For The Exclusive,
Muskan Joshi
When we think of video games, we often picture hours of entertainment, action-packed adventures, or friendly competition. But could they serve a greater purpose? Beyond the fun and excitement, video games are being explored for their potential therapeutic benefits, particularly in stroke rehabilitation. As researchers dive deeper, they are discovering how specific game mechanics can stimulate cognitive and motor recovery, turning an entertainment medium into a powerful tool for healing. This raises a compelling question: can video games be more than just play?
A stroke is a life-threatening condition when there is an obstruction in the blood supply to part of the brain, either due to ischemia where a clot blocks the blood flow in an artery supplying the brain, or an aneurysm causing the artery to burst and leading to a hemorrhage. Neurons are susceptible to hypoxia, and in the case of an ischemic stroke, they begin to undergo apoptosis 3-6 minutes after being subjected to hypoxia- resulting in long-term brain damage. While in a hemorrhage the leaked blood puts pressure on the neurons causing damage. Some of the manifestations of stroke include ataxia, aphasia, inability to see the visual field of the side affected from each eye, and impaired cognition.
The brain has an extremely unique phenomenon of regaining impaired functions due to the loss of neurons known as neuroplasticity- which is the brain's ability to reorganize itself by forming new neural connections in response to new information. This reorganization takes place by a mechanism known as axonal sprouting, where undamaged neurons sprout nerve endings and connect with other undamaged nerve cells, resulting in the formation of new neural pathways. Applying the concept of neuroplasticity, a novel therapy has recently emerged, where stroke patients are rehabilitated through the use of video games. Highly repetitive and task-oriented video games fulfill the principles of motor learning, inducing neuroplastic adaptations and recovery in stroke patients. Video games use principles such as meaningful play, feedback, goals, rewards, challenges, and increasing difficulty to keep players engaged, encourage repetition and help improve various functions including cognitive functions such as visual attention, memory, and reaction time; regain movement in the affected side and improve hand functions.
Video game consoles such as the Nintendo Wii and Sony’s PlayStation have been shown to provide improvement in the functions of the upper extremity; including hand motor function, grip strength, and dexterity. Microsoft Kinect, yet another gaming console, targets the upper limbs with movements, including having a grasp on the handheld controller and simultaneously performing given movements. Just Dance, a rhythm game, targets the entire body by imitating whole-body postures with rhythmic movements.
Virtual reality video games are also extremely beneficial and allow patients to fully immerse themselves in gaming. Users wear a headset and can interact with a variety of virtual simulations that provides a multisensory experience to perform task-specific exercises promoting neuroplasticity. CT Speech and Cognitive Therapy is yet another video game used for speech and cognitive training exercises that help improve functions such as language, memory, problem-solving, etc.
According to Stokes & Stack in 2014, it was reported that only 22% of healthcare professionals and 17% of patients agreed that there is good arm and hand therapy in hospitals for stroke patients, such results highlight the importance of self-management approaches for rehabilitation of stroke patients such as the use of video game therapy. It has been shown that the introduction of video game training in physical rehabilitation has offered similar results as conventional therapy and therefore, can be used as a treatment in the rehabilitation of stroke patients and to maintain the benefits of rehabilitation. Video games are easily accessible and cost-effective but low motivation and inefficient engagement are prominent concerns of this therapy. Evidence has shown that video games can be a powerful therapeutic tool when intelligently integrated into rehabilitation and can help counter these issues and keep the patients engaged to keep practicing.
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