Gamification in Physical Therapy

Gamification is the infusion of game mechanics, game design techniques, and game style to nongame contexts, such as physical therapy. It is aimed to increase physical activity, engagement, empowerment, and decrease health care utilization.

Table of Content

The healthcare domain has seen a rapid ascent of the adoption of gamification in health self-monitoring and management.

Game mechanics

For gamification to attain its full potential, it is essential to build digital solutions that exploit the psychological effects and core experience of game mechanics.

The most effective gamification elements include:

  • Feedback
  • Rewards
  • Progression
  • Social features

A combination of game mechanics can be used to encourage engagement with the app.


Feedback is mainly represented in the form of visual popups (e.g., textual measures, informative measures) or audible notifications (sound effects).

The adjustment of the real-time feedback is crucial because the game needs to provide feedback appropriate to your level. Feedback should, therefore, be dynamic and adaptable.


A game-like feature can be used to reward users with numerical values for an action or a combination of actions. This point-scoring system is generally associated with achievement rewards such as badges, trophies, and medals upon accumulating a certain amount of points.


Your progress can be monitored using a sensor, turning physiotherapy exercises into fun-to-play video games. Once you have logged in, your range of movement is measured and recorded. You then play a set of games, designed with input from physiotherapists, to achieve your individual physiotherapy goals. You progress through the different levels, which increases in difficulty.

Social features

Socialization can improve your engagement with gamified applications. The socialization component can be incorporated with social networks (e.g., Facebook, Twitter) to allow you to communicate with your peers and receive support from them. Social interaction consists of the setup of an in-game social community of players where you can communicate and support each other to stimulate prosocial behavior.

The leaderboard is an important aspect of socialization. This is based on status, which leads to greater visibility and social comparison, which encourages you to surpass your peers. As in the gamified applications, you can see each other’s rank and current status on a leaderboard. To advance levels, you have to perform challenges of a gradually increasing complexity.

Another competitive setting is that of creating a collaborative platform on which you can perform the application’s activities as part of a small group. It ultimately helps you enhance your physical accomplishments.

Game design

Integrating game design elements in therapy can make the therapy more attractive and exciting. It has the potential to increase your motivation and engagement in therapy. The therapy sessions should be designed in such a way as to trigger physical and cognitive-behavioral patterns required for treatment and neurological recovery.

In interactive game design, a context is curated in which the therapist is observing and treating via a virtual environment. Therapists can manipulate the game in real-time so that the level of training is guaranteed, and your behavior is elicited in the intended physical, cognitive, or socio-emotional approach. The therapist screen your level of performance and analyses whether the level is appropriate for your current condition and therapeutic goals.

Gamification in Physical Therapy

Gamification is used in physiotherapy to divert attention from the pain, making the pain bearable for you. It puts the therapy program in an entertaining context. It also increases your adherence to therapy while leaving full control over the rehabilitation process in the hands of the therapists.

The gamification of physical therapy is motivated by characteristics such as motivation, attractiveness, and engagement. These characteristics involve the reward-related dopaminergic systems in the brain that are known to facilitate learning through long-term potentiation of neural connections.

Engaging, interactive game-based rehabilitation tools, which match your abilities, could provide attractiveness and variation, thereby facilitating the recovery of residual motor and cognitive function. The physical rehabilitation approaches should be fine-tuned by combining knowledge from the fields of neuroscience and game design.


Regular engagement

The significant advantage of gamification is that of ensuring your regular engagement and increasing your immersion into the digital health therapy. Gamification seeks to take playful aspects of gaming experiences to restructure a typically boring activity into something enjoyable, competitive, and engaging.

Increase positive emotional states

Gamification is also intended to help you experience positive emotional states such as satisfaction, relatedness, and self-esteem. This results in the inducement of positive changes in your behavior that are beneficial for your overall health and wellness.

Improved adherence to treatment

Gamification is a successful means to improve your adherence to medication and treatment plans.

Social network

From a social perspective, gamification has vast potential as regards to improving communication and mutual encouragement using social sharing (e.g., posts and instant messaging).


The implementation of gamification techniques in the digital health realm is a critical and demanding process.

Long-term viability

One of the significant challenges is related to the long-term viability of the gamification effects. The noticeable short-term impact on motivation and engagement is unlikely to be sustained, as your interest and enthusiasm in the game-like features may decrease in the long run.

Poor game mechanics

Some game mechanics (e.g., points, badges) may not provide tangible competence and health skills. Furthermore, Some gamification applications offer a valuable reward for an activity that does not require a significant endeavor and vice versa.

Lack of fun and motivation

Because fun and motivation are not a “one-size-fits-all” proposition, a game element that seems motivational for one individual may not be persuasive for another.

Designers should create adaptive games that offer slightly different modes of play for different player types. Users should also be allowed to experience a sense of communion, autonomy, and competence through gamification to trigger motivation.

Not user-centric

Another critical issue is that most gamified solutions are not user-centric. They disregard the demographic characteristics of the targeted users to a significant extent, thus failing to provide an appropriate solution to the specific users.

Lack of healthcare professionals’ involvement

There is a lack of healthcare professionals’ involvement in the design and development of gamified digital solutions, which diminishes their credibility and respect among patients.

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