The Use of Gaming for Occupational Therapy Rehabiltation

Introduction

Occupational therapy and gaming can be used together to improve patients’ physical, cognitive, and social abilities. Gamification is the process of using game design elements and mechanics in non-game contexts, such as education, healthcare, business, or government, to engage and motivate people to achieve their goals. This can include elements such as points, badges, leaderboards, and virtual rewards, which can be used to encourage participation, engagement and positive behavior change. Gamification can be used in therapy to motivate patients to engage in their recovery process and adhere to their treatment plans.

Properties of Gamification for Occupational Therapy

  • Progress tracking: Therapists can use gamification elements such as points, badges, and leaderboards to help patients track and visualize their progress over time. This can help to build motivation and engagement, as patients can see their progress and achieve a sense of accomplishment.
  • Rewards and incentives: Therapists can use virtual rewards and incentives to encourage patients to complete therapy exercises or reach specific goals. For example, patients can earn virtual points or badges for completing a certain number of therapy sessions or reaching a specific level of progress.
  • Virtual environments: Therapists can use virtual reality or game-based environments to create immersive and interactive simulations of daily tasks and activities. This can help patients to practice and improve their skills in a safe and controlled environment.
  • Game-based assessments: Therapists can use games and virtual reality to assess patients’ abilities and progress, such as measuring reaction time, balance, or coordination. This can provide a more objective and quantitative measure of a patient’s abilities compared to traditional assessment methods.
  • Customized therapy: Therapists can work with game developers to create customized games that are tailored to specific patient needs, such as fine motor skill development or cognitive rehabilitation.
  • Self-monitoring: Gamification can be used to encourage patients to self-monitor their progress and track their own goals. For example, using a mobile app that allows patients to log their therapy exercises, track their progress, and set personalized goals can be a good way to encourage patients to take ownership of their recovery process.
  • Social interaction: Gamification can be used to create a sense of community and social interaction among patients. For example, by creating a leaderboard or a competition among patients, it can encourage patients to work together and support each other in their recovery process.
  • Personalization: Gamification can be used to personalize therapy and make it more engaging for patients. For example, by allowing patients to choose their own virtual avatars or customize their own virtual environments, it can make therapy more interesting and motivating.
  • Motivation and engagement: Gamification can be used to increase motivation and engagement in therapy. For example, by using virtual rewards and incentives, it can encourage patients to complete therapy exercises and reach specific goals.
  • Feedback and progress: Gamification can be used to provide immediate feedback and progress updates, which can help to increase motivation and engagement. For example, using games that provide real-time feedback on the patient’s performance can help to improve their skills and progress faster.

Occupational Therapy Uses of Games

Occupational therapists can use gaming as a form of leisure and recreation for patients. This can help patients to relax, reduce stress, and improve their overall well-being. Different games can be developed and used based on individual interests, preferences, and hobbies.

Occupational therapists can use games and virtual reality to assess patients’ abilities and progress, such as measuring reaction time, balance, or coordination. This can provide a more objective and quantitative measure of a patient’s abilities compared to traditional assessments methods.

Gaming can be used to help patients recover from specific conditions such as stroke, traumatic brain injury, or amputation. Virtual reality and games can be used to create simulations of daily tasks and activities, which can help patients practice and improve their skills in a safe and controlled environment.

Specific uses of gaming for occupational therapy include:

  1. Motor skills development: Games that require fine motor control, such as puzzle games or rhythm games, can be used to help patients improve their dexterity and hand-eye coordination.
  2. Cognitive skills development: Games that require problem-solving, memory, or attention, such as strategy games or memory games, can be used to help patients improve their cognitive abilities.
  3. Social skills development: Games that require communication, collaboration, or teamwork, such as multiplayer games or role-playing games, can be used to help patients improve their social skills.
  4. Emotional regulation: Games that incorporate mindfulness or relaxation techniques, such as meditation games or virtual reality games, can be used to help patients manage stress, anxiety, or depression.
  5. Virtual reality rehabilitation: Virtual reality games and simulations can be used to create immersive and interactive environments that can be used to help patients improve their physical and cognitive abilities, as well as emotional regulation.
  6. Therapeutic games: Occupational therapists can use specific games that are designed to target specific physical or cognitive skills, such as memory, balance, coordination, or fine motor skills.
  7. Gaming as motivation: Gaming can be used as a form of motivation for patients, making therapy sessions more engaging and fun, which can lead to better adherence to treatment plans and better outcomes.
  8. Telehealth: With the increasing use of technology in healthcare, occupational therapists can use virtual reality and gaming to deliver therapy remotely, making it more convenient and accessible for patients.
  9. Accessibility: Gamification can be used to make therapy more accessible to a wider range of patients, especially those who may have difficulty engaging in traditional therapy methods. For example, using virtual reality or mobile apps can make therapy more convenient and accessible for patients who have mobility issues or live in remote areas.
  10. Cost-effectiveness: Gamification can be a cost-effective solution for therapy, as it can be used to deliver therapy remotely, reducing the need for in-person visits. Additionally, using games and virtual reality can help to reduce the need for expensive equipment and materials.
  11. Adherence: Gamification can be used to improve adherence to treatment plans, as it can make therapy more engaging and enjoyable for patients, which can lead to better outcomes.
  12. Re-engagement: Gamification can be used to re-engage patients who may have dropped out of therapy or lost motivation. For example, by using games or virtual reality, it can make therapy more interesting and engaging for patients and encourage them to continue with their treatment.

Popular Use with Nintendo Wii

Wiihabilitation, also known as Wii rehab, is the use of the Wii gaming system for physical rehabilitation and therapy. This can include the use of games and controllers to improve balance, strength, coordination, and range of motion for individuals recovering from injuries or illnesses. It can also be used for patients with neurological conditions, such as stroke or Parkinson’s disease. The interactive and engaging nature of the Wii system can make therapy more enjoyable and effective for patients, and can be used in both inpatient and outpatient settings. It has been well-studied in the research and been used widely in settings such as SNFs. It’s current use may be less popular compared to before.[1]Gargin, O. T. R., & Pizzi, O. T. R. (2010). Wii-HAB: Using the Wii video game system as an occupational therapy intervention with patients in the hospital setting. Population Health Matters … Reference List[2]Herz, N. B., Mehta, S. H., Sethi, K. D., Jackson, P., Hall, P., & Morgan, J. C. (2013). Nintendo Wii rehabilitation (“Wii-hab”) provides benefits in Parkinson’s disease. Parkinsonism … Reference List[3]Anderson, F., Annett, M., & Bischof, W. F. (2010). Lean on Wii: physical rehabilitation with virtual reality Wii peripherals. Stud Health Technol Inform, 154(154), 229-34. Some examples of the popular video game console in rehabilitation include:

  • Stroke recovery: The Wii system can be used to help stroke patients improve their balance, coordination, and fine motor skills.
  • Parkinson’s disease: The Wii system can be used to help patients with Parkinson’s disease improve their balance, coordination, and overall mobility.
  • Arthritis: The Wii system can be used to help individuals with arthritis improve their range of motion and decrease pain.
  • Orthopedic injuries: The Wii system can be used to help individuals recovering from orthopedic injuries such as a broken bone, to improve their strength and coordination.
  • Balance training and fall prevention: Wiihabilitation can be used to help older adults improve their balance and prevent falls.

Virtual Reality (VR) Gaming

Virtual reality (VR) rehabilitation is a type of therapy that uses virtual reality technology to create interactive and immersive environments for patients to engage in rehabilitation exercises. VR technology can be used to simulate a wide range of environments and tasks, such as walking on a beach or climbing stairs, which can help patients improve their balance, coordination, and overall mobility. Studies have shown their uses with burn patients, those with chronic pain, stroke and much more.[4]Laver, K. E., Lange, B., George, S., Deutsch, J. E., Saposnik, G., & Crotty, M. (2017). Virtual reality for stroke rehabilitation. Cochrane database of systematic reviews, (11).[5]Howard, M. C. (2017). A meta-analysis and systematic literature review of virtual reality rehabilitation programs. Computers in Human Behavior, 70, 317-327.

It’s important to note that VR rehabilitation technology is relatively new and requires further research to fully understand its potential and limitations. It is also not very widely adopted, despite efforts by major companies such as Meta to implement it in things like the metaverse. It’s also important to note that VR rehabilitation should be used in conjunction with other forms of therapy, such as physical therapy, occupational therapy, and speech therapy, to maximize the benefits and results.

Some of the challenges with VR rehabilitation include:

  • Cost: VR systems can be expensive and may not be accessible to everyone.
  • Patient’s comfort: Some patients may experience discomfort or motion sickness while using VR systems.
  • Training and Expertise: VR systems may require special training and expertise to set up and operate.

VR rehabilitation has a potential as a tool for improving physical and cognitive function in patients recovering from injuries or illnesses, but it is only one tool and further research is needed to fully understand its potential and limitations.

Accessibility and Access

There are considerations for how a patient will interact with the game and access them both physically, cognitively, and psychosocial. Video game accessibility refers to the design and development of video games to make them more inclusive and accessible to a wide range of players, including those with disabilities. This can include features such as customizable controls, audio cues, and text-to-speech options to make games more accessible to players with visual, auditory, or motor impairments.

Here are a few examples of how video game accessibility can be used:

  1. Customizable controls: Video game developers can create customizable controls that allow players to adjust the layout and function of buttons, joysticks, and other input devices to suit their individual needs. This can help players with motor impairments to play games more comfortably and easily. More manufacturers and even DIY projects are introducing this technology to the masses.
  2. Audio cues: Video game developers can include audio cues that provide information about the game’s environment, such as the location of enemies or the presence of obstacles. This can help players with visual impairments to navigate the game more easily. Cues vary depending on listening preferences, tolerances, and sensitivities.
  3. Text-to-speech options: Video game developers can include text-to-speech options that can read out the game’s dialogue and other text, which can help players with visual impairments to understand the game’s story and gameplay. This technology can also use AI to improve communication and usability.
  4. High contrast mode and color blind mode: Video game developers can include high contrast mode and color blind mode that can help players with visual impairments to see the game more clearly and distinguish between different colors. This depends on the individual needs of the patient.
  5. Subtitles and closed captions: Video game developers can include subtitles and closed captions for dialogue and other audio, which can help players with auditory impairments to understand the game’s story and gameplay. This should be an important consideration for games for the general public and in rehabilitation.
  6. Remappable buttons: Video game developers can include the ability to remap buttons on the controller, which can help players with motor impairments to play games more comfortably and easily. The more customizability the better for the user.
  7. Assistive technology: Video game developers can support assistive technology such as switch controllers, eye-tracking, and speech-to-text, which can help players with a wide range of disabilities to play games. This technology can be combined to increase access, use, engagement, and feedback such as biofeedback.

Ongoing Development & Considerations

Occupational therapists can also work with game developers to create customized games that are tailored to specific patient needs, such as fine motor skill development or cognitive rehabilitation.

While gaming can be a valuable tool in occupational therapy, it is important to consider the individual needs and preferences of the patient. Occupational therapists should also consider the potential risks, such as gaming addiction, and monitor patients’ progress and adjust their treatment plans accordingly.

References

References
1 Gargin, O. T. R., & Pizzi, O. T. R. (2010). Wii-HAB: Using the Wii video game system as an occupational therapy intervention with patients in the hospital setting. Population Health Matters (Formerly Health Policy Newsletter), 23(1), 4.
2 Herz, N. B., Mehta, S. H., Sethi, K. D., Jackson, P., Hall, P., & Morgan, J. C. (2013). Nintendo Wii rehabilitation (“Wii-hab”) provides benefits in Parkinson’s disease. Parkinsonism & related disorders, 19(11), 1039-1042.
3 Anderson, F., Annett, M., & Bischof, W. F. (2010). Lean on Wii: physical rehabilitation with virtual reality Wii peripherals. Stud Health Technol Inform, 154(154), 229-34.
4 Laver, K. E., Lange, B., George, S., Deutsch, J. E., Saposnik, G., & Crotty, M. (2017). Virtual reality for stroke rehabilitation. Cochrane database of systematic reviews, (11).
5 Howard, M. C. (2017). A meta-analysis and systematic literature review of virtual reality rehabilitation programs. Computers in Human Behavior, 70, 317-327.
Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.