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In adults with brain injuries, video game–based treatment improves functioning more than usual treatment

Saywell N, Taylor N, Rodgers E, et al. Play-based interventions improve physical function for people with adult-acquired brain injury: A systematic review and meta-analysis of randomised controlled trials. Clin Rehabil. 2016 Feb 11. [Epub ahead of print]

Review question

In people who acquire brain injuries during adulthood, does video game–based treatment improve functioning more than usual treatment?


Injuries to the brain can happen with physical trauma, such as a car accident or fall, or with a medical emergency, such as a stroke. Symptoms of brain injury can include changes in vision, hearing, or other senses; difficulty thinking, remembering, sleeping, or talking; problems with balance or mood; paralysis; and seizures.

Rehabilitation that includes physical therapy and speech therapy often helps with long-term recovery from brain injuries. Repetitive activities may help with recovery, but they are time-consuming and often boring.

How the review was done

The researchers did a systematic review based on studies available up to November 2015.

They found 30 randomized controlled trials with 822 people.

The key features of the studies were:

  • people were 21 to 85 years of age;
  • most studies included  people who had strokes, many of whom had weakness on one side of their bodies;
  • people had had their injuries 11 days to 9 years before the study;
  • video game–based exercises included electronic gaming systems such as Nintendo Wii, IREX VR, Sony Playstation Eyetoy, Xbox Kinect, TheraDrive Therapy Games, T-WREX, Rutgers Ankle Rehabilitation System, robotic platforms, and customized systems;
  • people participated in video game–based exercises for 30 minutes to 1 hour, 3 to 5 times each week, for 1 day to 9 weeks; and
  • play-based exercises were compared with usual treatment or no treatment.

What the researchers found

Of the 30 studies, 13 were of high quality and 17 were of moderate quality.

Compared with usual treatment or no treatment, play-based treatments improved

  • arm functioning;
  • walking ability and speed;
  • balance;
  • independence; and
  • functioning.


In people who acquire brain injuries during adulthood, video game–based treatment improves functioning more than usual treatment.

Video game–based treatments vs usual treatment or no treatment for brain injuries acquired during adulthood


Number of trials

Effect of treatment*

Arm functioning


Small improvement

Walking ability and speed


Small improvement



Medium improvement



Medium improvement

General physical functioning


Small improvement

*Based on standard mean differences (SMDs), comparing video games vs usual treatment or no treatment; very small = less than 0.2 SMD, small = 0.2 to 0.49 SMD, medium = 0.5 to 0.79, large = 0.8 or more SMD.

Related Topics


Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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