Video games and rehabilitation: using design principles to enhance engagement in physical therapy.

Lack of patient adherence with therapy is a major barrier to rehabilitation. Recovery is frequently limited and requires prolonged, intensive rehabilitation that is time-consuming, expensive, and difficult. The authors review evidence for the potential use of video games in rehabilitation with respect to the behavioral, physiological, and motivational effects of gameplay. This Special Interest article offers a method to evaluate effects of video game play on motor learning and their potential to increase patient engagement with therapy, particularly commercial games that can be interfaced with adapted control systems. It takes the novel approach of integrating research across game design, motor learning, neurophysiology changes, and rehabilitation science to provide criteria by which therapists can assist patients in choosing games appropriate for rehabilitation. Research indicates that video games are beneficial for cognitive and motor skill learning in both rehabilitation science and experimental studies with healthy subjects. Physiological data suggest that gameplay can induce neuroplastic reorganization that leads to long-term retention and transfer of skill; however, additional clinical research in this area is required. There is interdisciplinary evidence suggesting that key factors in game design, including choice, reward, and goals, lead to increased motivation and engagement.

The authors maintain that video game play could be an effective supplement to traditional therapy. Motion controllers can be used to practice rehabilitation-relevant movements, and well-designed game mechanics can augment patient engagement and motivation in rehabilitation. The authors suggested future research and development exploring rehabilitation-relevant motions to control games and increase time in therapy through gameplay.