Exergaming: Video Games that Improve Health

If your patient needed rehabilitation for an injury or simply wanted to sharpen his or her cognitive skills, do you think they’d rather be asked to perform mundane movement drills and fi ll out test sheets or play a fun video game?

Video games have certainly come a long way since the Atari smash-hit Pong. The evolution of video games and their consoles has always been driven by graphics and the desire to make gameplay as entertaining as possible, whether it be “shoot-‘em- up” games or sports games that realistically simulate actual gameplay. While this will always be the goal for entertainment game developers, the fact of the matter is that video games have found a niche in the healthcare industry in the last five years, and all signs point to this trend continuing to grow. Whether it be the dynamic new way the Nintendo Wii allows users to engage in gameplay or the different ideas healthcare providers have been coming up with to use other consoles, the timing could not be better.

Many organizations exist solely to champion advances in this field. The Robert Wood Johnson Foundation (RWJF) has also been an instrumental part of this process, helping to fund and call attention to these organizations. In November 2009, RWJF announced that nine leading research teams had been selected to study how digital games can improve the health of players. The primary goal of these studies was to discover how interactive games could be used by patients with chronic conditions to help self-manage their care. RWJF donated a total of $1.85 million to the selected research teams through its Health Games Research (www.healthgamesresearch.org) national program. The researchers are investigating applications for video games in patients with a variety of conditions and health needs, including:

Children’s Hospital of Philadelphia (CHOP) — CHOP received funding to get its “Reward Circuitry, Autism and Games that Teach Social Perceptual Skills” program off the ground. The study will test the “effects of facial perception games on the brain activity and facial perception skills of 8- to 12-year- old children who have been diagnosed with an autism spectrum disorder (ASD).”

Long Island University (LIU) — Funding was allotted to LIU in order to compare the use of a commercially available dance pad video game, Dance Dance Revolution for the Nintendo Wii, to “two traditional treatment options that help people with Parkinson’s disease reduce their risk of falling by increasing their balance, strength, endurance, motor coordination and visual- motor integration.” The two traditional treatments are rhythmic stepping and treadmill training with music.

Teachers College, Columbia University — Teachers College has set out to develop and evaluate a smoking reduction game delivered on a mobile phone. The game is “intended to be an alternative to smoking with the goal of reducing or eliminating tobacco use in players’ lives,” and “involves breathing into a microphone to control gameplay and is coupled with sound, color, images, challenges and feedback to mimic the stimulant and relaxant effects of smoking.”

Among the other organizations that are devoted to incorporating video games into healthcare is the industry-leading Games for Health (www.gamesforhealth.org/index3.html); its mission is to “develop a community and best practices platform for the numerous games being built for health care applications.” To date, Games for Health has “brought together researchers, medical professionals, and game developers to share information about the impact games and game technologies can have on health care and policy.” They hold an annual conference (see sidebar for more info) so that game developers, physicians, and other stakeholders can come together and brainstorm new ideas to help patients through the use of video games. Visitors to the Games for Health site will fi nd slide presentations from various summits and events, videos about incorporating video games into healthcare, and links to blogs on the subject. Another area of the Games for Health network of organizations dedicated to this cause is the Serious Games Initiative, which focuses on “uses for games in exploring management and leadership challenges facing the public sector.” Visit the link above to explore all the ways in which the Games for Health network is working to make the most out of video gaming in healthcare with the help of healthcare professionals like you.

Although RWJF and Games for Health have been investigating the potential use of gaming in healthcare for some time, developments over the last fi ve years have really launched this topic into the forefront of healthcare. Perhaps the best example of a high-profi le gaming system that has incorporated games that can improve health has been Nintendo’s revolutionary new system, the Wii. This new style of interactive gaming has proven to be very popular and has consequently been at the forefront of the movement to utilize video games in maintaining and improving health. Owners of this system have a number of games to choose from that can help them tone their body, lose weight, and improve cognition. The Wii is naturally suited to help users improve health, because most games require players to use motion sensors and body movement to play, as opposed to traditional gaming systems that require users to sit and use a controller. The fi rst game released on the Wii was Wii Sports, which was an excellent way for players to engage, indoors, in games like tennis, bowling, and boxing. The system and gaming style was well received by consumers, and manufacturers were quick to jump on the motion sensor-style gaming. This opened the door for games that specifi cally focused on health; Nintendo took advantage of this opportunity by releasing Wii Fit, which contained a variety of activities that focused on making fitness fun. Released in October 2009, it has already become the second-best selling video game in history (http://tinyurl.co/2qfm5f). Because of these successes, consumers can now walk into their local video game retailer and buy games like Your Shape, which features Jenny McCarthy as your aerobic and exercise instructor, and Jillian Michaels Fitness Ultimatum 2010, which “features one-on-one training for players on-the-go, so you’ll never miss a workout.”

Aside from helping autistic children, Parkinson’s disease patients, and smokers, there are many ways video games are being used to benefi t patients; check out some of the other programs for which RWJF has provided funding at http://tinyurl.com/ydvdn8d. As game developers continue to create more dynamic and interactive games, there will continue to be opportunities to utilize well-known gaming systems in healthcare. In addition, leaders in this fi eld will surely come up with their own types of consoles and games specifi cally designed with patients in mind. Who would have thought that Q-Bert, Sonic, and Mario would one day be helping you and your patients get and stay healthy?

Further Reading

We’ve been keeping tabs on the development of video games that are intended to improve patients’ health for some time. To learn more about the different ways this type of technology is helping patients, visit the links below.

Wii-Habilitation: Medical Use of the Nintendo Wii

Until very recently, the thought of rehabilitation patients bowling, golfi ng, boxing, and playing baseball within a medical facility or offi ce was not only outrageous, but impossible. Well, times have changed, and Nintendo’s Wii console is steadily making its way into hospitals.

http://hcplive.com/technology/articles/Wii_Habilitation

5 Questions with... Tom Söderlund, CEO of Zyked

The Wii Fit has some competition. We spoke with Söderlund about the origins of Zyked and the future of exercising gaming. www.hcplive.com/technology/articles/Tom_ Söderlund_Zyked

Chronic Disease Improved with Interactive Games

Researchers are finding that interactive game systems like Nintendo’s Wii are especially helpful for people with chronic health conditions. Playing the games increases physical activity and can even improve the ability to care for oneself.

http://hcplive.com/technology/articles/chronic_ disease_interactive_games

Video Games for Health: A New Approach to Educating and Treating Pediatric Cancer Patients

Video games helping kids with cancer? A novel approach, but it’s a good one. Games are not just for kids anymore, after all. Read on to find out more.

http://hcplive.com/oncology/publications/oncng- Oncology/2007/Jan2007/ONG_Video_Games_for_Health

Interested in becoming more involved in the Games for Health Initiative? Sign up for this year’s Games for Health Fifth Annual Conference 2009. It will take place this May in Boston, MA and will “provide great insight to the growing worlds of exergaming/active games, health training games, disease management efforts, and much much more.” To learn more, and to check out a preliminary schedule, visit http://tinyurl.com/ydtl3ap.