Video games and health Video gaming is safe for most players and can be useful in health care
Although playing video games is one of the most popular leisure activities in the world, research ^into its effects on players, both positive and negative, is often trivialised. Some of this research deserves to be taken seriously, not least because video game playing has implications for health.1 One innovative application of video games in health care is their use in pain management The degree of attention needed to play such a game can distract the player from the sensation of pain, a strategy that has been reported and evaluated among paediatric patients. One case study reported the use of a handheld video game to stop an 8 year old boy pick ing at his face. The child had neurodermatitis and scarring due to continual picking at his upper lip. Pre vious treatments had failed so the boy was given a hand held video game to keep his hands occupied. After two weeks the affected area had healed. Control led studies using both randomised controlled trials and comparison with patient's own baseline measures show that video games can provide cognitive distraction for children during chemotherapy for cancer and treatment for sickle cell disease.2"5 All these studies reported that distracted patients had less nausea and lower systolic blood pressure than controls (who were simply asked to rest) after treatment and needed fewer analgesics. Video games have been used as a form of physiotherapy or occupational therapy in many different groups of people. Such games focus attention away from potential discomfort and, unlike more traditional therapeutic activities, they do not rely on passive movements and sometimes painful manipulation of the limbs. Video games have been used as a form of physiotherapy for arm injuries,wl in training the movements of a 13 year old child with Erb's palsy,w2 and as a form of occupational therapy to increase hand strength/3 Therapeutic benefits have also been reported for a variety of adult populations including wheelchair users with spinal cord injuries,6 people with severe burns,7 and people with muscular dystrophy/4 Video games have also been used in com prehensive programmes to help develop social and spatial ability skills in children and adolescents with severe learning disability or other developmental problems, including autismw5 w6; children with multiple handicaps (for example severely limited acquisition of speech)w7 w8; and children with impulsive and attention deficit disorders/9 However, there has been no long term follow-up and no robust randomised controlled trials of such interventions. Whether patients eventually tire of such games is also unclear. Furthermore, it is not known whether any distracting effect depends simply on con centrating on an interactive task or whether the content of games is also an important factor as there have been no controlled trials comparing video games with other distractors. Further research should examine factors within games such as novelty, users' preferences, and relative levels of challenge and should compare video games with other potentially distracting activities. While playing video games has some benefits in certain clinical settings, a growing body of evidence highlighting the more negative aspects of play? I References w1-w28 are on bmj.com
2) Let the game bigin
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