Gamification in physical therapy

In recent years there has been an enormous growth in digital applications that drew their inspiration from video games. This trend is often described as ‘gamification’ and has already been extensively studied and described within various disciplines (education, business, medicine, …). But what exactly does gamification mean? What forms can it take and how can it be used within the daily practice of physical therapy? 

Within the literature Gamification is often defined as ‘the use of game design elements in a non-game context’ [1]. By game design we mean the construction of concrete goals, challenges and rules. This structured and purposeful way of designing differentiates games from a rather free form of ‘playing’ [2,3]. However, a ‘gamified’ application is not the same as a full game, but should rather be seen as a system in which some motivating game aspects are interwoven.

‘Gamification is the use of game design elements in a non-game context.’

In addition to these gamified systems, there are also so-called serious games. These are full-fledged games that are specifically developed with a primary purpose other than mere entertainment. The first examples of these games often had a teaching (edutainment) or commercial purpose (advertainment) in mind, but since 1986 research has been done into the possibilities of these applications to stimulate psychomotor skills [4, 5]. The use of serious games within the health care sector has increased sharply in recent years. Moreover, in a digitizing world, it is increasingly easy to develop and use such applications. This new way of working can also play an important role for the rehabilitation sciences.

Within this sector, therapists can use so-called active video games (AVGs) or exergames as an applied form of serious games. Unlike classic video games, where a controller is used to control the game, exergames draw their input directly from the movements of the player. The commercialization of consoles such as the Nintendo® Wii™ (2006), Wii U™ (2007) and the Microsoft Xbox® Kinect™ (2010) made these high-tech applications accessible for the first time.

However, these consoles (and accompanying exergames) were developed for the widest possible audience and lack the necessary adaptability. In spite of this lack of flexibility, the use of these consoles within rehabilitation already shows positive results [7,8]. Researchers are therefore calling for a structural collaboration between therapists and game developers in order to achieve targeted and usable exergames [7]. The production stop of both the Nintendo® Wii™ and Xbox® Kinect™ makes this call for collaboration and innovation even more relevant.

Jorn OckermanPhysiotherapist / Researcher
Within Creative Therapy, Jorn researches applications of innovative technologies, such as Matti, within rehabilitation therapy.
Arno PendersCEO Creative Therapy
With a history as a researcher at UGent, Arno likes to share his knowledge on the application of innovative technologies within rehabilitation therapy.


  1. Deterding, S., Dixon, D., Khaled, R., & Nacke, L. (2011). From Game Design Elements to Gamefulness: Defining Gamification. Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments, MindTrek 2011. 11. 9-15.
  2. De Croon, R., Wildemeersch, D., Wille, J., Verbert, K., & Vanden Abeele, V. (2018). Gamification and Serious Games in a Healthcare Informatics Context. 2018 IEEE International Conference on Healthcare Informatics (ICHI), 53–63.
  3. Juul, J. (2005). Half-Real: Video Games between Real Rules and Fictional Worlds. The MIT Press.
  4. Malone, T. W. (1980). What Makes Things Fun to Learn? Heuristics for Designing Instructional Computer Games. Proceedings of the 3rd ACM SIGSMALL Symposium and the First SIGPC Symposium on Small Systems, 162–169.
  5. Dorval, M., & Pépin, M. (1986). Effect of Playing a Video Game on a Measure of Spatial Visualization. Perceptual and Motor Skills, 62(1), 159–162.
  6. Meijer, H. A., Graafland, M., Goslings, J. C., & Schijven, M. P. (2018). Systematic Review on the Effects of Serious Games and Wearable Technology Used in Rehabilitation of Patients With Traumatic Bone and Soft Tissue Injuries. Archives of Physical Medicine and Rehabilitation, 99(9), 1890–1899.
  7. Bonnechère, B., Jansen, B., Omelina, L., & Van Sint Jan, S. (2016). The use of commercial video games in rehabilitation: A systematic review. International Journal of Rehabilitation Research, 39(4), 277–290.
  8. Bonnechère, B. (2018). Serious Games in Physical Rehabilitation. Springer International Publishing.