The landscape of neuromuscular recovery is shifting, bringing recovery tools out of the clinic and into the home. At the heart of this evolution is the integration of Functional Electrical Stimulation (FES) with mobile gaming, which offers an engaging, scalable, and evidence-based support to patients through their recovery journey.

FES has long been a cornerstone in neurorehabilitation, supporting people with neurological conditions such as stroke, spinal cord injury, and cerebral palsy. It supports task-specific movements by stimulating target muscle groups, showing clear benefits in range of motion, muscle strength, and reduction of spasticity, while also improving motor control (Urton et al., 2007). These benefits are enhanced when FES is paired with the patient’s maximum voluntary effort (Rushton, 2003).

Mobile gaming technology has opened new avenues for delivering FES therapy in home settings, enhancing patient engagement, adherence, task repetition, and independence. Early evidence from Purohit et al. (2025) supports this integrated approach, demonstrating how the combination of FES and digital interfaces can empower stroke survivors to participate in structured, task-specific rehabilitation.

The Power of Play: Gaming Mechanics in Recovery

What makes mobile gaming relevant in this context isn’t just entertainment. It’s engagement mechanics. Gamified therapy introduces elements like:

These core mechanics significantly improve adherence. In a six-week feasibility study, over 84% of stroke survivors maintained participation in a smartphone-based functional electrical stimulation (FES) program that integrated exercise with digital tracking (Purohit et al., 2025). Participants also reported significant increases in motivation, enjoyment, and competence, essential ingredients for long-term recovery.

Real-World Use Cases: Where FES and Gaming Meet

1. FES-Assisted Hand Therapy Video Games for Children with Hemiplegia

A study by Fu et al. (2020) piloted a home-based program that combined contralaterally controlled functional electrical stimulation (CCFES) with custom-designed video games for children with hemiplegia. This novel approach allowed the stimulation of the more-affected hand to be controlled by the voluntary movement of the less-affected hand. Over six weeks, three children aged 8–11 showed high adherence (up to 97%), playing 5–7 hours weekly at home. Motor improvements were observed in assessments such as the Fugl-Meyer, Assisting Hand Assessment (AHA), and Melbourne Motor Assessment (Fu et al., 2020).

Games like Paddle Ball, Skee Ball, and Marble Maze were effective in facilitating repetitive hand movements and retaining children’s attention through goal-setting, difficulty scaling, and in-game feedback, addressing the common issue of low adherence in pediatric home therapy.

“The therapy helped me hold an iPad with my affected hand for the first time,” reported one participant.

This case study confirms that combining purpose-driven video game design with interactive FES can successfully translate clinical rehabilitation principles into a home-based format.

2. Smartphone-Based Exercise Training Integrated with FES After Stroke

Purohit et al. (2025) introduced Smartphone Exercise Training after Stroke to adults aged 60+ with moderate-to-high motor impairments. The system delivered multicomponent training (gait, balance, and strength exercises) through a smartphone app, integrated with Bluetooth-enabled functional electrical stimulation (FES) wearables.

Over six weeks, participants reported zero serious adverse events, achieved 84% adherence, and demonstrated notable clinical gains in balance, gait speed, and strength. Importantly, motivation and usability scores increased significantly across the board, with many participants expressing a desire to continue using the app and FES device even after the study ended.

“The stimulation helped me complete exercises I couldn’t do alone,” one participant noted.

This case highlights how gamified FES platforms can extend therapy beyond traditional clinical models, addressing the access and motivation challenges faced by older adults after a stroke.

Why This Matters: Key Benefits of Gamified Home Therapy

Enhanced Accessibility
Patients can continue therapy independently, overcoming logistical and financial barriers to in-clinic care.
Increased Engagement
Gamified features drive repetition and motivation, improving consistency and effort.
Personalised Therapy
Mobile-first systems can dynamically adapt stimulation intensity, difficulty levels, and exercise type to meet the patient's evolving needs.
Cost-Effectiveness
Reduces the need for therapist-supervised sessions while maintaining therapeutic value.

By embracing the synergy of FES and mobile gaming, neuromuscular recovery is evolving into a more accessible, adaptive, and patient-centred experience.

References

Urton, M., Kohia, M., Davis, J., & Neill, K. (2007). Functional Electrical Stimulation in Neurorehabilitation: Effects on Motor Function in Patients with Stroke.

Rushton, D. N. (2003). Functional electrical stimulation and rehabilitation: a hypothesis. Medical Engineering & Physics, 25(1), 75–78.

Fu, M. J., Curby, A., Suder, R., Katholi, B., & Knutson, J. S. (2020). Home-Based Functional Electrical Stimulation-Assisted Hand Therapy Video Games for Children with Hemiplegia: Development and Proof-of-Concept. IEEE Trans Neural Syst Rehabil Eng, 28(6), 1461–1470.

Purohit, R., Appelgren-Gonzalez, J. P., Varas-Diaz, G., Wang, S., Hosiasson, M., Covarrubias-Escudero, F., & Bhatt, T. (2025). Feasibility of Smartphone-Based Exercise Training Integrated with Functional Electrical Stimulation After Stroke (SETS): A Preliminary Study. Sensors, 25(4), 1254.

Home-Based FES and Mobile Gaming: A New Era in Neuromuscular Recovery