Competitive and cooperative arm rehabilitation games played by a patient and unimpaired person: effects on motivation and exercise intensity.

All patients completed only one brief session, so the study does not show whether motivation or movement speed would stay high over many sessions. The outcomes were questionnaire motivation and movement speed, not arm function or long-term recovery. The movement-speed increase was mainly seen in patients who chose competition as their favorite; patients who chose cooperation did not move faster than alone. The two patient groups were different: those with friends or relatives had finished clinical rehabilitation and were years after injury, while those with the therapist were months after injury. The same therapist served as co-player for all therapist sessions, so therapist effects cannot be separated from patient-group differences. Questionnaire answers were missing for some items, and one participant's movement data were lost. Personality was measured only in the friend/relative group, not in the therapist group. The cooperative games still included a computer opponent, and in split-field cooperation the impaired participant could be idle half the time. Some high-intensity movements included torso compensation, which may not help limb function. The study used only Pong-style games, so results may not apply to other game designs.

The study was funded by the National Institute of General Medical Sciences. The Bimeo rehabilitation system is commercially available from Kinestica d.o.o, Slovenia.

Do not read the higher movement speed as proof that competitive games improve arm function. The study lasted one session and measured movement speed and questionnaire enjoyment, not long-term arm recovery. The intensity gain was mainly in participants who chose competition as their favorite.