How can we gamify rehabilitation? This narrative review of 17 studies published in the past five years provides some insights.
Gamification is the application of game elements in non-game contexts. It can involve challenges, quests, points, levels, leaderboards, badges, and other rewards that incentivize participation and facilitate self-management for people with chronic conditions. When playing a video game, participants are immersed in the game and pay little attention to the world around them. If they play an active game, such as virtual reality or the Wii, they are not focused on potential knee pain, they are focused on beating Mario in tennis. Even traditional hand-held controllers (PlayStation, Xbox, etc.) can be beneficial for hand therapy, as patients work on coordination, dexterity, and endurance. Adverse events are low across the board. While this narrative review primarily assessed virtual reality and physical video games (e.g. Wii), showing video games are effective for rehabilitation, the concepts carry over to traditional exercise as well.
There are many options at our disposal without technology. Three of the primary drivers of success with gamification are distraction, enjoyment, and accomplishment. You can turn the exercises into games. Add targets for ball toss to develop rotational power. Measure the height a ball bounces when slamming the medicine ball on the floor. Create competition with target times, track personal records, and pit patients against the clinician. Add stakes to the events (hit a specific target weight and the patient gets to assign the PT an exercise of their choosing). Channel lessons from the Power of Moments and celebrate milestones – reaching triple digits on an exercise (e.g., 100 pounds), deadlifting their body weight, walking a mile. Keep a record board in the clinic (HIPAA compliant of course) or a list (nicknames) of people to reach certain “clubs” (body weight or 300-pound deadlift clubs).
If you have access to video games, use them or implement them into a home exercise program. There are many other ways to add fun, competition, and distraction into rehabilitation as well.