How to complete the Assisted Bicep Curl: (Assisted Elbow Flexion and extension Exercise) Game co-designed with a stroke survivor and guided by upper limb rehabilitation practice and music-based therapy principles. Aim This game facilitates an Assisted Bicep Curl movement, using the non-paretic arm to support and guide the paretic arm through a controlled elbow flexion-extension pattern. The game features original music that synchronises each section of the movement to a musical note, promoting fluidity of movement when repeated. Objectives To improve elbow flexion and extension range, strength, and control.To provide progressive challenge through music and different gaming levels.  To guide the paretic arm through a flexion and extension 'range of motion'.  Suitable for: Stroke survivors with severe hemiparesis. Guided levels: Beginner (Level 1): ~40 repetitions Intermediate (Level 2): ~100 repetitions Advanced (Level 3): up to 300 repetitions ​ Overview The Assisted Bicep Curl is a bilateral exercise where the clasped hands allow the non paretic arm to support the movement of the paretic arm, without needing to  bear the weight of the arm as both arms are supported by the table.  The forearms engage in elbow flexion and extension with the music guiding pacing and repetition. How to Perform the Assisted Bicep Curl Preparation Sit upright at a table. Gently clasp hands together, allowing time  previously to stretch or massage the paretic hand so it is easier to clasp (a stroke survivor with severe hemiparesis  and spasticity can take 5-10 minutes to enable this to occur).   Movement 1: Elbow Flexion – Arm Lift -With hands clasped, place both elbows on the table, shoulder-width apart. -Begin with your clasped hands resting on the switch. -Lift your hands toward your chin by bending the elbows, maintaining elbow contact with the surface. -Keep the wrists in neutral and avoid rotating the arms. Movement 2: Elbow Extension – Return to Start. -Lower your hands slowly and with control, returning them to the switch or start point. Avoid quick or jerky movements — let the music guide the timing. Gaming and Musical Integration Music guides the movement through structured note patterns: Beginner & Medium Level – A4-Note Pattern facilitates a slow transition from the table to the chin. Note 1: Hands touch the switch (start position) Note 2: Arms halfway up Note 3: Hands reach chin (peak of movement) Note 4: Arms halfway back down. (see example video below) This supports slow, focused movement, helping participants stay in control throughout the lift and return. Harder Level – 2-Note Pattern Note 1: Touch the switch Note 2: Reach the chin This fast-paced level runs for 10 minutes, offering up to 300 repetitions. It’s ideal for users with developed strength and endurance. Only attempt this level when confident in form and stamina! ​ ​Tips for Best Results Focus on form over speed — precision is key to improving control. Support the affected arm without overcompensating with the stronger side. Expect muscle and mental fatigue during longer sets, however the music and the gamification should enable you to complete high repetitions! If pain occurs, stop immediately and seek guidance. As you progress, you may begin to bear more weight through the paretic limb — begin gradually.  There is progressional possibilities  to add wrist or hand weights to this exercise, extend the game repetitions, repeat the games to achieve therapeutic dosage of exercises. Clinical Application This exercise supports  strengthening, and neuroplasticity. It is ideal for use for stroke survivors with severe hemiparesis•  Neurologic Music Therapy (NMT) – through Patterned Sensory Enhancement (PSE) and Rhythmic Auditory Stimulation (RAS) Early functional strengthening and range-of-motion training Music: RebeccaColclasure Gaming Platform: Stepmania