The effects of exergaming on individuals with limb loss: a systematic review

Authors: Jae-Llane Ditchburn1, Ileana Ciobanu2



1 University of Cumbria, Carlisle, UK

2 Elias University Emergency Hospital, Bucharest, Romania



Losing a limb is a life-changing experience. Affected individuals (amputees) have reduced physical range of motion, poorer balance control, strength, and experience pain and fatigue. Exergaming is currently used in physical rehabilitation. There is currently no consensus on the efficacy of exergaming delivered to people with missing limbs. This systematic review aims to evaluate and summarize the current research on the effects of exergaming among individuals with missing limbs. Studies reporting on exergaming intervention delivered to individuals receiving prosthetic rehabilitation were included in the analysis. Ten electronic databases were searched. Twelve articles were identified. Data were extracted and assessed for quality.

Three main categories of exergaming interventions comprised custom made exergames, Nintendo Wii and the Computer Assisted Rehabilitation Environment (CAREN) system. All participants in the studies were adults, except for one study which evaluated exergaming in adolescents and children. Studies reported improvements in EMG muscle control, cognitive-motor ability, walking capacity, function, balance and reduced pain, and positive experiences amongst most participants. Results suggest that exergaming supports improvements in physical activity, balance, cognition, emotional states, quality of life and pain.

Exergaming interventions administered to people with missing limbs show heterogeneity in protocol, duration and gaming platform. Although there was evidence of improved outcomes in participants, the efficacy of exergaming is inconclusive due to varied differences in types of amputation, participant characteristics and assessed outcome measures. Nevertheless, reported enjoyment, acceptance and levels of motivation during exergaming appear to support the feasibility of exergaming for prosthetic training.


Key words: amputees, exergaming, active video games, rehabilitation.

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The effects of exergaming on individuals with limb loss: a systematic review