The Role of Gamification in Neurocognitive Rehabilitation

Introduction

The new digital information and communication technologies (ICTs) have changed the way we live and work and have contributed to countless opportunities in several areas, including healthcare (Entwistle & Newby, 2013; Mühleisen, 2018; WHO, 2005). In addition to the advantages already documented in the literature, such as globalization, the narrow of cultural gaps and an easier, cheaper and wider form of communication (Mühleisen, 2018), the widespread use of digital ICTs has untapped potentialities; conversely safety, ethical standards, quality, and respect for the principles of confidentiality of information, privacy, equity, and equality are challenges that this kind of tools brings about (WHO, 2005).

Several concepts have been created to translate the application of digital ICTs to healthcare, including e-health. Although not consensual and with numerous meanings, the concept of e-health was defined by the World Health Organization (2005), at the 58th World Health Assembly, as “… the cost-effective and secure use of information and communications technologies in support of health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge and research” (WHO, 2005, p. 212). At this same conference, a set of recommendations was made to the member states for e-health’s proper development, implementation, and evaluation, enabling the dissemination of cost-effective models and evidence-based practices. As a result, new solutions that might support different sectors and health services have a new capacity for reaching populations that need them, including the more vulnerable groups such as migrants or refugees (Dores et al., 2017; Drda-Kühn et al., 2019).

People who suffered an acquired brain injury (ABI) are a vulnerable group. Although in recent years, ABI survival rate has increased, mainly because of the improvement of emergency services, survival is not always synonymous of a desirable quality of life, often compromised by emotional, cognitive, and behavioral changes (Dores et al., 2016; Menon & Bryant, 2019; Zasler & Martelli, 2003). In these cases, intervention should include neurocognitive rehabilitation as part of a more comprehensive neuropsychological rehabilitation process (Miotto et al., 2008; Zasler & Martelli, 2003).

Despite the evidence about the efficacy and effectiveness of neurocognitive rehabilitation (Cicerone et al., 2019; Geraldo et al., 2018), there is a long path to overcome limitations related to service providers and to the process itself, which is often long, slow, and associated with significant changes in patients’ lives.

Integrating digital ICTs in neurocognitive rehabilitation processes has been shown to be an important asset. However, the great potential of digital ICTs remains to be explored, namely developing rehabilitation tasks closer to real-life activities, increasing their ecological validity and engagement capacity building (van der Ham et al., 2018).

Platforms, serious games, and virtual environments have been developed and made progressively available, with good results (Rego et al., 2018; Ma & Zheng, 2011). Boosted by the technological development and the widespread acceptance of gambling and gaming as recreational activities (Griffiths et al., 2012), gamification has emerged as a strategy capable of providing the necessary incentives to improve people's involvement in non-recreational activities, as the ones’ proposed during rehabilitation process. Gamification has the potential to enhance characteristics such as perseverance, learning, optimism, and curiosity (McGonigal, 2014), through the increment of motivation related to the pleasure provided by game’s experiences (Schell, 2010), thereby increasing the possibility of a successful intervention. Therapists may propose game-based experiences, without an enormous investment in technology.

This chapter proposes to reflect and deepen the knowledge about the use of serious games and gamification in the neurocognitive rehabilitation of ABI patients. We will begin by presenting an overview of the existent scientific evidence and knowledge of rehabilitation services and move towards the identification of challenges and future paths. A section with solutions and recommendations on how to possible overcome the problems previously identified is also included. A section with solutions and recommendations on how to possible overcome the problems previously identified is also included.