JMIR Publications

ABSTRACT

Background:

Low levels of treatment adherence can negatively affect the outcome of physical rehabilitation. Theories on human behavior and supportive alternatives to conventional therapies, such as serious games, have been developed to improve adherence. However, there are still gaps in serious games when implementing motivation, engagement and improving treatment adherence.

Objective:

Design a conceptual framework for serious games based on key adherence factors and the GameFlow model to improve patient adherence to physical therapy.

Methods:

The conceptual framework is based on two fundamental concepts: key adherence factors to increase adherence to physical exercise and the GameFlow model to incorporate enjoyment in the developed videogames. As a result, they will be intrinsically motivating and increase user engagement.

Results:

This framework was created from the search in systematic reviews for factors that promote adherence to rehabilitation and elements of the original GameFlow model. Regarding adherence, the following factors were included: perception of therapy, self-efficacy, motivation, initial exploration and exercise history, social support, accessibility, personalization of the exercise program, and use of technology. For the original GameFlow model: concentration, feedback, immersion, and social interaction, along with three new elements: adaptivity, usability and accessibility, and motivational factor.

Conclusions:

With the implementation of this framework in the development of serious games, motivation, participation, engagement, collaboration, and enjoyment will be encouraged to contribute to adherence to the physical rehabilitation process of patients.