How to complete the Rooftop Exercise (Simultaneous MP Joint Flexion and IP Joint Extension) Game developed through co-design with a stroke survivor and refined from stroke rehabilitation clinical references: Royal Berkshire NHS (2024) Colditz (2015)​ Aim To promote fine motor control, range of motion, and coordination of the fingers through a rhythmic hand movement supporting ADL's like reaching, pressing, and grasp preparation. Gaming context brings gamifcation to the exercise, with music regulating the timing and spacing of movement. Different levels will feature different number of repetitions and length of game. Overview The Rooftop Exercise targets the metacarpophalangeal (MP) and interphalangeal (IP) joints of the fingers, encouraging the  palm  to lift lift while the fingers remain extended and in contact with a surface.  How to Perform the Rooftop Exercise 1.    Sit at a table with your forearm resting on the surface. 2.    Place the switch beneath your palm and possibly a sheet of paper underneath the fingers to allow the fingers to slide naturally during the exercise 3.    Allow your hand rest naturally on the table. 4.    If necessary, stabilise the thumb using your opposite hand to encourage finger isolation. 5.    Begin by flexing at the MP joints (base of the fingers) to draw the knuckles inward, lifting the heel of the palm off the table to create a ‘rooftop or tent’ position,  while keeping the fingers extended and in contact with the surface. 6.    Press your palm back down onto the switch or sensor, achieving full contact to activate a click during the game and match the click press to the arrow on the screen. 7.    Repeat the motion rhythmically with the music and with control. Gaming and Musical Integration •A guitar chord signals the press down motion on the first beat of each bar. This guitar chord will repeat every 8 beats.  After the guitar chor, lift the palm and begin the next cycle.. This auditory structure helps entrain smoother, more natural transitions and supports sensorimotor timing. Practise will make perfect! Tips for Best Results •    Perform each repetition in time with the music and concentrate on the quality of the movement •    Don’t worry about not clicking the switch in time, this is a game – so will improve with practise! •    Keep the shoulders relaxed and avoid upper arm tension. •    Emphasise a fluid movement as you transition between lift and press. Music: RColclasure Gaming Platform: Stepmania Exercise Level Design: Co-design between RColclasure and stroke survivors