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Gamification in Physical Therapy: More Than Using Games

Janssen, Joep MSc; Verschuren, Olaf PhD; Renger, Willem Jan MA; Ermers, Jose MPPT; Ketelaar, Marjolijn PhD; van Ee, Raymond PhD

doi: 10.1097/PEP.0000000000000326

The implementation of computer games in physical therapy is motivated by characteristics such as attractiveness, motivation, and engagement, but these do not guarantee the intended therapeutic effect of the interventions. Yet, these characteristics are important variables in physical therapy interventions because they involve reward-related dopaminergic systems in the brain that are known to facilitate learning through long-term potentiation of neural connections. In this perspective we propose a way to apply game design approaches to therapy development by “designing” therapy sessions in such a way as to trigger physical and cognitive behavioral patterns required for treatment and neurological recovery. We also advocate that improving game knowledge among therapists and improving communication between therapists and game designers may lead to a novel avenue in designing applied games with specific therapeutic input, thereby making gamification in therapy a realistic and promising future that may optimize clinical practice.

The authors propose an application of game design approaches to design therapy sessions.

Department of Paediatrics, De Hoogstraat Rehabilitation, Utrecht, the Netherlands (Mr Janssen and Ms Ermers); Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands (Mr Janssen and Drs Verschuren and Ketelaar); NetChild, Utrecht, the Netherlands (Drs Verschuren and Ketelaar); Faculty of Art, Media and Technology Utrecht, Hilversum, the Netherlands (Mr Renger); and Department of Brain, Body & Behavior, Philips Research Laboratories, Eindhoven, the Netherlands, University of Leuven, Laboratory of Experimental Psychology, Leuven, Belgium, and Department of Biophysics, Donders Institute, Radboud University, Nijmegen, the Netherlands (Dr van Ee).

Correspondence: Joep Janssen, MSc, De Hoogstraat Rehabilitation, Center of Excellence for Rehabilitation Medicine Utrecht, Rembrandtkade 10, 3582 TM, Utrecht, the Netherlands (

Grant Support: Raymond van Ee was supported by the Flanders Scientific Organisation (FWO), the EU Horizon 2020 program (HealthPac) awarded to J. van Opstal, and a Methusalem Grant (METH/08/02) awarded to Johan Wagemans.

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.