Games extend the dose of skilled therapy
The largest synthesis in this space is the 2025 Cochrane review of virtual reality and
interactive video gaming for stroke rehabilitation (190 RCTs,
7,188 participants). Its central, positive finding:
Added to usual care SMD 0.42
Gaming that increases the dose of therapy probably improves upper-limb
function — moderate certainty. Adverse events were few and mild.
In practice, that means games let a clinician deliver more of the right repetitions, in a form
clients want to keep doing. They work alongside the therapist, amplifying skilled care.
The review covers many more outcomes and populations, and is candid about where evidence is
stronger or still developing. Read it in full:
Cochrane CD008349.pub5 (Laver et al., 2025) ↗
A fast-growing area of practice
Game-based intervention is an active, expanding area in occupational therapy — studied in the
profession's own flagship journal and positioned in AOTA's practice guidelines as emerging
alongside established, task-oriented methods. The evidence is building, and the direction is
promising.
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