A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges
Abstract
:1. Introduction
- (a)
- To identify and evaluate gamification applications used in rehabilitation;
- (b)
- to classify the gamification applications used in rehabilitation; and
- (c)
- to discuss significant challenges of the gamification applications in rehabilitation and determine the potential research opportunities in e-health.
2. Survey Methods
3. Gamification and Rehabilitation
3.1. The Concepts of Gamification
3.2. General Game Elements
- Points—The game element is an essential one that is typically used as a reward for completing particular activities in the gamified environment. A gamified application can adopt several types of points depending on the purpose the points serve. Points are collected, transferred, and reused for other purposes. This game element is implemented as a reward for gaining experiences, obtaining a higher or different status; or for providing feedback; or as redeemable points. Alternatively, points are also recognized as rewards and scores.
- Leaderboard—The leaderboard is an element that summarizes and shows a player’s achievement. The leaderboard is an indicator of player performance where it might induce among the players a desire to compete. It shows the players’ achievements and ranks them based on their best performance in a particular task or activity, or in the gameplay overall.
- Badges—Badges are a symbol of status. A badge is an element that symbolizes a specific achievement in gamified applications. Badges also are collected after earning a particular number of points. Generally, badges are not compulsory; however, receiving them can socially influence players’ behavior, mainly when the badges are rare and difficult to get. Every achievement (completing levels or goals) will mean receiving different badges that show different statuses of players in the gameplay. Alternatively, it is also recognized as a medal.
- Trophies—A trophy is a specific award given to a player upon the accomplishment of a particular task or activity. Unlike points and badges, trophies usually relate to the achievement of behavior. They are awarded when a player achieves a behavioral goal in gameplay. For example, every person’s health records in a gamified application might be given points. When a person is logging health records every day for one week, he/she will receive a ‘compliance’ badge. Achieving a good health record in a week will allow one to get a ‘healthy player’ trophy. Alternatively, it is also recognized as an award, medal, or stars.
- Level—The level is an element applied based on points, where the players can move from one level to another level as they reach a certain required stage. Levels are used to indicate game difficulties. A higher level is usually installed with increasingly difficult challenges.
- Ranks—A ranking positions the players from the top to the lowest. It is presented to all players, and thus, it would increase competitiveness. The roles are just like the leaderboard; however, the latter has more information than the ranking. Player positions are customarily based on their accumulative points and achieved levels. They also are positioned based on their progress in completing the given activities.
- Story/theme—A story or theme in a gamified application brings a gameful experience. In some situations, it creates an immersive experience that helps the players to adapt to their situation and learn from it. However, stories play an important role in gamified applications as they create an interesting situation when the stories reflect the player’s personal interest. The context or storyline is an analogy of a real-world setting. It is also known as the narrative, context, or storytelling.
- Feedback—This element provides immediate feedback on the players’ performance and achievement of given tasks. Iterative visual feedback is given on the interfaces or through agents. Feedback is also regarded as a response.
- Progression—Progression represents milestones. It makes the players alert to their situation and current position. Additionally, it helps the player to strategize their movement so that it will affect their progression. It provides the player’s game status or achievement status or how far they achieved them. In some situations, the status bar is used to show the progress.
- Challenge—An element with increasing difficulties at different levels, this has to be carefully designed as over-easy tasks make the players bored, while over-difficult tasks make the players leave. Alternatively, this element is also known as a quest.
- Roles/Avatar—An avatar can be identified as the player’s virtual identity or self-representation in gameplay. It creates the player roles that evoke immersive environments. Avatars also represent the other characters (non-player characters) who are interactively involved in the game. In many e-health applications, the avatar is used for visual feedback or in response to an individual health condition. It is also known as self-representation and virtual identity
- Status—A status is an element that shows the player’s status in gameplay. It also relates to the ranking that shows a player’s reputation. The application is presented through either the player’s avatar or badges. It is also known as reputation.
- Voting—Voting is an element provided to facilitate voting activities. The players will be able to vote and receive responses or results after voting. The players are also offered some in-game rewards like points, bonuses, or stars to motivate them to vote. Voting is generally used to get feedback from the players, or it is just an added fun element in the gameplay.
- Betting—Betting is an element that enables the players to make a bet on a specific occasion, such as an estimation. The betting winner will receive an in-game reward, like points that are exchangeable for other elements in the gameplay.
4. Implementing Gamification in Rehabilitation
4.1. Current Gamification Trends in Rehabilitation
- (1)
- Physiotherapy, which includes motor-rehabilitative, postural stability, exercising, hand therapy, and heart disease;
- (2)
- neurological, which includes stroke-related and neurological disorders; and
- (3)
- psychological rehabilitation.
4.2. Rehabilitation Gamifying Requirement
- Gameful design—The practice or processes to design a gameful gamification application that evokes live experiences [12]. This process involves structuring the tasks and activities with suitable game elements and their techniques.
5. Gamified Intervention in Rehabilitation
5.1. The Type of Gamified Intervention in Rehabilitation
- The robotics-based system/Social robotics is an external tool that is embedded physically in the rehabilitation to guide patients by giving instructions on how to play the gamified applications. Most importantly, the robot provides feedback on individual performances and achievements during and after gameplay (see studies by [11,15,30]). As social robotics, patients can invite the robot to play together and they can challenge each other in the gameplay. Additionally, social robotics is embedded as a game companion where the robot takes the role of a coach and motivator when performing rehabilitative exercises [15,31]. Other than the element of feedback, the gamified robot-based system uses levels. Each level has different rehabilitation tasks, and they are designed with increasing difficulty. The selected articles demonstrated that Social robotics could help improve individual motivation and engagement in rehabilitative therapies [11,30] and improvement in neurological deficits, particularly with motor functions [24].
- A virtual agent embedded during rehabilitation training shares a similar function to robotics. They serve as guides or playmates (companions) but they are virtually adopted in the application and not as a physical instrument attached to the application. As a guide, the implementation of a virtual agent acts as the virtual therapist that can track individual rehabilitation progress while assuming the role of a coach to prescribe appropriate exercises [5,29]. This approach was used to reduce face-to-face rehabilitation settings, thus decreasing consultation costs, and being less time-consuming and more logistically appealing [29]. A virtual agent is also implemented as an individual avatar—a self-representation in the gameplay [18,29,32,33,34,35]. The game consequences and feedback are visualized through the individuals’ avatar in real-time [32,34]. Good feedback serves as a motivational drive, but poor feedback would either promote the progression element in training or demotivate patients, leading to dropouts from therapy sessions. Other than the element of feedback, the elements of level, dashboard, and avatar customization are also part of the gamified application. In the study by Rapp and Cena [18], replicating an individual virtually through an avatar is an excellent strategy to improve one’s interest in managing personalized emotional care and psychological aspects during rehabilitation.
- Game-based therapy uses commercial off-the-shelf games adopted in gamified rehabilitation care. The game can be related to the individual condition or serve as a general game that is included in the rehabilitation environment. A game that imitates a real situation may demotivate patients at some point after playing the game [8,9]. A general game is included as a means to balance the environment, whereby it can evoke an immersive environment to the therapy sessions during rehabilitation [8]. Therefore, game-based therapy is instilled as a series of games connected to a mobile app [18,19,21,36,37], or a computer software application [32,38].
- Video game-based therapy uses commercial off-the-shelf games and implements mixed reality (virtual and augmented). This type of play is usually related to the exergame, one of the available kinds of games. For instance, the game has added devices or equipment, a Leap motion, a Wii balance board, and a tool for Microsoft Kinect. This approach is used as a support for exercising activity, fitness-related activities, or physiotherapy activities. Following Muñoz et al. [35], the Kinect motion sensor is used to detect an individual body movement during fitness training and these movements are reflected through their in-game avatar. This approach is similar to Manolova [3], but they used Leap motion as the motion sensor to detect hand movement during hand rehabilitation. In this approach, the video game is part of the gamified rehabilitation application. The patients play the related game, including the game elements such as the scoring and leaderboard element, for evoking gamefulness experiences during rehabilitation training.
- Web-based intervention is a gamified system that utilizes a web-based architecture for telerehabilitation. The architecture is either cloud-based [36] or server-based [39]. In the architecture, a series of games are implemented and personalized to individual needs. Personal analytics is utilized in a web-based system for demonstrating a summary of performances and achievements throughout the rehabilitation process.
- Social application is an application that allows an individual to socialize with other people while undergoing rehabilitation activities. Its use depends on whether the application is a games-based [26] or a web-based application [21]. By socializing virtually, individuals could collaborate or complete their rehabilitation performance, as well as discuss and exchange opinions about their condition. This type of rehabilitation application usually utilizes elements of social games, with game elements such as the avatar/agent, quest, leaderboard, and ranking.
5.2. Mapping Intervention and Gamification Requirement
6. The Classification of Gamification Application in Rehabilitation
6.1. Gamification Building Blocks
6.2. Classification of Gamification
- -
- First, the domain of rehabilitation was extracted. It was found that gamification in rehabilitation was related to the post-stroke condition, and the previous works were bounded in the domain of physiotherapy, neurology, and psychology. Thus, these domains developed as the general rehabilitation domains that been addressed for the implementation of gamification.
- -
- Second, the common intervention tools were scrutinized and grouped within the same domain. However, the tools could also be cross-applied in other domains. In this category, the intervention group was proposed based on its suitability and effectiveness from previous works.
- -
- Third, the gamified application was correlated with the gamification requirements usually designated when solving particular rehabilitation issues.
- -
- Fourth, following the game elements’ selection block listed in Table 3, the collection of extracted targeted techniques from the previous works was mapped with the gamification requirements in step 3. The techniques include motivational narratives, goal-oriented tasks, responsive feedback, rewards, fantasy, personalization, personal informatics, visual feedback, iterative feedback and evaluation, rewards, and personalized experience.
- -
- Finally, following the techniques, the most-applied game elements are proposed, but they are not limited only to the list. The game elements can be applied following their suitability and purposes. A game element is proposed based on the commonly applied elements when using particular gamification techniques.
7. Challenges and Research Opportunity
8. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
No | Author, Year | Title | Problem Address | Rehab Domains | Gamification Application | Targeted Outcomes and Clinical Findings (If Relevant) |
1 | Buonocunto et al. [36] | A limb tracking platform for telerehabilitation | Addressing problems in motor-rehabilitative therapies for telerehabilitation care and providing solutions through a cyber-physical platform | Motor-rehabilitative | ReHapp, an android application—A Limb Tracking Platform for Tele-Rehabilitation | Outcome: Engagement to care |
2 | Chromy et al. [32] | DeskBalance: Novel Gamified System for Diagnosis and Treatment of Postural Stability | Introducing a gamified application for postural stability that provide individual diagnostic and therapeutic features. | Postural stability | DeskBalance, a gamified system—detect the patient’s stabilization moves and presents them on the monitor as visual feedback | Outcome: Motivation and engagement to care |
3 | Segura et al. [15] | Playification: The PhySeEar case | Exploring the used of software agents in physiotherapy replacing the physiotherapist in playfulness environment | physiotherapy | “PhySeEar”—Agent-based in the gamification of rehabilitation therapy which acts as physiotherapist and playmate. | Outcome: Motivation and engagement to care |
4 | González-González et al. [4] | Serious games for rehabilitation: Gestural interaction in personalized gamified exercises through a recommender system | How a recommender system can help the therapist to personalize gamified activities for the user | Physiotherapy (body gesture exercising) | TANGO: H as a personalized exercise designer and simulator for patients. | Outcome: Motivation and engagement to care |
5 | Korn & Tietz [33] | Strategies for playful design when gamifying rehabilitation. A study on user experience | Exploring how the game mechanics and which game mechanics have a successful implementation in gamification. Additionally, how those mechanics lead to improved motivation | Physiotherapy (motion/fitness training/balance) | A gamified application implementing off-the-shelf games technology (Wii) | Outcome: Motivation and engagement to care |
6 | van der Kooij et al. [40] | Gamification as a sustainable source of enjoyment during balance and gait exercises | how the design and use of game elements help to develop individual’s motivation over time and how enjoyment influences rehabilitation care, in particular, the motor performance | Motor-rehabilitative (physiotherapy) | A gamified application implementing a series of games (balance game and gait game) | Outcome: Motivation and engagement to care |
7 | Deacon et al. [16] | Can Wii balance? Evaluating a stepping game for older adults | Addressing balance control issues to older adults. Using off the shelf technology in the gamified system and providing iterative feedback to therapists and patients have helped increase participation and engagement. | Physiotherapy (balance control) | A gamified application implementing off-the-shelf games technology (Wii balance boards) | Outcome: Motivation and engagement to care |
8 | Muñoz et al. [35] | Lessons Learned from Gamifying Functional Fitness Training Through Human-Centered Design Methods in Older Adults | They were designing a beneficial application for fitness training in older adults using game elements as motivation. Lack of synchronization between game preferences, technology, and involvement for users has resulted in a poor design application. | Physiotherapy (fitness training) | Gamified application using Kinect motion sensor to detect body movements and manipulate avatar in a game. | Outcome: Motivation and engagement to care |
9 | Stanmore et al. [41] | The effectiveness and cost-effectiveness of strength and balance Exergames to reduce fall risk for people aged 55 years and older in the UK assisted living facilities: A multi-centre, cluster randomized controlled trial | They explore the effectiveness of developed exergame gamified application in improving balance for older adults how the game can maintain body functions and reduce the risk of falling. | Physiotherapy (balance control) | Gamified application: OTAGO/FaME-based strength and balance Exergame for improving balance, maintaining the function, and reducing falls | Outcome: Motivation and engagement to care |
10 | Kappen et al. [28] | Gamification through the Application of Motivational Affordances for Physical Activity Technology | Motivational affordances design and application or game elements that promotes participation in physical activities in particular to a different group of users (age) | General Rehabilitation | No gamified application but used Exercise Motivations Inventory-2 scale (EMI-2) to survey gamification application in rehabilitation | Outcome: Motivation affordances in the gamification of therapy |
11 | Manalova [3] | Application for Hand Rehabilitation Using Leap Motion Sensor Based on a Gamification Approach Application for Hand Rehabilitation Using Leap Motion Sensor Based on a Gamification Approach | Lack of research exploration and direction of hand gesture recognition using a gamification approach | Physiotherapy (Hand motion) | Gamified application: using a series of games and leap motion sensor | Outcome: Motivation and engagement to participate more in the care |
12 | Afyouni et al. [5] | Rehabot: Gamified virtual assistants towards adaptive telerehabilitation | Challenges in traditional therapy lead to attempts to use technologies in physical rehabilitation that can guide the patient in completing their therapy session. | Body Therapy (gesture) | Rehabot—a gamified robot-based system; virtual assistants to guide the patient through the different sets of gestures required to complete the session | Outcome: Motivation and engagement to care |
13 | Afyouni et al. [54] | A therapy-driven gamification framework for hand rehabilitation | Lack of research in facilitating a therapy-based hand gestures application to navigate movement. Also, less application and framework that address ab enriching user experiences in a gameful environment for individuals with hand disabilities. | Therapeutic hand exercises (gesture) | e-health adaptive serious games using leap motion controller to facilitate and encourage individual with hand disabilities | Outcome: significant improvement in patient engagement |
14 | Fotopoulos et al. [44] | Gamifying Motion Control Assessments Using Leap Motion Controller | Incorrect motor patterns through exercising have a considerable impact on individual motivation and experiences in therapy activities | Physiotherapy (Hand motion) | Gamified application using the virtual 3D game environment and leap motion controller for interaction | Outcome: Motivation and engagement to participate in an exercise session |
15 | Colomer et al. [43] | Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke | A low-cost intervention for motor recovery after stroke is required to transform conventional tools into a practical intervention | Hand rehabilitation | A gamified system that used augmented reality in motor and ADL training | Outcome: useful and motivating for rehabilitation Findings: Significant improvement in arm function (Wolf Motor Function Test, p < 0.01) and finger dexterity measured (Box and Blocks Test, p < 0.01; Nine Hole Peg Test, p < 0.01) |
16 | Eizicovits et al. [31] | Robotic Gaming Prototype for Upper Limb Exercise: Effects of Age and Embodiment on User Preferences and Movement | The requirement to understand the effectiveness of human-robot interaction in rehabilitation | Upper limb rehabilitation | A robotic system; Robot-assisted therapy as a partner on everyday task and using a gamified approach | Outcome: human-robot interactions Motivate an individual’s engagement |
17 | Allam et al. [25] | The Effect of Social Support Features and Gamification on a Web-Based Intervention for Rheumatoid Arthritis Patients: Randomized Controlled Trial | Lack of studies in the usefulness of online social support particularly the gamification on individuals behaviour and health conditions | Hand rehabilitation | a Web-based application with gamification on physical activities that provides patient-centred health education | Outcome: promising individual’s behavioural and health outcomes. Findings: Increased Physical activity (B = 3.39, p = 0.02) |
18 | Melero et al. [45] | Upbeat: Augmented Reality-Guided Dancing for Prosthetic Rehabilitation of Upper Limb Amputees | Unsuccessful rehabilitation rate for upper limb amputees because of dissatisfaction and rejection in rehabilitation experiences | Upper limb rehabilitation | Gamified application with augmented reality (AR) dance game | Outcome: Motivation and engagement in care |
19 | Stuart [2] | Exercise as therapy in congenital heart disease—A gamification approach | Lack of research in congenital heart rehabilitation. More evidence of beneficial treatment in congenital heart treatment is needed particularly in adherence to the rehabilitation activities | Congenital heart | Gamified method—uses off-the-shelf games (Nike+ fuelband) | Outcome: behavioural motivation (commitment to an exercise) Findings: Physical activity (measured with fuel points, a scoring system in the game) improved by 96% after three months. |
20 | Dithmer et al. [51] | “The Heart Game”: Using Gamification as Part of a Telerehabilitation Program for Heart Patients | Low participation of heart patient in rehabilitation treatment and care due to many problems and this include the lack of information and motivation | Cardiac rehabilitation | The Heart Game—Web-based Gamification of the tele-rehabilitating process of heart disease patients | Outcome: Motivation and engagement in care |
21 | Polak et al. [11] | Novel gamified system for post-stroke upper-limb rehabilitation using a social robot: Focus groups of expert clinicians | Repetitive practice of rehabilitation is a great challenge to the therapist due to limited therapy time with the patient. Besides, the patients have to be highly motivated to engage with the repetitive tasks | Post-stroke upper limb | gamified robot-based system (using a socially assistive robot -SAR) | Outcome: Motivation and socially engaged in care |
22 | Vallejo et al. [29] | An agent-based approach to physical rehabilitation of patients affected by neurological diseases | A neurological disorder is a global challenge, and understanding their technology requirement is essential to improve the patient’s quality of life. For that, agent technology may help to improve rehabilitation care. | Neurological diseases (stroke, dementia, ABI) | A gamified application implementing software agent that can play different characters to support the rehabilitation process | Outcome: Motivation and engagement in care |
23 | Janssen et al. [1] | Gamification in physical therapy: More than using games | Applying gamification design therapy session is argued to provide a positive physical and cognitive behavioural pattern to the recovery process | Therapeutic | Gamification approach that uses physical games related to therapy | Outcome: Behavioural patterns for treatment and recovery |
24 | Lv et al. [34] | Clinical feedback and technology selection of game-based dysphonic rehabilitation tool | Dysphonic therapy is archived through the different pitch estimation of the patient’s voice. | Neurological (Dysphonic rehabilitation) | Video game using gamification approach by providing visual feedback for voice exercises | Outcome: Motivation and engagement in care |
25 | Ferreira et al. [20] | Gamification of stroke rehabilitation exercises using a smartphone | The patient’s compliance and motivation for stroke therapy are deficient. | Stroke rehabilitation | Gamification approach using games and phone sensors as a controller | Outcome: Motivation to exercise and compliance in therapy |
26 | Elor et al. [22] | Project Star Catcher: A novel immersive virtual reality experience for upper limb rehabilitation | Evidence of the immersive virtual reality that has a high potential to motivate the patients to go through the recovery process | Upper limb rehabilitation | Project Star Catcher (PSC)—an immersive virtual reality (VR) game in gamified rehabilitation | Outcome: Motivation and engagement in care |
27 | Jung et al. [39] | Ubiquitous gamification framework for stroke rehabilitation treatment based on the web service | Patient’s motivation easily breakdown and delay participation in the rehabilitation program | Stroke rehabilitation | A web gamification framework with individualized game | Outcome: Motivation and engagement in care |
28 | Worthen-Chaudhari et al. [21] | Reducing concussion symptoms among teenage youth: Evaluation of a mobile health app | Youth are at risk of concussion. Mobile health platform is a creative way to connect youth with the concussion problem, particularly in tracking symptom, give treatment and provide support. | Neurological (concussion) | a mobile health application that includes gamification and elements of social game | Outcome: Motivation and engagement in care Findings: symptoms improved more for the experimental than for the active control cohort (U = 18.5, p = 0.028, r = 0.50) |
29 | Taherian et al. [56] | Are we there yet? Evaluating commercial-grade brain-computer interface for control of computer applications by individuals with cerebral palsy | The used of brain-computer interaction as assistive technology for the recovery process of individuals with cerebral palsy | Neurological (Cerebral Palsy) | A gamified application that uses EEG-based visual feedback | Outcome: Promoting motivational encouragement in treatment Findings: variable inconclusive results in the ability to produce two distinct EEG patterns. |
30 | Gauthier et al. [49] | Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multicenter comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis | Constraint-Induced Movement therapy clinical comparative effectiveness trial of in-home gamified therapy has not been conducted yet. | Stroke rehabilitation (hemiparesis) | Game-based exercise using commercially available games in the market and gamified home-based monitoring systems | Outcome: promising individual’s behavioural and health outcomes. |
31 | O’Neil et al. [50] | Virtual Reality for Neurorehabilitation: Insights From 3 European Clinics | The clinical evidence of the effectiveness of virtual reality for motor impairment treatment is sparse | Neurological (Parkinson) | Virtual reality assisted rehabilitation for Parkinson’s neurorehabilitation and gamified home-based telerehabilitation application | Outcome: promising individuals behavioural and health outcomes. |
32 | Yunusova et al. [59] | Game-Based Augmented Visual Feedback for Enlarging Speech Movements in Parkinson’s Disease | The feasibility of using augmented visual feedback to speech rehabilitation treatment on hypokinesia due to Parkinson. | Neurological (Parkinson- speech therapy) | Gamified application for speech therapy via Augmented Visual Feedback (AVF) | Outcome: promising individuals behavioural and improving health outcomes. Findings: 8/9 participants increased their articulatory working space to a greater degree. |
33 | Chen et al. [19] | Breeze: Smartphone-based Acoustic Real-time Detection of Breathing Phases for a Gamified Biofeedback Breathing Training | Slow-paced feedback that guides breathing has shown an improvement in cardiac functioning. | Cardiac rehabilitation | A mobile app application uses Gamified biofeedback-guided for breathing training | Outcome: promising individuals behavioural and improving health outcomes. Findings: User’s significantly lower breathing rates during the Breeze training (b = −6.27, p < 0.001) and the active control condition (b = −3.24, p < 0.001). |
34 | van Dooren et al. [53] | Reflections on the design, implementation, and adoption of a gamified eHealth application in youth mental healthcare | How game design and techniques are applied for a gamified e-health application | Psychological rehabilitation | A gamified e-Health application for youth mental healthcare | Outcome: Change in behaviour and motivation |
35 | Rapp & Cena [18] | Personal informatics for everyday life: How users without prior self-tracking experience engage with personal data | Self-tracking or self-monitoring becomes an issue when dealing with a lot of health personal record | Psychological rehabilitation | A mobile app that includes gamification and personal informatics | Outcome: Change in behaviour and motivation |
36 | Pinto et al. [46] | Adaptive Gameplay and Difficulty Adjustment in a Gamified Upper-Limb Rehabilitation | Patient lack of motivation in physical rehabilitation treatment and care | Upper-limb rehabilitation | a gamified application uses Kinect game for the home-based rehabilitation system | Outcome: promote motivation and engagement |
37 | Ozgur et al. [42] | Gamified Motor Training with Tangible Robots in Older Adults: A Feasibility Study and Comparison with the Young | Sustaining motor skills and functions is important. Assessing the effectiveness of robotic for upper limb motor in gamify environment is minimal | Upper-limb rehabilitation | Gamified Motor Training with the Cellulo, a Tangible Robots system | Outcome: promising individuals behavioural and improving health aging Finding: Elderly participants were able to improve their game performance over time (t(874) = 2.97, p < 0.01) |
38 | Kern et al. [52] | Immersive virtual reality and gamification within procedurally generated environments to increase motivation during gait rehabilitation | Gait rehabilitation required a tool that increases motivation which is achieved by using virtual reality technology | Gait Rehabilitation | Gamification approach in the immersive VR gait training | Outcome: Motivation and engagement in care |
39 | Dobosz et al. [37] | Gamification of cognitive rehabilitation | Improving the quality of brain functions through different cognitive processes | Cognitive Rehabilitation | “RehaMob”—A mobile application for e-health that used gamification for the operation of rehabilitation | Outcome: A positive influence in care |
40 | Chung & Ching [38] | Developing and Evaluating Creativity Gamification Rehabilitation System: The Application of PCA-ANFIS Based Emotions Model | Factors that influence rehabilitation achievement after knee replacement | Physiotherapy (knee) | An emotion model-based game rehabilitation system, which combines virtual reality (VR) and motion capture technology | Outcome: Motivation and engagement in care |
41 | Carneiro et al. [47] | A gamified approach for hand rehabilitation device | Searching for an improved recovering approach for hand rehabilitation | Hand rehabilitation | A gamified approach attached with a set of therapeutic games and implementing augmented feedback | Outcome: Motivation, engagement and therapy effectiveness |
42 | Arlati, S. et al. [26] | A Social Virtual Reality-Based Application for the Physical and Cognitive Training of the Elderly at Home | Improve treatment adherence and motivation to do home self exercises | Physical and Cognitive Training | A virtual-reality social games with SocialBike application for elderly users home rehabilitation | Outcome: Motivation, engagement |
References
- Janssen, J.; Verschuren, O.; Renger, W.J.; Ermers, J.; Ketelaar, M.; Van Ee, R. Gamification in physical therapy: More than using games. Pediatr. Phys. Ther. 2017, 29, 95–99. [Google Scholar] [CrossRef] [PubMed]
- Stuart, A.G. Exercise as therapy in congenital heart disease—A gamification approach. Prog. Pediatr. Cardiol. 2014, 38, 37–44. [Google Scholar] [CrossRef]
- Manolova, A. Application for Hand Rehabilitation Using Leap Motion Sensor Based on a Gamification Approach Application for Hand Rehabilitation Using Leap Motion Sensor Based on a Gamification Approach. Int. J. Adv. Res. Sci. Eng. 2016, 5, 61–69. [Google Scholar]
- González-González, C.S.; Toledo-Delgado, P.A.; Muñoz-Cruz, V.; Torres-Carrion, P.V. Serious games for rehabilitation: Gestural interaction in personalized gamified exercises through a recommender system. J. Biomed. Inform. 2019, 97. [Google Scholar] [CrossRef]
- Afyouni, I.; Einea, A.; Murad, A. Rehabot: Gamified virtual assistants towards adaptive telerehabilitation. In Proceedings of the 27th Conference on User Modeling, Adaptation and Personalization, Larnaca, Cyprus, 9–12 June 2019; ACM: New York, NY, USA, 2019; pp. 21–26. [Google Scholar] [CrossRef]
- Deterding, S.; Sicart, M.; Nacke, L.; O’hara, K.; Dixon, D. Gamification: Using Game Design Elements in Non-Gaming Contexts. In Proceedings of the CHI’11 Extended Abstracts on Human Factors in Computing Systems, Vancouver, BC, Canada, 7–12 May 2011; ACM: New York, NY, USA, 2011; pp. 2425–2428. [Google Scholar]
- Hamari, J.; Koivisto, J.; Sarsa, H. Does gamification work?—A literature review of empirical studies on gamification. In Proceedings of the Annual Hawaii International Conference on System Sciences, Waikoloa, HI, USA, 6–9 January 2014; pp. 3025–3034. [Google Scholar] [CrossRef]
- Johnson, D.; Deterding, S.; Kuhn, K.A.; Staneva, A.; Stoyanov, S.; Hides, L. Gamification for health and wellbeing: A systematic review of the literature. Internet Interv. 2016, 6, 89–106. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sardi, L.; Idri, A.; Fernández-Alemán, J.L. A systematic review of gamification in e-Health. J. Biomed. Inform. 2017, 71, 31–48. [Google Scholar] [CrossRef] [PubMed]
- Tamayo-Serrano, P.; Garbaya, S.; Blazevic, P. Gamified In-Home Rehabilitation for Stroke Survivors: Analytical Review. Int. J. Serious Games 2018, 5, 1–26. [Google Scholar] [CrossRef] [Green Version]
- Polak, R.F.; Bistritsky, A.; Gozlan, Y.; Levy-Tzedek, S. Novel gamified system for post-stroke upper-limb rehabilitation using a social robot: Focus groups of expert clinicians. In Proceedings of the International Conference on Virtual Rehabilitation (ICVR), Tel Aviv, Israel, 21–24 July 2019; pp. 1–7. [Google Scholar] [CrossRef]
- Seaborn, K.; Fels, D.I. Gamification in theory and action: A survey. Int. J. Hum. Comput. Stud. 2015, 74, 14–31. [Google Scholar] [CrossRef]
- Werbach, K. (Re)defining Gamification: A Process Approach; Lecture Notes in Computer Science (Including Subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics); Springer: Cham, Switzerland, 2014; pp. 266–272. [Google Scholar] [CrossRef]
- Huotari, K.; Hamari, J. A definition for gamification: Anchoring gamification in the service marketing literature. Electron. Mark. 2017, 27, 21–31. [Google Scholar] [CrossRef] [Green Version]
- Segura, E.M.; Waern, A.; Segura, L.M.; Recio, D.L. Playification: The PhySeEar case. In Proceedings of the CHI PLAY 2016—2016 Annual Symposium on Computer-Human Interaction in Play, Autin, TX, USA, 16–19 October 2016; ACM: New York, NY, USA, 2016; pp. 376–388. [Google Scholar] [CrossRef]
- Deacon, M.; Parsons, J.; Mathieson, S.; Davies, T.C. Can Wii balance? Evaluating a stepping game for older adults. IEEE Trans. Neural Syst. Rehabil. Eng. 2018, 26, 1783–1793. [Google Scholar] [CrossRef]
- Cugelman, B. Gamification: What it is and why it matters to digital health behaviour change developers. J. Med. Intern. Res. 2013, 15, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Rapp, A.; Cena, F. Personal informatics for everyday life: How users without prior self-tracking experience engage with personal data. Int. J. Hum. Comput. Stud. 2016, 94, 1–17. [Google Scholar] [CrossRef]
- Chen, H.S.; Tomita, N.; Lukic, Y.; Reguera, Á.H.; Fleisch, E.; Kowatsch, T. Breeze: Smartphone-based Acoustic Real-time Detection of Breathing Phases for a Gamified Biofeedback Breathing Training. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 2019, 3, 1–30. [Google Scholar] [CrossRef] [Green Version]
- Ferreira, C.; Guimarães, V.; Santos, A.; Sousa, I. Gamification of stroke rehabilitation exercises using a smartphone. In Proceedings of the REHAB, Oldenburg, Germany, 20–23 May 2014; ICST: Brussel, Belgium, 2014; pp. 282–285. [Google Scholar] [CrossRef] [Green Version]
- Worthen-Chaudhari, L.; McGonigal, J.; Logan, K.; Bockbrader, M.A.; Yeates, K.O.; Mysiw, W.J. Reducing concussion symptoms among teenage youth: Evaluation of a mobile health app. Brain Inj. 2017, 31, 1279–1286. [Google Scholar] [CrossRef]
- Elor, A.; Teodorescu, M.; Kurniawan, S. Project Star Catcher: A novel immersive virtual reality experience for upper limb rehabilitation. ACM Trans. Access. Comput. 2018, 11. [Google Scholar] [CrossRef]
- Kearney, E.; Haworth, B.; Scholl, J.; Faloutsos, P.; Baljko, M.; Yunusova, Y. Treating speech movement hypokinesia in parkinson’s disease: Does movement size matter? J. Speech Lang. Hear. Res. 2018, 61, 2703–2721. [Google Scholar] [CrossRef] [PubMed]
- Mubin, O.; Alnajjar, F.; Jishtu, N.; Alsinglawi, B.; Al Mahmud, A. Exoskeletons with virtual reality augmented reality, and gamification for stroke patients’ rehabilitation: Systematic review. J. Med. Internet Res. 2019, 21, 1–11. [Google Scholar] [CrossRef] [Green Version]
- Allam, A.; Kostova, Z.; Nakamoto, K.; Schulz, P.J. The effect of social support features and gamification on a web-based intervention for rheumatoid arthritis patients: Randomised controlled trial. J. Med. Internet Res. 2015, 17, e14. [Google Scholar] [CrossRef]
- Arlati, S.; Colombo, V.; Spoladore, D.; Greci, L.; Pedroli, E.; Serino, S.; Cipresso, P.; Goulene, K.; Stramba-Badiale, M.; Riva, G.; et al. A Social Virtual Reality-Based Application for the Physical and Cognitive Training of the Elderly at Home. Sensors 2019, 19, 261. [Google Scholar] [CrossRef] [Green Version]
- Eppmann, R.; Bekk, M.; Klein, K. Gameful Experience in Gamification: Construction and Validation of a Gameful Experience Scale [GAMEX]. J. Interact. Mark. 2018, 43, 98–115. [Google Scholar] [CrossRef]
- Kappen, D.L.; Mirza-Babaei, P.; Nacke, L.E. Gamification through the application of motivational affordances for physical activity technology. In Proceedings of the CHI PLAY 2017—Annual Symposium on Computer-Human Interaction in Play, Amsterdam, The Netherlands, 15–18 October 2017; ACM: New York, NY, USA, 2017; pp. 5–18. [Google Scholar] [CrossRef]
- Vallejo, D.; Schez-Sobrino, S.; Albusac, J.; Castro-Schez, J.J.; Glez-Morcillo, C. An agent-based approach to physical rehabilitation of patients affected by neurological diseases. Procedia Comput. Sci. 2019, 160, 346–353. [Google Scholar] [CrossRef]
- Winkle, K.; Caleb-Solly, P.; Turton, A.; Bremner, P. Social Robots for Engagement in Rehabilitative Therapies: Design Implications from a Study with Therapists. In Proceedings of the ACM/IEEE International Conference on Human-Robot Interaction, Chicago, IL, USA, 5–8 March 2018; ACM: New York, NY, USA, 2018; pp. 289–297. [Google Scholar] [CrossRef]
- Eizicovits, D.; Edan, Y.; Tabak, I.; Levy-Tzedek, S. Robotic gaming prototype for upper limb exercise: Effects of age and embodiment on user preferences and movement. Restor. Neurol. Neurosci. 2018, 36, 261–274. [Google Scholar] [CrossRef] [Green Version]
- Chromy, A.; Zalud, L.; Klima, O. DeskBalance: Novel Gamified System for Diagnosis and Treatment of Postural Stability. IFAC-PapersOnLine 2016, 49, 200–205. [Google Scholar] [CrossRef]
- Korn, O.; Tietz, S. Strategies for playful design when gamifying rehabilitation. A study on user experience. In Proceedings of the 10th International Conference on PErvasive Technologies Related to Assistive Environments (PETRA ‘17), Island of Rhodes, Greece, 21–23 June 2017; ACM: New York, NY, USA, 2017; pp. 209–214. [Google Scholar] [CrossRef]
- Lv, Z.; Esteve, C.; Chirivella, J.; Gagliardo, P. Clinical feedback and technology selection of game-based dysphonic rehabilitation tool. In Proceedings of the 9th International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2015, Istanbul, Turkey, 20–23 May 2015; ICST: Brussel, Belgium, 2015; pp. 253–256. [Google Scholar] [CrossRef]
- Muñoz, J.E.; Gonçalves, A.; Rúbio Gouveia, É.; Cameirão, M.S.; BermúdezBadia, S. Lessons Learned from Gamifying Functional Fitness Training through Human-Centered Design Methods in Older Adults. Games Health J. 2019, 8, 387–406. [Google Scholar] [CrossRef]
- Buonocunto, P.; Giantomassi, A.; Marinoni, M.; Calvaresi, D.; Buttazzo, G. A limb tracking platform for telerehabilitation. ACM Trans. Cyber-Phys. Syst. 2018, 2. [Google Scholar] [CrossRef]
- Dobosz, K.; Dobosz, M.; Wojaczek, M. Gamification of Cognitive Rehabilitation. In Computers Helping People with Special Needs; ICCHP 2018. Lecture Notes in Computer Science; Miesenberger, K., Kouroupetroglou, G., Eds.; Springer: Cham, Switzerland, 2018; Volume 10896. [Google Scholar] [CrossRef]
- Chung, H.S.; Ching, H.C. Developing and Evaluating Creativity Gamification Rehabilitation System: The Application of PCA-ANFIS Based Emotions Model. Eurasia J. Math. Sci. Technol. Educ. 2016, 12, 1443–1468. [Google Scholar] [CrossRef]
- Jung, I.; Lee, J.; Kim, J.; Choi, C. Ubiquitous gamification framework for stroke rehabilitation treatment based on web service. In Proceedings of the 4th Workshop on ICTs for Improving Patients Rehabilitation Research Techniques, Lisbon, Portugal, 13–14 October 2016; ACM: New York, NY, USA, 2016; pp. 117–120. [Google Scholar] [CrossRef]
- van der Kooij, K.; van Dijsseldonk, R.; van Veen, M.; Steenbrink, F.; de Weerd, C.; Overvliet, K.E. Gamification as a sustainable source of enjoyment during balance and gait exercises. Front. Psychol. 2019, 10, 1–12. [Google Scholar] [CrossRef]
- Stanmore, E.K.; Mavroeidi, A.; De Jong, L.D.; Skelton, D.A.; Sutton, C.J.; Benedetto, V.; Munford, L.A.; Meekes, W.; Bell, V.; Todd, C. The effectiveness and cost-effectiveness of strength and balance Exergames to reduce fall risk for people aged 55 years and older in the UK assisted living facilities: A multi-centre, cluster randomized controlled trial. BMC Med. 2019, 17, 49. [Google Scholar] [CrossRef]
- Ozgur, G.A.; Wessel, M.J.; Olsen, J.K.; Johal, W.; Ozgur, A.; Hummel, F.C.; Dillenbourg, P. Gamified Motor Training with Tangible Robots in Older Adults: A Feasibility Study and Comparison With the Young. Front. Aging Neurosci. 2020, 12, 1–16. [Google Scholar] [CrossRef] [Green Version]
- Colomer, C.; Llorens, R.; Noé, E.; Alcañiz, M. Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. J. Neuroeng. Rehabil. 2016, 13. [Google Scholar] [CrossRef] [Green Version]
- Fotopoulos, D.; Kilintzis, V.; Chytas, A.; Mavromoustakos, P.; Loizidis, T.; Chouvarda, I. Gamifying Motion Control Assessments Using Leap Motion Controller. Stud. Health Technol. Inform. 2018, 251, 63–66. [Google Scholar] [CrossRef] [PubMed]
- Melero, M.; Hou, A.; Cheng, E.; Tayade, A.; Lee, S.C.; Unberath, M.; Navab, N.; Cutolo, F. Upbeat: Augmented Reality-Guided Dancing for Prosthetic Rehabilitation of Upper Limb Amputees. J. Healthc. Eng. 2019, 2163705. [Google Scholar] [CrossRef] [Green Version]
- Pinto, J.F.; Carvalho, H.R.; Chambel, G.R.R.; Ramiro, J.; Gonçalves, A. Adaptive gameplay and difficulty adjustment in a gamified upper-limb rehabilitation. In Proceedings of the IEEE 6th International Conference on Serious Games and Applications for Health (SeGAH), Vienna, Austria, 16–18 May 2018; pp. 1–8. [Google Scholar] [CrossRef]
- Carneiro, F.; Tavares, R.; Rodrigues, J.; Abreu, P.; Restivo, M.T. A gamified approach for hand rehabilitation device. Int. J. Online Eng. 2018, 14, 179–186. [Google Scholar] [CrossRef]
- Ferreira, B.; Lourenço, J.; Menezes, P. A Serious Game for Post-Stroke Motor Rehabilitation. In Proceedings of the 2019 5th Experiment International Conference (exp.at’19), Funchal, Portugal, 12–14 June 2019; pp. 383–387. [Google Scholar] [CrossRef]
- Gauthier, L.V.; Kane, C.; Borstad, A.; Strahl, N.; Uswatte, G.; Taub, E.; Morris, D.; Hall, A.; Arakelian, M.; Mark, V. Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): Protocol for a multi-centre comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis. BMC Neurol. 2017, 17, 109. [Google Scholar] [CrossRef] [PubMed]
- O’Neil, O.; Fernandez, M.M.; Herzog, J.; Beorchia, M.; Gower, V.; Gramatica, F.; Starrost, K.; Kiwull, L. Virtual Reality for Neurorehabilitation: Insights from 3 European Clinics. Innov. Influ. Phys. Med. Rehabil. 2018, 10, S198–S206. [Google Scholar] [CrossRef]
- Dithmer, M.; Rasmussen, J.O.; Grönvall, E.; Spindler, H.; Hansen, J.; Nielsen, G.; Sørensen, S.B.; Dinesen, B. “The Heart Game”: Using Gamification as Part of a Telerehabilitation Program for Heart Patients. Games Health J. 2016, 5, 27–33. [Google Scholar] [CrossRef] [Green Version]
- Kern, F.; Winter, C.; Gall, D.; Kathner, I.; Pauli, P.; Latoschik, M.E. Immersive virtual reality and gamification within procedurally generated environments to increase motivation during gait rehabilitation. In Proceedings of the 26th IEEE Conference on Virtual Reality and 3D User Interfaces, VR 2019, Osaka, Japan, 23–27 March 2019; pp. 500–509. [Google Scholar] [CrossRef]
- van Dooren, M.M.M.; Siriaraya, P.; Visch, V.; Spijkerman, R.; Bijkerk, L. Reflections on the design, implementation, and adoption of a gamified eHealth application in youth mental healthcare. Entertain. Comput. 2019, 31, 100305. [Google Scholar] [CrossRef]
- Afyouni, I.; Rehman, F.U.; Qamar, A.M.; Ghani, S.; Hussain, S.O.; Sadiq, B.; Rahman, M.A.; Murad, A.; Basalamah, S. A therapy-driven gamification framework for hand rehabilitation. User Model. User Adapt. Interact. 2017, 27, 215–265. [Google Scholar] [CrossRef]
- Shameli, A.; Althoff, T.; Saberi, A.; Leskovec, J. How gamification affects physical activity: Large-scale analysis of walking challenges in a mobile application. In Proceedings of the 26th International World Wide Web Conference, Perth, Australia, 3–7 April 2017; ACM: New York, NY, USA; pp. 455–463. [Google Scholar] [CrossRef] [Green Version]
- Taherian, S.; Selitskiy, D.; Pau, J.; Claire Davies, T. Are we there yet? Evaluating commercial-grade brain-computer interface for control of computer applications by individuals with cerebral palsy. Disabil. Rehabil. Assist. Technol. 2017, 12, 165–174. [Google Scholar] [CrossRef]
- Dias, L.P.S.; Barbosa, J.L.V.; Vianna, H.D. Gamification and serious games in depression care: A systematic mapping study. Telemat. Inform. 2018, 35, 213–224. [Google Scholar] [CrossRef]
- Nussbaum, R.; Kelly, C.; Quinby, E.; Mac, A.; Parmanto, B.; Dicianno, B.E. Systematic Review of Mobile Health Applications in Rehabilitation. Arch. Phys. Med. Rehabil. 2019, 100, 115–127. [Google Scholar] [CrossRef] [PubMed]
- Yunusova, Y.; Kearney, E.; Kulkarni, M.; Haworth, B.; Baljko, M.; Faloutsos, P. Game-based augmented visual feedback for enlarging speech movements in Parkinson’s disease. J. Speech Lang. Hear. Res. 2017, 60, 1818–1825. [Google Scholar] [CrossRef] [PubMed]
Domain | Sub Domain | Gamified Type of Intervention | The Requirement/Needs | References | ||
---|---|---|---|---|---|---|
Gameful Experiences | Sustainable Engagement | Intrinsically Motivation | ||||
Rehabilitative therapies (physiotherapy) | Fostering Self-efficacy and encourage motor training/activities | Gamified application with a series of games | [15,38,40] | |||
Exergame-based training system | [4,33,35,41] | |||||
Mobile Apps and Gamified application | [32,36,37] | |||||
Gamified robot-based system | [5,42] | |||||
Social Application and VR | [26] | |||||
Improve behaviour and health outcomes. | A Web-based intervention which includes gamification on physical activities | [25] | ||||
Nurture self-learning motor recovery | Physical games related to therapy | [1] | ||||
Hand rehabilitation (upper-limb rehabilitation) | Motor recovery | Gamified application with mixed reality (VR/AR) assisted immersive in gamified rehabilitation | [22,43,44,45] | |||
Gamified application with a series of adaptive games | [46] | |||||
Improve muscle strength | Gamified application with series of games and motion sensors | [3] | ||||
Improve motor control | Gamified application with a series of games | [47] | ||||
Gamified robot-based system | [31] | |||||
General Stroke rehabilitation | Improve muscle strength | gamified robot-based system | [11] | |||
Web based gamified system with games | [39] | |||||
Improve motor coordination | Gamified application with a series of games | [48] | ||||
Improve movement and mobility | Games and smartphone sensors | [20] | ||||
Gamified application with video games | [49] | |||||
Neurological rehabilitation (Parkinson) | Improve movement and mobility | A video game—Virtual reality exergames Augmented Reality games | [23,50] | |||
Neurological rehabilitation | Reduce concussion | Mobile social gamified apps | [21] | |||
Improve quality of life | Gamified application with multiple roles of Software agent | [29] | ||||
Video game using gamification approach | [34] | |||||
Nurture self-learning and adherence | Gamified application with a series of games | [2,51] | ||||
Gait rehabilitation | Improve movement | Gamification approach using VR in training | [52] | |||
Psychology Rehabilitation | Improve quality of life | A gamified mobile e-Health application | [53] |
Selection Block | References | Target Techniques | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Motivational Narratives | Goal-Oriented Tasks | Responsive Feedback | Rewards | Fantasy | Personalization | Personal Informatics | Visual Feedback | Iterative Feedback | ||
Levels and challenges | [3,24,33,36,43] | |||||||||
Scoring (points-based system), quests, and avatar | [32,35,40] | |||||||||
Dashboard and levels | [4] | |||||||||
Avatar (identification and personalization), narrative context, and feedbacks | [15,30] | |||||||||
Avatar (identification and personalization), dashboard (analytics), levels, feedback, challenges, rewards, and narrative context | [11,20,34,50,54] | |||||||||
Dashboard and feedback | [16,47] | |||||||||
Leaderboards, score, levels, and challenges | [31,44,45,55] | |||||||||
Points, badges, and medals (awards) | [21,25,49] | |||||||||
Leaderboard, points, trophy, and rewards | [2] | |||||||||
Badges, leaderboards, and levels | [51] | |||||||||
Leaderboard, score (point), progression (tracking), star | [29] | |||||||||
Feedback and rewards | [1,56] | |||||||||
Levels, feedback, status, and challenge | [19,22] | |||||||||
Feedback, progress, score, personalization, and dashboard (analytic) | [23,39] | |||||||||
Points, badges, challenges, visualization of progress, narrative, goal settings, and visual progress | [53,57] |
Rehab Domain | Gamified Application | Gamification Requirements | Gamification Technique | Applied Game Element | Status | |
---|---|---|---|---|---|---|
[32] | Physiotherapy | mobile & web system | Motivation Engagement | visual feedback Rewards | Feedback Scoring (Points-based system) | |
[4] | Physiotherapy | Exergame | Motivation and engagement | Personalize experiences | Narrative, challenges, avatar | |
[16] | Physiotherapy | Exergame | Motivation and engagement | Personal informatics | Dashboard feedback | |
[29] | Neurological diseases (dementia) | Web Application system | Motivation and engagement | Goal oriented task | Avatar, leaderboard, score | |
[34] | Neurological (Dysphonic) | Gamified application | Motivation and engagement | Visual feedback | Avatar, feedback, narrative context | |
[21] | Neurological (concussion) | Mobile apps | Motivation and engagement | Rewards | Points, badges, award | |
[18] | Psychological Rehabilitation | Gamified Web applicaton | motivation | Personal informatics | Progression, challenges, points | |
[53] | Psychological Rehabilitation | Gamified web application | Motivation | Motivational narratives Personal Informatics | Points, badges, challenges, progression |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Tuah, N.M.; Ahmedy, F.; Gani, A.; Yong, L.N. A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges. Information 2021, 12, 91. https://doi.org/10.3390/info12020091
Tuah NM, Ahmedy F, Gani A, Yong LN. A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges. Information. 2021; 12(2):91. https://doi.org/10.3390/info12020091
Chicago/Turabian StyleTuah, Nooralisa Mohd, Fatimah Ahmedy, Abdullah Gani, and Lionelson Norbert Yong. 2021. "A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges" Information 12, no. 2: 91. https://doi.org/10.3390/info12020091
APA StyleTuah, N. M., Ahmedy, F., Gani, A., & Yong, L. N. (2021). A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges. Information, 12(2), 91. https://doi.org/10.3390/info12020091