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Mr. Huang says it brightens his day when he gets calls from gamers — and their parents — who are using Guitar Hero (whose sales by early 2008 had exceeded $1 billion in North America alone) for therapeutic use.

“Video games having a positive impact on kids is not what we usually hear,” he says. “It’s very rewarding to get those calls.”

Tweaked games often don’t make it to market because the demand is relatively small and the games may not make significant enough profits to make them worthwhile to game companies, Mr. Heckendorn says.

“The bottom line is — no matter how good the game is — it’s got to make money,” he says.

Ms. Penny uses at least 10 games in her therapies, including WiiFit, which enables patients to work on strength and balance through various yoga, hula-hoop and other exercises. She also uses Cooking Mama, in which the patient-gamer simulates chopping veggies, cutting meat and arranging items on a plate.

She says she started using video games in therapy about 15 months ago, and the results are promising.

“Gaming helps break the monotony of physical therapy,” she says.

Also, it helps get rid of discrimination, she says, because the patient-gamers can play online against people who don’t know they are disabled, which is liberating.

“They can play against and win against someone in France who has no idea they’re a stroke patient,” she says. “It gives them bragging rights. ‘I played Wii today, and I knocked someone out.’”

While much emphasis is put on physical rehabilitation, mental rehabilitation is just as important, Ms. Penny says.

“Our big concern is that people will sink into depression,” she says. “That’s why re-connecting to something that they enjoyed and were good at before the injury is so important.”

Mr. Heckendorn says he keeps this in mind when he does his “tweaking.”

“I’m not in the medical field, but it seems to me that how you feel mentally is a big part of therapy,” Mr. Heckendorn says. “I hope [Guitar Hero] can help make them feel like they’re back in the groove.”