"It Depends": Re-Authoring Play Through Clinical Reasoning in Wearable AR Rehab Games

Augmented reality (AR) games hold promise for rehabilitation, yet most remain confined to laboratory studies with limited clinical uptake. Recent advances in spatial computing, especially lightweight, glasses-form-factor AR, create a timely opportunity to embed rehabilitative play into clinical practice and daily contexts. To investigate this potential, we systematically reviewed 132 applications and conducted playtesting with 14 licensed physical therapists. Our analysis revealed three ways therapists re-authored AR games: co-authored play (reshaping movements, progressions, and difficulty), situated play (adapting across specialties, conditions, and contexts), and dual play (mediating both physical recovery and psychological support). We reframe therapists’ frequent phrase—“It depends”—as a generative design principle. This study contributes a clinical reasoning–based framework and design principles and guidelines for creating personalized, situated forms of play that align with therapists’ everyday workflows and inform future lab-to-clinic translation.