Spotlight, Volume 1 Number 3

Video games in rehabilitation – Therapeutic and fun

What if playing a video game could be therapeutic for you as well as entertaining? NIDRR researchers are using commercial-off-the-shelf technologies to create fun, challenging games to improve balance and coordination for individuals in rehabilitation. The result? “It was hard work but I enjoyed it!”

In one University of Southern California study, Albert Rizzo, PhD, and his team combined a Wii Fit Balance Board and a regular PC to create a game designed to improve balance and stability for people who have experienced neurological injury such as stroke or traumatic brain injury. The software and hardware were designed using an “iterative” approach: With each design they consulted with therapists and talked to potential players, received feedback, and made changes until they had a game that engaged and amused the player while providing beneficial therapy-like treatments.

The result is an inexpensive, custom-designed interactive game focused on balance training, specifically weight shift (shifting from one leg to the other or changing your balance to the front or the back). Players stand on the Balance Board, possibly with help of the therapist, and watch on the screen as a balloon floats through a cityscape avoiding falling rocks. By shifting their weight, players guide the balloon in virtual space. Players found the game enjoyable, motivational, and more engaging than other therapies. When asked, most felt they would benefit from playing these games in therapy.

Using video games and virtual reality (VR) in a rehabilitation setting is a relatively new idea but one that is gaining traction. A quick search for “wii” and “rehabilitation” in Google’s news service found 22 news articles about it. A review of the literature by the Rehabilitation Engineering Research Center for Successful Aging with Disability, another NIDRR-funded project, found that VR and gaming were particularly effective in rehabilitation, particularly for people aging with or into disability, with improvements seen in mobility and function, activity, and participation.

Video games and virtual reality have many features that would benefit the rehabilitation process. Audiovisual feedback, positive reinforcement from increasing scores, variation and challenge in play levels, and an automatic log of players’ performance may all encourage the individual in therapy. In clinical trials, researchers observed that the usual hierarchy of therapist and client seemed less marked and therapists were more encouraging and complimentary, saying “Great score!” or “Look how well you’re doing!”

Full-scale, “serious” VR systems can be large, expensive, and highly technical. The system developed by Dr. Rizzo and his team, by contrast, is small and relatively inexpensive. Judging by the comments of the study participants, it may be just the right therapy tool for successful restoration of balance!

For more information on this project, please visit:

The following articles were published by this NIDRR-sponsored RERC project and available from the NARIC project and Rehabdata database (search using the NARIC accession number):

Lange, B. S., Requejo, P., Flynn, S. M., Rizzo, A. A., Valero-Cuevas, F. J., Baker, L., Winstein, C. (2010). The potential of virtual reality and gaming to assist successful aging with disability. Physical Medicine and Rehabilitation Clinics of North America, 21(2), Pgs. 339-356. NARIC Accession number: J58934

Lange, B., Flynn, S., Proffitt, R., Chang, C.-Y., Rizzo, A. (2010). Development of an interactive game-based rehabilitation tool for dynamic balance training. Topics in Stroke Rehabilitation, 17(5), Pgs. 345-352. NARIC Accession number: J59969

Jung, Y., Yeh, S., McLaughlin, M., Rizzo, A. A., Winstein, C. (2009). Three-dimensional game environments for recovery from stroke. In U. Ritterfeld, M. Cody & P. Vorderer (Eds.), Serious games: Mechanisms and effects. Routledge/LEA, Pgs. 413-428. NARIC Accession number: J59392