Getting fit is child’s play: Gamification in rehabilitation and physiotherapy

More and more people love to play games – and do so on a regular basis by using a video game console or their cell phones. An opinion poll by the GfK research institute from last year shows that games cast a big spell on all age groups. It’s no surprise that a growing number of rehabilitation and physiotherapy concepts include game design elements to pursue recovery goals.

"Gamification" is the name of a process in which game design concepts are integrated into activities that are actually not a game. This includes aspects like point systems, high score listings or progress bars. More and more companies specializing in rehabilitation or physical therapy are allocating their resources to game development or are designing new game-based approaches and concepts.

Dorota Matczak did the latter after she realized that conventional physiotherapy approaches didn’t work for her son who suffered from posture problems. He would quickly get bored or was easily distracted during his exercises. As a physiotherapist and CEO of PhiLabs, Matczak took matters into her own hands and developed Phibox together with her team.

Phibox is a small, portable device that allows children between the ages of five and eleven to do their exercises to correct posture issues such as a valgus deformity (knock knees) or flat feet anywhere, anytime. Equipped with a small camera and a computer armed with artificial intelligence and games, users only need a big screen monitor to get started. After he began using the Phibox, Matczak's son was soon getting more excited about his physical therapy exercises thanks to the games and was motivated to keep going:

"Patients like my son exercise standing in front of the Phibox and accumulate points if they do the activities correctly. They don’t get points if they do them wrong or use improper technique. At no point will they lose points. They simply must improve their concentration and repeat the exercise they did wrong. If done correctly, they will get the point."

Motivation to perform the exercises is not externally driven. The game and its mechanisms create intrinsic motivation. This also fosters ambition as users are encouraged to still go for the points if an exercise was previously not done properly.

However, since children tend to have a low frustration tolerance, it is critical to strike a balance in game design: While ambition should be stimulated, the difficulty level mustn’t be too high to cause frustration and discouragement and prompt the user to be demotivated. Ways to avoid this are staying away from any loss of points and incorporating artificial intelligence, which can adapt and personalize the level of difficulty to fit the patient.

It's clear that game design is so much more than having a great idea and adding a few nice animations. This process also requires empathy with the needs of the patient – whether it’s pertaining to the emotional or physical level. Matczak sums up her son’s success with the device: "You see progress that would normally take months to achieve within a few short weeks."

Children are not the only ones excited about the gamified aspects in rehabilitation and physiotherapy. A great example of this is H-MAN by Articares. This portable robotic device assists arm rehabilitation. Users can access a library of games (“Serious Games") that are personalized to fit specific therapy needs and goals, such as building strength or strengthening coordination skills.

Michael Frank, CCO of Articares, says the best therapy results means striking the right balance between learning and having fun. The company has been specializing in game designs for 15 years and uses intelligent algorithms for optimization. Although much has changed in recent years, the basic idea behind the correlation between therapy and play remains the same:

“The success of rehabilitation hinges largely on the patient's motivation and endurance during treatment. Serious games support users in overcoming the monotony of the highly repetitive treatment process via the therapy robot, while making it easier to define exercises with various levels of difficulty.”

Both adults and children benefit from the ease with which games transform otherwise serious and even stressful aspects such as rehabilitation or physiotherapy.

Fabian Fröhlich, Managing Director of Roceso Medical, has a similar outlook. With CyngiSENSE Motion and SunBall, Roceso Medical has launched therapy products with a therapeutic approach that highlight rehabilitation and body training in a playful way. Fröhlich underscores the importance of movement for patients – not because they have to but because they want to move. Gamification makes usually repetitive tasks more enjoyable, focusing more on the fun versus the chore aspect.

"Both patients and therapists who use our systems appreciate these benefits,” he adds. Tracking technology makes it possible to record therapy processes and monitor progress accurately – which can also increase motivation of users, similar to the effects of a high score. Besides the direct benefits for patients, therapists also benefit from the unique features gamification adds to physiotherapy and rehabilitation.

Whether it’s increased motivation, fun, variety, practicality, or customization options – gamification offers many benefits to a gamut of applications. As the technology advances, it will play an even bigger role in health and wellness applications in the future.