Modifiable Exergames Can Promote Self-Motivation During Rehabilitation

How can technology support healthcare?

As the proportion of the world’s population in older ages continues to increase, the associated demand on the healthcare system increases. In time existing healthcare facilities, organisations and resources will become increasingly stretched. Accordingly, new systems leveraging technology may be developed to combat this growing problem.
There are numerous potential benefits associated with the incorporation of electronic health (eHealth) technologies into healthcare. Positive outcomes have already been demonstrated in interventions associated with smoking cessation, diabetes education, physical activity promotion and health status monitoring.

Rehabilitation Orientated Exergames

eHealth tools may be used as an instrument to support existing rehabilitation processes or promote remote rehabilitation. In particular, eHealth interventions have the potential to be highly customisable, in order to target a wide range of health conditions. As such, rehabilitation games (or exergames) offer the ability to create entertaining, customisable and accessible rehabilitation tools that suit a majority of individuals, irrespective of physical or cognitive capabilities.

Entertainment (relating to self-motivation) represents a challenge within rehabilitation. Home exercise programming (HEP) is an important instrument for supporting patient care and management. Unfortunately, it has also been demonstrated that many individuals do not complete prescribed HEP with full adherence. Exergames represent one possible tool for promoting self-motivation through entertainment.

In addition, to ensure effective, evidence-based rehabilitation strategies, exergames should utilise relevant therapeutic content, with consideration towards the end-user’s physical and cognitive capabilities. Currently, a majority of exergames are developed for the entertainment market. As such, these exergames fail to adapt gameplay according to patients’ capabilities and rehabilitation requirements.

An Example – Goalie Rehabilitation Exergame

The Goalie exergame aims to provide an evidence-based rehabilitation tool, usable in musculoskeletal rehabilitation by individuals with a wide range of capabilities. Gameplay was designed to reduce cognitive demand, with game character movement mirroring the user’s movement patterns. Additionally, graphics were designed to be visually simple and intuitive. The user can interact with the game using prescribed movement patterns, through sensors which are worn on the user’s arms to track movement patterns.

Figure – Goalie exergame movement pattern and game image

Playing the game requires performance of shoulder abduction, raising the arms to stop pucks entering the goal. Gameplay aims to promote muscular strength-endurance and improved range of motion around the shoulder. This movement was selected, as shoulder pain is a common musculoskeletal complaint.

Preliminary testing and feedback has found the exergame to be a motivating, understandable, and scalable tool for supporting the rehabilitation needs of various patients. Further testing is required in the future, however initial results were promising suggesting rehabilitation exergames can positively impact patient motivation and enjoyment.


Kyle Mulholland: Physiotherapist, Master of Health Care (Welfare Technology)