Motion-Games in Brain Injury Rehabilitation: An In-Situ Multi-Method Study of Inpatient Care
Cynthia Putnam, Jinghui Cheng · 2013 · Proceedings of the 15th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS) · doi:10.1145/2513383.2513390
Summary
This poster paper explores how commercial motion-based video games (Xbox Kinect, Nintendo Wii) are used in a rehabilitation hospital for patients with brain injuries. The researchers collaborated with therapists at the Schwab Rehabilitation Hospital (SRH) in Chicago, which served 107 inpatients with brain injury in 2012 and employs 45 physical therapists, 32 occupational therapists, and 11 speech-language pathologists. The study used a multi-method approach: semi-structured interviews with 11 therapists (3 occupational, 3 physical, 3 recreational, and 2 speech-language pathologists) with 2-14 years of experience, plus observations of 16 game play sessions involving 5 therapists and 16 patients (ages 43-64, brain injuries within the past 30 days). The study aimed to understand how commercial games meet therapeutic goals, what physical and cognitive help patients need to play, and what factors affect engagement and enjoyment.
Key findings
Three major findings emerged. First, the social aspects of gaming were highly valued by both therapists and patients — gaming sessions created opportunities for social interaction, laughter, and group engagement that traditional rehabilitation exercises typically lack. Second, therapists had varied and overlapping physical, cognitive, and social goals when incorporating games into therapy — the same game might be used for balance training by a physical therapist, attention and sequencing by an occupational therapist, or social engagement by a recreational therapist. Third, and most critically, therapists chose games primarily based on their own familiarity with specific titles rather than systematically matching games to therapeutic goals and patient profiles. This means therapists may be missing opportunities to use games that would better serve their patients' specific rehabilitation needs. The researchers identified a clear need for decision-support tools that use case-based reasoning to help therapists make evidence-based game selections, and expanded their research to include diary studies to gather seed cases for such tools.
Relevance
This research highlights both the promise and the gap in using commercial gaming technology for rehabilitation. Motion games are already widely used in brain injury rehabilitation because they make repetitive exercises more engaging and motivating — a key challenge given that BI patients must perform extensive repetitive movements to recover. However, the finding that therapists select games based on familiarity rather than evidence exposes a significant missed opportunity. For accessibility and assistive technology practitioners, this study underscores that tool availability alone is insufficient — clinicians need structured guidance to match technology to individual patient needs. The call for case-based decision tools is particularly relevant as the number of available motion games continues to grow. The study is limited by its single-site design and small observation sample, but it provides valuable in-situ insights into how rehabilitation technology is actually used in clinical practice.
Tags: brain injury · rehabilitation · motion gaming · exergame · game accessibility · occupational therapy · physical therapy · cognitive rehabilitation