Play seriously: systematic review of effectiveness of active video games in physical rehabilitation

Abstract

Background: “Gamification†in health promotion has obvious potential for development. The study aim was to assess physical functioning, adherence to treatment and the use of empirically-based behavioral change strategies in serious gaming for physical rehabilitation. Method: A literature search was performed on ISI WOS, PubMed, PsychInfo, Cochrane, and Health Game Research Portal. The criteria for inclusion were: age >18; physical rehabilitation (following stroke/injury/other impairing incident, targeting limb and/or muscle training), met at least two games features, measures of adherence were present. The primary outcome were measures of mobility-related physical functioning. Game contents were coded following the health behavior change taxonomy. Secondary outcomes included adherence and satisfaction with treatment. Findings: The results were inconclusive regarding long-term efficiency (also in terms of adherence) of serious games in physical rehabilitation, due to variability of quality and otcomes of studies. Most of them are not empirically or theoretically driven so there is little insight on the change mechanisms incurred by active gaming. Discussion: Serious games may be promising outlets for interventions if they are based on solid empirical research and change mechanisms are pinpointed.