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Game Over for Pain – The Healing Power of Video Games in Physical Therapy

 

Video games have long been associated with mindless entertainment and the sedentary lifestyle, but what if we told you that video games can actually be a valuable tool in the process of rehabilitation? It may sound counterintuitive, but numerous studies have shown that video games can improve cognitive and physical function, enhance motor skills, and even help with pain management. Whether you’re recovering from an injury or dealing with a chronic illness, video games may just be the prescription you need to speed up your recovery and get back to your normal life. In this article, we’ll explore the science behind video game therapy and examine some of the most effective games for rehabilitation. So put down that controller and read on to discover how video games can be a game-changer in the world of rehabilitation.

There is a major concern in rehabilitation that patients are not meeting the sufficient “dosage” of movements required to induce neuroplastic adaptations underlying behavioral improvement. An argument can be made that motion-controlled video games are an appealing avenue of research to augment therapy, because using rehabilitation-relevant movements in the context of an engaging and motivational game can potentially augment the dosage of therapy. Gameplay can induce desirable behavioral and physiological changes. Interdisciplinary evidence suggests that specific game mechanics/design principles increase motivation and engagement, increasing the amount of time players/patients are willing to spend in the game. 

 

So, in what type of conditions can we utilise video games for rehabilitation? Fortunately, many!

    1. Stroke –  Video games have been shown to be an effective tool for stroke rehabilitation, improving both physical and cognitive function and providing a more engaging and enjoyable rehabilitation experience for patients. In one study, the use of the Nintendo Wii led to significantly improved motor function in participants within 6 months of stroke. Positive results associated with playing Wii (upper limb exercises) were seen in poststroke participants after six 30-minute sessions. There was also a significant increase in Fugl-Meyer and Motricity Index scores, and participants had a desire to continue the therapy as a part of their rehabilitation and to recommend it to others, reporting that they felt it was at least as useful as conventional therapy. Increased enjoyment and desire to continue using the gaming system has also been reported. The Wii controller has also been used in a biofeedback platform to reduce unwanted compensatory movements during exercise in participants poststroke, eg, twisting at the trunk to move the hand to the midline rather than transverse adduction at the shoulder. A punishment/reward system discouraged compensation and encouraged “good” motions. This biofeedback motivated participants to reduce their compensatory movements and improved the quality of movement in the more-affected limb.
  • Cerebral Palsy –  video games can help children with cerebral palsy is by improving their motor function. Games that require movement and coordination can help to strengthen weak muscles and improve balance and coordination. For example, games that use motion controls or require the player to perform specific movements, such as jumping or kicking, can be especially beneficial. Video games can also help to improve hand-eye coordination and fine motor skills, which can be particularly helpful for children with cerebral palsy who struggle with tasks such as writing or using utensils. Games that involve precise movements, such as drawing or tracing shapes, can help to improve these skills. In addition to physical benefits, video games can also be used to improve cognitive function in children with cerebral palsy. Games that challenge memory, attention, and problem-solving skills can help to improve these areas of cognitive function, which can have a positive impact on overall academic performance.
  • Sports – By using video games, athletes can engage in a form of active recovery that not only speeds up the healing process but also maintains their physical fitness and improves their mental focus. One of the most significant benefits of video game rehabilitation in sports is its ability to simulate the movements and challenges of the athlete’s sport. By using games that focus on movements specific to their sport, athletes can practice these movements in a controlled environment, reducing the risk of re-injury while still getting a workout. Video games can also be used to help athletes maintain their physical fitness while they recover from an injury. For example, games that require the player to engage in physical activity, such as dancing or boxing games, can be used to maintain cardiovascular fitness, muscle tone, and flexibility.
  • Parkinsonism –  The Wii helps in the rehabilitation of Parkinson’s disease by improving hand-eye coordination and fine motor skills. Games that require precise movements, such as pointing, aiming, or tracing, can help to improve these skills, which can be particularly helpful for individuals with Parkinson’s who experience tremors or difficulty with fine motor movements. The Wii can also help to improve balance and coordination, which can be a significant challenge for individuals with Parkinson’s disease. Games that involve movements such as stepping or swaying can help to improve balance and reduce the risk of falls, which is a common concern for those with Parkinson’s. In a study investigating home based training on the Wii balance board for people with Parkinson’s disease, improvements in static and dynamic balance were recorded.

 

In recent years the integration of gaming system technologies in the field of rehabilitation has been expanding. The use of gaming systems as a treatment strategy incorporates essential elements of motor learning. When used as a rehabilitation tool, gaming systems provide, not only real time practice of tasks and activities, but opportunities to engage in intensive, meaningful, enjoyable and purposeful tasks related to real-life environment. Physical activity in these games includes a great deal of movements and tasks that involves a wide range of sensory feedback; adjustable movement amplitudes, speed, and precision levels; and incorporation of a variety of visual-spatial, cognitive, and attention tasks. The practice of these activities may be promising as it may increase participation and motivation during therapy and can be used as part of the home therapy program. Various low-cost commercial gaming systems and game packages are available for use as rehabilitation tools. The role of clinicians is essential in prescribing and promoting the use of gaming systems as they relate to patients’ physical function and wellness. A major responsibility of clinicians is to select and educate patients on use of gaming systems that are safe and appropriate for the patients’ goals and needs. Clinicians should consider dosing intensity of training and the balance between practicing tasks using gaming systems and practicing functional tasks outside the simulated environment. Selection and progression of training should allow transfer of training from the simulated environment to the real-life environment.

In conclusion, video game rehabilitation has shown to be a promising tool in helping individuals with various conditions, including stroke, cerebral palsy, and Parkinson’s disease, among others. It can provide a fun and engaging way for patients to improve their physical and cognitive abilities while also reducing the stress and anxiety associated with traditional therapy exercises. 

However, it is important to note that the evidence regarding the effectiveness of video game rehabilitation is still lacking. More research is needed to fully understand its benefits, limitations, and how it can best be incorporated into traditional rehabilitation programs.

Nonetheless, the current evidence suggests that video game rehabilitation can be a useful tool in rehabilitation, particularly in motivating patients to participate in their therapy and providing a more enjoyable experience. While it may not replace traditional rehabilitation techniques, it can certainly serve as an adjunctive therapy option that can help patients achieve their goals and improve their quality of life.

Therefore, it is important for healthcare professionals and researchers to continue exploring the potential benefits of video game rehabilitation and to develop innovative ways of incorporating this technology into rehabilitation programs.

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