Digital Rehabilitation through Play: Improving Core Stability in Post-Abdominal Surgery Patients Using Gamified Balance Platform

Home > 2025, Vol. 12 No. 1 > Digital Rehabilitation through Play: Improving Core Stability in Post-Abdominal Surgery Patients Using Gamified Balance Platform

Published: January 9, 2026

Download PDF

Download HTML

Authors

K. Sowndarya, K. Saravanan, and A. Ahamed Thajudeen

DOI Number
https://doi.org/10.15415/jmrh.2025.121004

Keywords
Abdominal surgery, Core stability, Gamified therapy, Digital balance board, Postoperative physiotherapy

Abstract

Background:Core muscle dysfunction is a common complication after major abdominal surgeries, often leading to delayed recovery, postural instability, and an increased risk of hernia recurrence. Conventional physiotherapy, though effective, may lack the engagement required for long term adherence. Integrating gamification into rehabilitation introduces an interactive and motivating approach that enhances neuromuscular coordination and patient participation. This study evaluates the effectiveness of a gamified digital balance platform in improving core stability among post abdominal surgery patients compared to traditional physiotherapy.

Objective: To evaluate the effectiveness of a gamified digital balance board in improving core stability in patients recovering from abdominal surgery by integrating interactive play based therapy with conventional rehabilitation.

Methods A quasi experimental study was conducted on 30 participants aged 30–40 years who had undergone elective or emergency abdominal laparotomy. Participants were purposively assigned to two groups: Group A (digital rehabilitation using a gamified balance board, n = 15) and Group B (conventional core exercises, n = 15). Both groups trained thrice weekly for six weeks. Core stability was assessed using McGill’s Core Endurance Tests, including trunk flexor, extensor, and side bridge endurance. Statistical analysis was performed using paired and independent t tests at a significance level of p < 0.05.

Results: Among the 30 participants (median age 35.5 years, 20 women), both groups showed significant improvement (p < 0.05), but Group A demonstrated greater gains in core stability.

Conclusion: Gamified rehabilitation using the MEND digital balance board significantly enhanced core stability compared to conventional methods. This approach presents a valuable adjunct to traditional physiotherapy, promoting better engagement and improved outcomes in post surgical recovery.

References

2050 Healthcare. (2005). Rehabilitation after abdominal surgery: How to regain core strength and avoid complications. 2050 Healthcare. https://www.2050healthcare.com/healthcare-articles/rehabilitation-after-abdominal-surgery-how-to-regain-core-strength-and-avoid-complications
Abdominal Core Health Quality Collaborative. (2020). Abdominal core surgery rehabilitation protocol: Patient guide (Version 6-17-2020) [PDF]. https://achqc.org/uploads/general_images/ACHQC_Abdominal_Core_Surgery_Rehabilitation_Protocol_Patient_Guide_6.17.20.pdf
Aldhuhoori, F. Z., Walton, L. M., Bairapareddy, K. C., Amaravadi, S. K., & Alaparthi, G. K. (2021). Physiotherapy practice for management of patients undergoing upper abdominal surgery in United Arab Emirates: A national survey. Journal of Multidisciplinary Healthcare, 14, 2513–2526. https://doi.org/10.2147/JMDH.S328528
Alfieri, F. M., da Silva Dias, C., de Oliveira, N. C., & Battistella, L. R. (2022). Gamification in musculoskeletal rehabilitation. Current Reviews in Musculoskeletal Medicine, 15(6), 629–636. https://doi.org/10.1007/s12178-022-09797-w
Alves, I., Moreira, A. P., Sousa, T., Gonçalves, F., Magalhães, B. M., & Fernandes, C. S. (2025). Exergames rehabilitation program for postoperative cancer patients undergoing abdominal surgery: A quasi-experimental study. Enfermería Clínica. Advance online publication. https://doi.org/10.1016/j.enfcle.2025.502212
Alves, I., Moreira, A. P., Sousa, T., Teles, P., Magalhães, B. M., Gonçalves, F., & Fernandes, C. S. (2024). The effect of exergame rehabilitation on the quality of life of cancer patients undergoing abdominal surgery: A randomized controlled trial. Supportive Care in Cancer, 32(12), 794. https://doi.org/10.1007/s00520-024-09005-0
Americas Hernia Society Quality Collaborative Foundation. (2019). Abdominal core health rehabilitation: Abdominal core surgery rehabilitation protocol physical therapist guide (Version 08-09-2019) [PDF]. https://achqc.org/uploads/resources/AHSQC-Abdominal-Core-Surgery-Rehabilitation-Protocol-Physical-Therapist-Guide-08-09-2019.pdf
Barry, G., Galna, B., & Rochester, L. (2014). The role of exergaming in Parkinson’s disease rehabilitation: A systematic review of the evidence. Journal of NeuroEngineering and Rehabilitation, 11, 33. https://doi.org/10.1186/1743-0003-11-33
Behm, D. G., Drinkwater, E. J., Willardson, J. M., & Cowley, P. M. (2010). The use of instability to train the core musculature. Applied Physiology, Nutrition, and Metabolism, 35(1), 91–108. https://doi.org/10.1139/H09-127
Boden, I. (2024). Physiotherapy management of major abdominal surgery. Journal of Physiotherapy, 70(3), 170–180. https://doi.org/10.1016/j.jphys.2024.06.005
Butowicz, C. M., Ebaugh, D. D., Noehren, B., & Silfies, S. P. (2016). Validation of two clinical measures of core stability. International Journal of Sports Physical Therapy, 11(1), 15–23.
Deltombe, T., Wautier, D., De Cloedt, P., Fostier, M., & Gustin, T. (2017). Assessment and treatment of spastic equinovarus foot after stroke: Guidance from the Mont-Godinne interdisciplinary group. Journal of Rehabilitation Medicine, 49(6), 461–468. https://doi.org/10.2340/16501977-2226
Donath, L., Rössler, R., & Faude, O. (2016). Effects of virtual reality training (exergaming) compared to alternative exercise training and passive control on standing balance and functional mobility in healthy community-dwelling seniors: A meta-analytical review. Sports Medicine, 46(9), 1293–1309. https://doi.org/10.1007/s40279-016-0485-1
Fitton Davies, K., Clarke, S., Martins, R., Rudd, J. R., & Duncan, M. (2024). The effect of a home-based, gamified stability skills intervention on 4–5-year-old children’s physical and cognitive outcomes: A pilot study. Psychology of Sport and Exercise, 73, 102636. https://doi.org/10.1016/j.psychsport.2024.102636
Hodges, P. W., & Richardson, C. A. (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain: A motor control evaluation of transversus abdominis. Spine, 21(22), 2640–2650. https://doi.org/10.1097/00007632-199611150-00014
Hope, W. W., Abdul, W., & Winters, R. (2025). Abdominal wall reconstruction. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK431108/
Huxel Bliven, K. C., & Anderson, B. E. (2013). Core stability training for injury prevention. Sports Health, 5(6), 514–522. https://doi.org/10.1177/1941738113481200
Khaleghi, A., Aghaei, Z., & Mahdavi, M. A. (2021). A gamification framework for cognitive assessment and cognitive training: Qualitative study. JMIR Serious Games, 9(2), e21900. https://doi.org/10.2196/21900
Moghadam, N., Ghaffari, M. S., Noormohammadpour, P., Rostami, M., Zarei, M., Moosavi, M., & Kordi, R. (2019). Comparison of the recruitment of transverse abdominis through drawing-in and bracing in different core stability training positions. Journal of Exercise Rehabilitation, 15(6), 819–825. https://doi.org/10.12965/jer.1939064.352
MRC. (2025, May 11). Balance training with technology: A new era in physical therapy. RehabIndia. https://rehabindia.org/blog/balance-training-with-technology-a-new-era-in-physical-therapy/
MRC. (n.d.). Balance training with technology: A new era in physical therapy. RehabIndia. Retrieved September 22, 2025, from https://rehabindia.org/blog/balance-training-with-technology-a-new-era-in-physical-therapy/
Park, S., Hetzler, T., Hammons, D., & Ward, G. (2018). Effects of biofeedback postural training on pre-existing low back pain in static-posture workers. Journal of Back and Musculoskeletal Rehabilitation, 31(5), 849–857. https://doi.org/10.3233/BMR-171071
Perrodin, S. F., Salm, L., & Beldi, G. (2023). Safety of core muscle training immediately after abdominal surgery: Systematic review. BJS Open, 7(6), zrad142. https://doi.org/10.1093/bjsopen/zrad142
Physical Treatments. (2014). Effect of 8-week core stabilization exercises on low back pain, abdominal and back muscle endurance in patients with chronic low back pain due to disc herniation. Physical Treatments, 4, 25–32.
Pirovano, M., Surer, E., Mainetti, R., Lanzi, P. L., & Borghese, N. A. (2016). Exergaming and rehabilitation: A methodology for the design of effective and safe therapeutic exergames. Entertainment Computing, 14, 55–65. https://doi.org/10.1016/j.entcom.2015.08.003
Rehabtronics. (n.d.). How gamification is transforming rehab. Rehabtronics. https://rehabtronics.com/healing-through-play-how-gamification-is-transforming-rehab/
Sardi, L., Idri, A., & Fernández-Alemán, J. L. (2017). A systematic review of gamification in e-health. Journal of Biomedical Informatics, 71, 31–48. https://doi.org/10.1016/j.jbi.2017.05.011
Sulfikar Ali, A., Arumugam, A., & Kumaran, S. D. (2021). Effectiveness of an intensive, functional, gamified rehabilitation program in improving upper limb motor function in people with stroke: A protocol of the EnteRtain randomized clinical trial. Contemporary Clinical Trials, 105, 106381. https://doi.org/10.1016/j.cct.2021.106381
Wolf, S., Zanker, J., Sommer, F., Vlasenko, D., Pinto, D. R. M., Hoffmann, M., Anthuber, M., & Schrempf, M. C. (2022). Immersive virtual reality fitness games for enhancement of recovery after colorectal surgery: Study protocol for a randomized pilot trial. Pilot and Feasibility Studies, 8(1), 256. https://doi.org/10.1186/s40814-022-01213-x
Zlotnik, S., Weiss, P. L. T., Raban, D. R., & Houldin-Sade, A. (2023). Use of gamification for adult physical rehabilitation in occupational therapy: A novel concept? Hong Kong Journal of Occupational Therapy, 36(2), 51–56. https://doi.org/10.1177/15691861231179037

How to Cite

K. Sowndarya, K. Saravanan, and A. Ahamed Thajudeen. Digital Rehabilitation through Play: Improving Core Stability in Post-Abdominal Surgery Patients Using Gamified Balance Platform. J. Multidiscip. Res. Healthcare. 2025, 01, 29-38

Digital Rehabilitation through Play: Improving Core Stability in Post-Abdominal Surgery Patients Using Gamified Balance Platform

Current Issue

Periodicity	Biannually
Issue-1	June
Issue-2	December
ISSN Print	2393-8536
ISSN Online	2393-8544
RNI No.	CHAENG/2014/57978

This work is licensed under a Creative Commons Attribution 4.0 International License.

Articles in Journal of Multidisciplinary Research in Healthcare by Chitkara University Publications are Open Access articles that are published with licensed under a Creative Commons Attribution- CC-BY 4.0 International License. Based on a work at https://jmrh.chitkara.edu.in/. This license permits one to use, remix, tweak and reproduction in any medium, even commercially provided one give credit for the original creation.

View Legal Code of the above-mentioned license, https://creativecommons.org/licenses/by/4.0/legalcode

View Licence Deed here https://creativecommons.org/licenses/by/4.0/