PTOTSLPNarrative ReviewJournal of neuroengineering and rehabilitation2021

Immersive virtual reality health games: a narrative review of game design.

Gordon Tao, Bernie Garrett, Tarnia Taverner and 2 others

PMID 33573684

WHAT IT FOUND

Most virtual reality health games rely on simple points and scoring rather than engaging game design.

Therapists should not assume immersion alone drives adherence; without compelling mechanics, these tools may fail to sustain long-term patient engagement.

Key findings

01The majority of reviewed games used scoring and extrinsic rewards as their core motivation, rather than complex game dynamics or narratives.

02Game design details were often missing or superficial, with 8 of 29 games lacking sufficient information to analyze their mechanics or dynamics.

03Few studies used validated measures for user experience or technology adoption, relying instead on ad-hoc questionnaires that make comparisons difficult.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

This is a narrative review, not a systematic review, meaning the selection of articles and interpretation of design features were more subjective. The search was restricted to English-language articles and those published from 2015 onwards, potentially missing earlier or non-English innovations. Many primary studies did not report sufficient game design details, making it difficult to assess the quality of the interventions. The review did not evaluate the clinical efficacy of the games, only their design and evaluation methods.

Declared interests

The authors declared no competing interests. The work was supported by non-US government funding.

The easy way to misread this

Do not assume that virtual reality games are inherently more engaging or effective than traditional therapy because they are immersive. The review found that most games rely on simple point-scoring mechanics that may not sustain long-term adherence, and few were evaluated with validated measures of user experience.

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