title: Intrinsic or Extrinsic? Using Videogames to Motivate Stroke Survivors: A Systematic Review.
abstract: OBJECTIVE
  The main objective of this study was to explore, via a systematic review of available literature, the effectiveness of videogame-based rehabilitation interventions on the motivation and health outcomes of stroke patients.
  
  
  METHODS
  Using a systematic literature review of 18 articles, we sought to address three key research questions: (1) Do videogames improve function or health outcomes among stroke survivors? (2) Do videogames increase stroke patients' motivation to engage in rehabilitation exercise and activities? (3) Which motivational techniques, principles, and theoretical frameworks have been applied in the reviewed studies? A key word search was conducted, and articles were coded for inclusion of motivational theories or principles, intervention effectiveness, and participants' motivation to perform tasks. Three motivational frameworks and principles were used (self-determination theory [SDT], flow theory, and operant conditioning) to investigate intrinsic and extrinsic approaches.
  
  
  RESULTS
  Past research suggests videogame-based interventions are effective at improving and increasing a variety of health-related outcomes, including motor functioning, energy expenditure, muscle strength, and recovery times in stroke patients.
  
  
  CONCLUSIONS
  Past evidence shows videogame-based interventions are a promising tool to motivate stroke patients' engagement in effective rehabilitation activities. This study also identifies an opportunity for future research to apply motivational theories from SDT to studies on stroke rehabilitation and videogames.
authors.affiliation: Purdue University , West Lafayette, India na.
authors.forename: LaTasha R
authors.initials: LR
authors.lastname: Swanson
authors.affiliation: Purdue University , West Lafayette, India na.
authors.forename: David M
authors.initials: DM
authors.lastname: Whittinghill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity; D053580:Muscle Strength; D020127:Recovery of Function; D000071939:Stroke Rehabilitation / Q000379:methods* / Q000523:psychology*; D017741:Survivors / Q000523:psychology; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014584:User-Computer Interface; D018910:Video Games / Q000523:psychology*