–(−3.15)	4.51	−3.42
p	p < 0.001	p < 0.001	p < 0.001–p = 0.003	p < 0.001	p = 0.002
Annotations: - Positive t-value: Indicates that the mean of the post-measurement is greater than the mean of the pre-measurement. - Negative t-value: Indicates that the mean of the post-measurement is less than the mean of the pre-measurement. - p < 0.05: This is a common standard, indicating there is less than a 5% probability that the result is due to chance; thus, the result is considered significant. - p < 0.01: This is a more stringent standard, indicating there is less than a 1% probability that the result is due to chance; thus, the result is considered more significant. - p < 0.001: This is a very stringent standard, indicating there is less than a 0.1% probability that the result is due to chance; thus, the result is considered extremely significant.

) and box plots (Figure 5) of pre- and post-experiment data, achieving a dual “quantitative–qualitative” data analysis. To further examine the impact of happiness on hand function, regression analysis using the least squares method was conducted. The detailed analysis process is described below and shown in Figure 6 and Figure 7 and

Table 2. OLS regression results.

	Coef	Std Err	t	p > |t|	[0.025	0.975]
CONST	60.83	21.58	2.82	0.01	16.28	105.38
SWLS	−2.62	0.58	−4.52	0.00	−3.81	−1.42
SHS	2.57	2.12	1.21	0.24	−1.81	6.94
PANAS Positive	−0.11	0.13	−0.84	0.41	−0.36	0.15
PANAS Negative	0.48	0.42	1.14	0.27	−0.39	1.35
PWB	0.23	0.21	1.10	0.29	−0.20	0.66
R-squared	0.97	Omnibus	0.83	F-statistic		160.5
Adj. R-squared	0.96	Prob (Omnibus)	0.66	Prob (F-statistic)		1.25 × 10−17
Durbin–Watson	1.09	Jarque–Bera (JB)	0.87

Coef: Coefficient; Std err: Standard Error; t: t-Value (t-statistic); p > |t|: p-Value (Probability > t); [0.025 0.975]: 95% Confidence Interval (CI) [Lower Bound 0.025, Upper Bound 0.975]; CONST: Constant; SWLS: Satisfaction With Life Scale; SHS: Subjective Happiness Scale; PANAS_Positive: Positive Affect of the Positive and Negative Affect Schedule; PANAS_Negative: Negative Affect of the Positive and Negative Affect Schedule; PWB: Psychological Well-Being; R-squared: Coefficient of Determination; Adj. R-squared: Adjusted R-squared; Durbin–Watson: Durbin–Watson Statistic; Omnibus: Omnibus Test of Model Coefficients; Prob (Omnibus): Probability of Omnibus Test; F-statistic: F-statistic; Prob (F-statistic): Probability of F-statistic; Jarque–Bera (JB): Jarque–Bera Test.

.

A paired samples t-test was conducted on the pre- and post-experiment data, and the results are shown in Table 1. Significant differences were found between Pre and Post for all variables, indicating significant improvements in both happiness and hand function after the training. Analyzing the changes in mean and standard deviation from Table 1, the results are as follows:

Life Satisfaction (SWLS): t = 5.12, p < 0.001, showing a significant difference, indicating a substantial improvement in life satisfaction.

Subjective Happiness (SHS): t = 4.23, p < 0.001, showing a significant difference, indicating a significant increase in subjective happiness.

Positive Affect (PANAS_Positive): t = 5.51, p < 0.001, showing a significant difference, indicating a significant enhancement in positive emotions.

Negative Affect (PANAS_Negative): t = −3.15, p = 0.003, showing a significant difference, indicating a significant reduction in negative emotions.

Psychological Well-Being (PWB): t = 4.51, p < 0.001, showing a significant difference, indicating a significant improvement in psychological well-being.

Physical Health (DASH): t = −3.42, p = 0.002, showing a significant difference, indicating a significant improvement in physical health.

Combining the paired t-test and boxplot analysis, a dual “quantitative–qualitative” analysis of the data has been achieved. The t-test provides quantitative significance testing, while the boxplot visually supplements qualitative information, making the research results more comprehensive and intuitive.

Figure 5 displays the distributions of SWLS, SHS, PWB, PANAS_Positive, PANAS_Negative, and DASH, leading to the following conclusions:

Overall High Well-being: The median and IQR of SWLS, SHS, and PWB indicate that the overall sample exhibits high levels of satisfaction, subjective happiness, and psychological well-being.

Comparison of Positive and Negative Emotions: The distribution of PANAS_Positive shows significant variability, indicating that the participant’s experiences of positive emotions varied considerably over time. In contrast, the PANAS_Negative scores are more concentrated but with a higher median, suggesting that the participant consistently experienced relatively high levels of negative emotions during the study period.

Health Impairment: The median in the box plot of DASH is relatively low, indicating that the participant generally did not perceive severe health impairments, and the reports of health impairments were relatively consistent.

The analysis of the box plots suggests that the participant generally has good psychological states, with high levels in SWLS, SHS, PWB, and PANAS_Positive, but PANAS_Negative and DASH remain issues that need attention.

Although the paired t-test and box plot analysis have shown significant improvements in well-being and hand function, the specific relationship between well-being and hand function remains unclear. To verify whether well-being can promote the recovery of hand function, further exploration of the interaction effects between well-being and hand function through regression analysis is necessary and important.

Figure 6 examines whether the residuals are randomly distributed around the zero line to assess the validity of the regression model’s assumptions. The observed results show that the residuals are randomly distributed and the red smoothing line is approximately flat, indicating no obvious trends or systematic errors. This suggests that the model assumptions are reasonable and meet the requirements for linear regression.

Figure 7 shows that most data points are close to the diagonal, indicating that the model’s predicted values are very close to the actual values. Although some points may slightly deviate, the overall tight distribution of points suggests that the model has good predictive accuracy. Figure 7 indicates that the regression model performs well in prediction, with most predicted values close to the actual values, verifying the model’s robustness and accuracy.

The results are shown in Table 2:

• The Overall Model Explanation

R-squared (R² = 0.97): This value indicates that the model explains 97% of the variance in the dependent variable, DASH. This means that the model can explain most of the variability in DASH.

Adjusted R-squared (Adj. R² = 0.96): The adjusted R² takes into account the number of predictors in the model and indicates that the model still has strong explanatory power.

F-statistic (F = 160.5, Prob (F-statistic) = 1.25 × 10⁻¹⁷): The result of the F-test is highly significant (p-value is extremely low), indicating that the independent variables, as a whole, have a significant effect on the model.

2.

Regression Coefficients and Significance Levels

Constant (const = 60.83): This represents the predicted value of DASH when all independent variables are zero.

Life Satisfaction (SWLS = −2.62, p < 0.001): Life satisfaction is significantly negatively correlated with DASH. For each unit increase in SWLS, DASH is reduced by approximately 2.62 units. This indicates that higher life satisfaction is associated with lower DASH levels.

Subjective Happiness (SHS = 2.57, p = 0.24): There is no significant linear relationship between subjective happiness and DASH, with a p-value of 0.24 (greater than 0.05), indicating that this variable is not significant in the model.

Positive Affect (PANAS_Positive = −0.11, p = 0.41): Positive affect negatively impacts DASH, but this relationship is not significant with a p-value of 0.41. This suggests that while positive affect might reduce DASH, this effect is not statistically significant.

Negative Affect (PANAS_Negative = 0.48, p = 0.27): Negative affect has a positive but non-significant impact on DASH, with a p-value of 0.27. This indicates no significant linear relationship between negative affect and DASH.

Psychological Well-Being (PWB = 0.23, p = 0.29): There is also no significant linear relationship between psychological well-being and DASH, with a p-value of 0.29. This shows that psychological well-being does not have a significant impact on DASH.

Through detailed analyses shown in Figure 6 and Figure 7, the regression model’s performance in explaining the variability of DASH can be further confirmed. The residual plots indicate that the model assumptions are reasonable, and the fitted value plots demonstrate the model’s high predictive accuracy. These graphs further validate the model’s applicability and effectiveness in regression analysis.

The regression analysis indicates that life satisfaction (SWLS) is the most significant variable, having a notable negative effect on DASH. Although other variables affect DASH, their impacts are not statistically significant. Overall, the model is robust and provides a comprehensive insight, explaining the variability in DASH effectively.

4. Discussion

4.1. Compare Data for PRE and POST

The purpose of this experiment is to evaluate the effectiveness of Happiness Memory Therapy in producing a sense of well-being and the impact of personalized daily life games designed based on Positive Creation Mirror Theory on the patient’s hand function. The blue dots are closely clustered around the 45-degree diagonal line, suggesting that the model’s predictions are very close to the actual scores. This high concentration near the ideal line indicates that the regression model has a high level of accuracy in predicting the outcomes, demonstrating its effectiveness and reliability in estimating hand function impairment (DASH scores) based on the given independent variables, as shown in Figure 5. By comparing pre-intervention (PRE) and post-intervention (POST) data, we observed significant positive effects across multiple aspects as shown in Table 1.

• Subjective Well-Being (SWLS)

The SWLS score increased from 10 before the intervention (PRE) to 22 after the intervention (POST), showing a marked improvement. This indicates that the interventions had a clear positive impact on enhancing an individual’s life satisfaction. This finding is consistent with the study by Feigin et al. [1], which demonstrated the effect of psychological interventions on life satisfaction. Our study further validates the effectiveness of psychological counseling and lifestyle adjustments in improving life satisfaction.

2.

Happiness (SHS)

The SHS score increased from 3 before the intervention to 4 after the intervention, showing a slight improvement. This suggests that the interventions somewhat enhanced the individual’s happiness, but a more extended period or stronger interventions might be needed to see more substantial effects. This is in line with the findings by Zhang et al. [2], who studied the adherence to functional exercises in young and middle-aged patients with hemorrhagic stroke. This implies that, while short-term effects may be minimal, long-term interventions might lead to greater improvements.

3.

Positive and Negative Affect (PANAS)

The positive affect score in PANAS increased from 18 pre-intervention to 33 post-intervention, while the negative affect score decreased from 41 pre-intervention to 26 post-intervention. This indicates that the interventions significantly increased positive emotions and reduced negative emotions. This result is consistent with the study by Wang et al. [23] on the application of emotion management techniques in rehabilitation. Our study demonstrates that emotion management techniques and psychological interventions have significant effects in emotional regulation.

4.

Psychological Well-Being (PWB)

The PWB score significantly improved from 21 before the intervention to 43 after the intervention, showing a notable increase in psychological well-being. This suggests that the interventions effectively enhanced aspects of psychological well-being, such as resilience, self-acceptance, and a sense of life purpose. This is consistent with the findings by Mathew et al. [24] on the impact of psychological interventions on psychological well-being.

5.

Hand Function Disability (DASH)

The DASH score decreased from 55 pre-intervention to 33 post-intervention, indicating a significant improvement in hand function disability. This suggests that the interventions were very effective in restoring hand function, reducing pain, and improving the ability to perform daily activities. This result aligns with the study by Xie et al. [25] on the improvement of upper limb function after stroke through brain–machine interface training.

4.2. Regression Analysis

As depicted in Figure 6 and Figure 7 and Table 2, the overall model fit was high (R-squared = 0.971). The p-value for SWLS was <0.001, indicating that SWLS had a significant negative impact on DASH (β = −2.62, p < 0.001). This means that higher life satisfaction is associated with lower hand function disability. This suggests that improvements in life satisfaction may contribute to hand function recovery. Other variables (SHS, PANAS Positive, PANAS Negative, PWB) did not show significant effects on DASH, warranting further research to confirm their significance.

The results of the experiment demonstrate that the combined use of Happiness Memory Therapy and Positive Creation Mirror Theory has significant positive effects on enhancing happiness, positive psychology, reducing negative emotions, and improving hand function disability. These results support the effectiveness of comprehensive intervention measures, indicating that combining psychological and emotional interventions can significantly improve overall well-being and functional status.

However, the limitations of the personalized daily hand movement training method mainly lie in variable selection, the influence of external factors, and generalizability. To overcome these limitations, future research could further explore the specific mechanisms of Happiness Memory Therapy and Positive Creation Mirror Theory and how to optimize comprehensive intervention programs for more lasting and significant effects. Increasing sample sizes and extending follow-up periods can also help validate the generalizability and long-term effects of these findings. By deeply studying the interactions of these psychological intervention methods, we can better understand and track changes in happiness and hand function during rehabilitation to improve quality of life.

5. Conclusions

This study aims to propose a method for generating personalized daily life hand movement training, allowing patients to engage in rehabilitation training while experiencing happiness. The gamified training method significantly improved individual subjective well-being (SWLS), enhanced happiness (SHS), increased positive emotions and reduced negative emotions (PANAS), significantly boosted psychological well-being (PWB), and improved hand function disability (DASH). These results demonstrate that the training method is highly effective in enhancing individuals’ sense of happiness and hand rehabilitation exercise. They also validate the effectiveness of combining Happiness Memory Therapy and Positive Creation Mirror Theory in generating personalized daily life hand movement training.

These significant positive effects indicate that combining psychological and emotional interventions can substantially improve individuals’ quality of life and mental health. Future research should further explore the specific mechanisms of these interventions, increase sample sizes, extend follow-up periods, and optimize comprehensive intervention programs. By deeply studying the interactions of these psychological intervention methods, we can better understand and apply these theories to enhance individuals’ happiness and quality of life.