Strokes affect 800,000 people a year (Medical News Today). When a person has a stroke, a portion of their body is rendered weak, or even paralyzed. After a stroke, there is no cure for the lack of body movement, and rehabilitation is the only way to regain the lost movement. A form of treatment that may prove helpful in this issue is treatment via video games, which can help these post-stroke patients recover in many different ways. One of the leading issues in therapy is lack of patient motivation and compliance; patients are having a difficult time staying motivated during their therapy sessions while doing dull exercises and training. Video games offer a solution to this issue of patient compliance by being more interesting and entertaining than many boring conventional treatment options. Video games are also important because of the ability to be just as successful, if not more successful to post-stroke patients as conventional therapies and because of the independence that it gives the patients. Though there is a stigma surrounding video games that may make them seem as if they are only for entertainment and joy, games can be used in the medical field for therapy, with the added boost of entertainment to the patients. Video games such as VR systems or Wii games are a reputable treatment option for post-stroke patients.

This isn’t the first time that video games have been considered in the medical field. They could prove useful “as a means to educate and train people” by using “…serious games that are designed specifically for training and education purposes, but also of commercially available off-the-shelf games that are repurposed to meet certain behavioral goals in health care” (Pamela M. Kato). Video games can be used in the medical field to not only assist in patient treatment, but can also be used to train physicians and help assist in human error. Especially with the advancement in technology, the use of any new and helpful treatment or training options can prove very useful in the medical field. The idea that video games can be useful in such a serious field only reinforces the fact that games can be used in therapies and training. Though there are many benefits of games in training and therapy, it is possible that video games can affect the brain in ways that may prove to not be so positive.

Video games can affect the brain in ways that may not be helpful to therapies and treatments. There is stigma surrounding video games that make them seem as if they are continuously bad and can cause damage to the hippocampus, which is the part of the brain “primarily associated with memory and spatial navigation” (Dr. Ananya Mandal). This part of the brain proves especially important for patients who are trying to gain back use in their limbs. For example, an article from Science Daily wrote about a study that was conducted on a group of adult gamers that spent around 6 hours a week gaming. They concluded that though gaming causes “players [to] display more efficient visual attention abilities”, it can result in “decreased grey matter and lower functional brain activity in the in the hippocampus. This means that people who spend a lot of time playing video games may have reduced hippocampal integrity, which is associated with an increased risk of…Alzheimer’s disease” (Douglas Mental Health University Institute). This is stating that though there are benefits of gaming, there may be evidence proving that games can be harmful to the brain. A decrease in this part of the brain could cause memory loss and a decrease in spatial awareness, which are both unconstructive if these are side-effects for therapy with gaming. Though the author says that there may be evidence, nothing has been completely proven, as he writes towards the end of his article “it is important for future research to confirm that gaming does not have a negative effect on the hippocampus” (Douglas Mental Health University Institute). A counter to this that can enforce the fact that gaming may not have a negative effect on the hippocampus can be found in an article from BBC, where the author explores the changes that video games make to your brain. The author writes about a study in which the researcher studies “the brains of subjects as they played Super Mario 64 DS, over a period of two months. Remarkably, she found that three areas of the brain had grown-the prefrontal cortex, right hippocampus, and cerebellum…” (Horizon: How Video Games Can Change Your Brain). This statement enforces the idea that video games are not detrimental to the brain like many researchers think, and won’t be detrimental to the patients using these video games as options for their post-stroke treatments.

Video games also can also to be used to aid in assisting with patient compliance. Per an article by the Dove Medical Press, a significant barrier to effective treatment is “the patient’s failure to follow the recommendation of his or her physician or health care provider” (Therapeutics and Clinical Risk Management). This is a relatively large issue in the rehabilitation field because many exercises used for therapy are simple and dull and simply do not keep patients interested and motivated to continue to do their much-needed exercises. An example of a popular traditional treatment option is constraint-induced movement therapy, where a sling is placed on the patient’s strong arm to keep them from using it fully, which causes the patient to have to use their weak arm for daily tasks (Physical Therapist’s Guide to Stroke). This is a very popular and successful treatment, but such a treatment option seems to be incredibly dull compared to treatment via video games. If a patient cannot find a treatment that is interesting or entertaining for them stay motivated enough for them to do multiple times daily to successfully recover, they ultimately will not have the motivation to do their exercises. In a journal by Pamela M Kato, she writes about how important patient compliance and motivation is in rehabilitation. She states, “Engaging a patient’s motivation is frequently necessary in health care because patients are often requited…to engage in behaviors that are…boring and mundane…” (Pamela M Kato). Video games on consoles such as Wii or VR systems offer an alternative that can be helpful in therapy and can also be fun and engaging for patients. In a research study focusing on the topic of motivation and engagement, it is stated that “computer games have much to offer to rehabilitation...well-designed games can be highly engaging, even addictive…” (Burke, J.W., McNeill, M.D.J., Charles, D.K. et al).  One example of a patient who enjoyed their new treatment is a patient from a study conducted by a group of researchers. The patient recounted that “she felt highly involved in all games and strong agreed that they were easy to learn, replayable, sufficiently varied, challenging, and rewarding to play…[and] she expressed a great interest in being able to own a version of the system herself” (Burke, J.W., McNeill, M.D.J., Charles, D.K. et al). This account enforces the idea that patients enjoy having a rewarding and entertaining way to rehabilitate. All three of the patients in this research study “displayed enthusiasm and excitement during gameplay and some expressed a keen interest in being able to obtain a version of themselves for home use” (Burke, J.W., McNeill, M.D.J., Charles, D.K. et al). This research study concluded that this patient and two more patients felt strongly for this treatment option, so this kind of reaction is not unheard of. The monotonous sessions with the same exercises for weeks are useful and just as effective, but can surely cause patients to not want to stay consistent, but varying games and the ability to take gaming systems home with them can help keep them motivated to get better. The result of having a treatment option that is not only helpful to rehabilitation but is also entertaining is being able to avoid this issue of patient compliance. Not only does it assist in patient compliance, but is also shown to actually work as well as proven traditional forms of physical therapies.

Other than being a more entertaining and engaging than conventional forms of therapy, the use of games in therapy and rehabilitation has proven to be successful in rehabilitating many different patients, which can be proven in multiple studies conducted on this topic.  For one example, a series of nineteen studies were conducted to determine if virtual reality games were better to improve arm function than conventional therapies such as “approaches involving things like reaching for and manipulating everyday objects” (Anderson). These studies concluded that treatments using games on virtual reality systems resulted in higher arm function. The same researchers also conducted studies to determine if VR therapy was also better than conventional in improving walk speed, but showed no evidence that it was better or worse than conventional (Anderson). Another research study conducted to determine if virtual reality proves helpful in therapy combines a conventional treatment option with gaming. The patient uses their affected hand to complete tasks in a video game (Gauthier). This therapy option “encourages participants to reflect on their daily use of the weaker arm and engaged the gamer in additional problem-solving ways of using the weaker arm for daily activities” (Gauthier). This form of therapy has shown positive results for patients who participated in the study. The study even concludes that in some ways, the gaming was treatment more successful than the traditional options of treatments. A third example is a study from a YouTube video from Neuroscience Research Australia, which has Dr. Penelope McNulty speaking about her proposed therapy protocol that she says will help with patient compliance using the Wii system. This protocol assists lower and upper limb function, along with balance and cardiovascular fitness (McNulty). McNulty shows one of her patients, a man with a weak arm, who had significant increase in range of motion and power in two weeks of therapy. Another one of her patients, another man with lower leg weakness, and was able to step with a greater range of motion after a period of two weeks (McNulty). These three different examples of studies conducted to determine the usefulness of this type of therapy all showed positive effects on the patients’ recovery, and all prove that video gaming in therapy is a reputable therapy option and is just as good, if not better, than conventional therapy or training options. 

Another reason that video games can prove helpful in the medical field is how they help patients become independent and learn how to be more successful living alone. Learn to do things at home, have their treatments at home. In a YouTube video from Neuroscience Research Australia, Dr. Penelope McNulty speaks about the benefits that therapy with gaming has on the everyday lives of post-stroke and post-therapy patients. Dr. McNulty tells of one of her patients, a man who is eleven months after therapy but still isn’t able to do simple tasks, such as picking up a pencil. McNulty tells about how after two weeks of therapy, this patient went from not being able to use his fingers to pick up a pencil off of a table, to being up to pick up the pencil very easily. In an article titled “Optimizing Engagement for Stroke Rehabilitation using Serious Games”, the authors write about the benefits of having their video game systems at home to do their therapy sessions. They write, “home based programs, perhaps with visiting professionals, allow the person to develop skills in their home environment” (Burke, J.W., McNeill, M.D.J., Charles, D.K. et al). If video game systems were more affordable and accessible to patients, this would be a helpful way to allow the patient to not have to travel to specialists, who could possibly be far away, just to get a specific treatment. Though the patient would need to learn how to use the system to send results to a physician, it would still be suitable for the patient. If systems become cheaper and more readily available to patients, it can help them be more comfortable and steady in their own home. This can also “encourage the person to become more motivated, involved, and immersed in their rehabilitation…if the technology were suitable for home deployment then this could support increased levels of therapy for the stroke user” (Burke, J.W., McNeill, M.D.J., Charles, D.K. et al). This increased level of motivation can be helpful to the patient if they are used to doing their dull, conventional exercise. If the patient has a video game system at home that they enjoy using for their treatment, they will be more excited to want to do their exercises. This can keep them from skipping on their exercises if they are doing them at home. In another example of the help that at-home therapy can provide, a video from The Ohio State University Wexner Medical Center tells of a stroke survivor that was able to see signs of increased strength in her hands in only one week (Recovering from Strokes Using Video Game Therapy). The patient was able to see improvement in everyday tasks, such as picking up objects at a grocery store. It is hard to realize the difficulty that many patients face in daily life, but after they are given access to these therapy sessions in the comfort of their own home, they are able to complete everyday tasks and live their lives easier. 

In conclusion, video games such as VR systems or Wii games are a reputable treatment option for post-stroke patients. Many different researchers and studies have concluded that video games assist in therapy, be it with motivation and patient compliance, or just as a more interesting form of therapy. Patients can take a break from the dull conventional exercises to use their Wii or VR system, or whatever their therapist suggests, and actually enjoy their sessions. Sessions can be done in an outpatient facility, or in the comfort of their own home by having their very own gaming system, which can help them stay motivated to do their exercises when not going into the out-patient centers. Video games assist in the issue of patient compliance and motivation, which are both a large issue in rehabilitation, by providing a fun, addicting alternative to treatment options that just as effective, but are not as enjoyable. Video games have been proven to not harm the brain, and actually help with some coordination, and can help post-stroke patients regain many of the skills needed to live a normal life. They have also been proven just as good, if not better than traditional styles of therapy, which can help people of all ages and gaming level. With technology advancing in many other forms, it is smart to bring such technologically advanced forms of therapy such as virtual reality into such a serious issue. All in all, therapy using video games are just as reputable as any other form of therapy. 
