This paper presents a system to deliver automated, noninvasive, and effective fine motor rehabilitation through a rhythm-based game using a Leap Motion Controller. The system is a rhythm game where hand gestures are used as input and must match the rhythm and gestures shown on screen, thus allowing a physical therapist to represent an exercise session involving the user's hand and finger joints as a series of patterns. Fine motor rehabilitation plays an important role in the recovery and improvement of the effects of stroke, Parkinson's disease, multiple sclerosis, and more. Individuals with these conditions possess a wide range of impairment in terms of fine motor movement. The serious game developed takes this into account and is designed to work with individuals with different levels of impairment. In a pilot study, under partnership with South West Advanced Neurological Rehabilitation (SWAN Rehab) in Phoenix, Arizona, we compared the performance of individuals with fine motor impairment to individuals without this impairment to determine whether a human-centered approach and adapting to an user's range of motion can allow an individual with fine motor impairment to perform at a similar level as a non-impaired user.