Gamification in practice

In our previous article the concept of ‘gamification’ and its role within physical therapy was already discussed, but how can these concepts be applied in daily practice? What are concrete examples of game design elements and how exactly can you introduce these elements during therapy?

In order to answer these questions we will use the Therapist Toolkit for Gamification in Therapy [1] in this article. This toolkit aims to provide a concise framework for therapists to get started. By giving sufficient attention to the four parts of the toolbox, the therapist can structurally introduce game-design elements within the (practice) therapy.


The Therapist Toolkit for Gamification in Therapy formulates the following goals in the gamification of therapy:

1. The use of game mechanics

Game mechanics are the building blocks of a game system. They determine how a user can interact with the system.

2. Using game language

Define large (Big Game) and small goals (Little Game). The small goals work towards the bigger goals.

3. Personalizing the therapy

Taking into account the personality and interests of the patient.

4. Attention to the neuroplastic function of reward

Receiving a reward causes dopamine to be released into the brain. Dopamine stimulates the production of new synaptic connections and thus also the (motor) learning process.

To illustrate the use of this application we start from the following two cases:

Tinneke ( 8 years) Brecht ( 24  years)
Problem description DCD ACL – rupture
Goals Stimulate general body coordination and balance Regain mobility, strength and stability of the right knee
Information Tinneke loves playing, dancing, singing and the group K3 very much. Brecht is a competitive soccer player. He wants to get back on the field as soon as possible.
Personalizing the therapy Tinneke’s fondness for the group K3 can be an important starting point. For example, body coordination can be practiced by dancing to the music she loves to listen to. Brecht is a person who always wants to get the best out of things. By offering exercises that are related to soccer, the therapy remains recognizable and relevant for him.
Using game language Big Game

  • Dance along correctly with some video clips

Little Games:

  • Learning individual dance steps
  • Automate small parts of the choreograph
Big Game

  • New participation in the current soccer competition

Little Games:

  • Regain strength in the knee
  • Improve stability
  • Participate in training sessions without complaints
The use of game mechanics The different dance steps within one choreography are demarcated and divided into boxes. Tinneke rolls the dice to determine which steps will be practiced during this session. After the session the boxes with the practiced steps will be partly colored. Indicate the maximum height of a vertical jump with a line on the wall. When Brecht jumps higher, the line is moved upwards. The original line remains visible.
Attention to the neuroplastic function of reward Tinneke is allowed to put a sticker on a box each time it is completely colored. For Brecht, observing improvement is a reward in itself. In addition, encouraging words and concrete planning around his participation in soccer can also be very motivating.
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. Janssen, J., Verschuren, O., Renger, W. J., Ermers, J., Ketelaar, M., & van Ee, R. (2017). Gamification in Physical Therapy: More Than Using Games. Pediatric Physical Therapy, 29(1), 95–99.