For clinicians

Evidence library

Research on what games and play can do within occupational therapy — organized by area of practice, with each finding stated plainly and every source linked.

What the evidence shows →

By area of practice

The site's four evidence areas — described in evidence-honest language.

Cognition

Games demand active participation, quick decision-making, and adaptation to changing scenarios. Within skilled therapy, they are used to work on attention, memory, mental flexibility, and executive-function skills — with the aim of carryover to daily activities.

Physical disabilities

Through motion-controlled systems and virtual environments, games let people practice targeted movement. Therapists use them to support range of motion, postural control, strengthening, and functional use of the upper limbs — as an adjunct within a plan of care.

Therapeutic exercise

Motion-controlled and interactive gameplay can make repetitive exercise more engaging. Therapists grade it toward strength, flexibility, balance, range of motion, and endurance goals — the game raises adherence and dose, the clinician provides the skilled work.

Mental health & participation

Games and play are explored within therapy to support motivation, engagement, self-efficacy, and social participation. We describe this as emerging and supportive — not as treatment for any specific condition.

Selected research

Each card carries the population, the honest finding, and a link to the source.

Virtual reality and interactive video gaming for stroke rehabilitation (Cochrane Review, update)

Verified

Laver KE, et al. · 2025

Population: 190 randomized trials · 7,188 participants · adults after stroke

Gaming ADDED to usual care (increasing therapy dose) probably improves upper-limb function — moderate-certainty (SMD 0.42). Adverse events were few and mild. The review examines many other outcomes and populations, and is candid about where evidence is stronger or still uncertain — read it in full via the link.

Read the source ↗

AOTA Practice Guidelines — Adults with stroke

Primary source

AOTA (AJOT) · 2023

Population: Occupational therapy after stroke

The profession’s own 2023 guideline reserves its STRONGEST evidence ratings for conventional, task-oriented methods (task-oriented training, mirror therapy, mental imagery, balance training, self-management). The single game-based intervention it rated — a wearable device paired with training games — earned only moderate evidence, and for social participation. Safe reading: game-based OT is promising and emerging, not yet established in the guidelines.

Read the source ↗

This is a starter set of verified sources. More systematic reviews will be added only after the same verification pass — see SOURCES.md.

The through-line: games extend the dose of skilled therapy — more of the right practice, delivered in a form clients want to keep doing. That is what the strongest evidence supports.

The evidence library is for members

Inside this resource:

Research summaries by area of practice
Verified citation cards with real effect sizes
Plain-language findings and primary sources

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