Exercise is important for everyone. Also for patients in the hospital and rehab patients in the rehabilitation department. But right now, exercising during admission is not attractive at all. The hallways are dull and there is little to do in the ward. In addition, patients often lose confidence in their bodies or do not always know that exercise contributes to faster recovery.

Little exercise negatively affects muscle strength, which also reduces their ability to function in daily life at home. The risk of complications increases, increasing the likelihood of a transfer to a care facility. The stay in the hospital or rehabilitation center also takes longer, creating a vicious cycle.

”You deteriorate in the hospital when you should actually be getting better.”

Patiënt E

Department of lung diseases, UMC Utrecht

As a result, in the hospital, during the day, 60% of the time is spent in bed. However, by implementing more exercise, patients yield less physical function and reduce complications. Increased exercise also reduces the length of hospitalization from 5 to 14%. That’s physical gain for the patient, and financial gain for the hospital.

Even in rehabilitation centers, patients lie on their beds or sit in their chairs a lot outside of therapy and move little. On average, they receive only 22 to 60 minutes of training per day. It is known that if they are offered intensive rehabilitation (70 minutes more exercise per day in the first six months) it leads to better results during daily activities.

Extended reality (XR) gaming has gained popularity in the rehabilitation sector. Several studies show the benefits of XR gaming. However, most XR games are played on a screen or obstruct the player’s view of their surroundings, preventing movement in free space. Integrating the game into the player’s environment creates a mixed reality (MR) environment. Gaming in MR increases movement and maintains the learned motor principles longer and at a higher level compared to regular physical therapy.

HoloMoves’ MR games focus on more and more fun movement in free space. And additionally address specific therapy goals such as: range of shoulder and elbow movement, moving in free space and encouraging arm-hand function on the table. Moving in MR provides learning (differential and implicit) and feedback (knowledge of results) in different ways. This keeps the practiced therapy goals more present and at a higher level. This allows for more exercise and a higher degree of independence at home after discharge.

“It’s a fun way to be able to exercise my arm.” ” I tried it out during HandArmGroup and was able to play it again in the evening with the nurse.”

Rehabilitator F

Rehabilitation, The High Street

The HoloMoves exergames have not yet been scientifically studied. We do know that more intensive rehabilitation is achieved using virtual reality (VR) game. This is expected to be even better with MR, as a result of home integration.

In addition to adequate exercise, it is important for a patient to have adequate knowledge about his/her condition and why exercise is important. There is not enough time and resources to properly bring the patient into the knowledge of complex consequences of their condition.

In fact, in a conversation with the healthcare provider, only 20-60% are remembered. It is important that, once again, a patient can take in the information at his own pace. This increases the patient’s empowerment, which will make him/her more committed to his/her recovery.

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