Innovative toys turn hand therapy into a more enjoyable and effective experience for children with cerebral palsy

Although effective hand therapy programs such as Constraint-Induced Movement Therapy and bimanual training are available in clinical settings, they often do not sufficiently align with the everyday realities of families. Exercises are frequently repetitive, time-consuming, and heavily dependent on guidance from parents or caregivers, which can negatively affect the motivation of both children and caregivers.

All children are different and deserve a personalized, but also enjoyable, play experience. With Toys4Therapy, I let children play in a way where the game itself stimulates the hand movements required for their therapy, helping to prevent boredom.

Pinos Cisneros’ research focuses on bridging the gap between clinically designed therapies and the lived experiences of families. Using a Research through Design approach, she combines insights from rehabilitation science, game theory, motivation theory, and human–computer interaction. Design is not only the result, but also a means of generating new knowledge about how therapy can better fit into daily life.

Central to the dissertation is Magic Monster, a smart therapeutic toy that transforms prescribed hand movements into playful interaction. By using sensors and machine learning techniques, the toy automatically adapts to the child’s abilities and provides feedback and feedforward. This results in a form of self-adaptive game complexity, in which challenge and enjoyment remain in balance.

Field studies conducted in families’ homes show that this playful, adaptive approach helps children stay engaged with their therapy, while the role and burden of parents do not increase.

The dissertation concludes with the Smart Toy–CTT (Context–Therapy–Technology) Framework. This framework offers designers, researchers, and healthcare professionals a structured approach to developing smart therapeutic technologies that fit within everyday family life. As such, the research contributes not only to design research and digital health but also to the practice of pediatric rehabilitation.

Tamara Pinos Cisneros will publicly defend her dissertation, “Toys4Therapy: Designing Playful Smart Toys to Support Home-Based Hand Therapy for Children with Cerebral Palsy,” on Friday, 6 February 2026, at the University of Twente.