One of the main criticism of conventional rehabilitation is its deficiency in eliciting patient involvement and engagement which leads to poor outcome. The monotonous nature of rehabilitation requires the repetition of movements. Even though these repetitions can be demotivating, they are critical to the patient's therapy. Virtual reality and games are considered to address this issue, where a virtual reality based serious game for arm rehabilitation using a wearable robotic exoskeleton was developed and tested. The underlying framework that allows the interplay of the various hardware blocks is reviewed and described with relevant details. The serious game allows accurate reconstruction of the user arm in an immersive reality experience. Using this approach will engage the patient and reduces the overall rehabilitation time saving cost for both the patient and the health services. © 2017 IEEE.