At peak popularity, the smartphone game resulted in injuries similar to those linked with other moderate-intensity outdoor activities.
In July 2016, a new smartphone game called Pokémon Go rose to record-breaking popularity. The app encourages players to walk to real-world locations in order to collect virtual creatures called “Pokémon” and “battle” them against nearby players’ Pokémon. Within two weeks of its release, more people in the United States were playing Pokémon Go every day than any other mobile game in history.
“While the game isn’t allowed inside hospitals, my colleagues at Kaiser Permanente Santa Clara were trading tips about PokéStops nearby where they could collect Pokémon during breaks,” said Erika Barbero, MD, now a primary doctor at Kaiser Permanente’s Redwood City Medical Center. “Patients told me the game made them get outside more, but word also spread about game-related injuries coming into the emergency room.”
Buzz about the risks and benefits of Pokémon Go inspired Barbero — who has played the game herself — and her colleagues to systematically explore these effects. In a new study published April 30, 2018, in the journal Games for Health, they show that patients treated in the Kaiser Permanente Northern California system reported more benefits than injuries from the game between July and November of 2016.
To identify patients who may have had doctor visits related to the game, study co-author Diane Carpenter, MPH, of the Biostatistical Consulting Unit at the Kaiser Permanente Northern California Division of Research, searched for the words “Pokémon” or “Pokemon” in electronic medical records. After her clinical colleagues reviewed the charts, Carpenter performed further analyses to illuminate additional patient characteristics and help interpret the results.
“Dr. Barbero was a resident at the time, and this project is a great example of the type of work we do in the Biostatistical Consulting Unit to support resident research,” Carpenter said.
Out of 222 patients who experienced a Pokémon Go-related injury or benefit, two thirds (147) reported a benefit, such as getting more exercise, while one third (75) reported an injury, such as a sprain or fracture resulting from a distracted fall. The types of reported injuries were similar to those typically seen with light-to-moderate outdoor activities like hiking or walking.
“We didn’t see quite as many severe injuries as we expected from what we saw in the news,” said senior author Daniel Tseng, MD, MS, FACP, a primary care doctor at Kaiser Permanente’s Campbell Medical Offices. “Overall, the risk of injury appeared fairly low, considering that over 250,000 Kaiser Permanente Northern California members were likely playing the game at the time.”
More than one third of patients who reported benefits from playing Pokémon Go had diabetes or prediabetes, and the proportion of obese patients in the study was higher than in the general U.S. population. “This suggests the game may be reaching a population that needs increased physical activity,” Barbero added.
Based on the findings, Barbero and Tseng said they would not dissuade patients from playing Pokémon Go, but would encourage them to be aware of their surroundings to minimize risk of injury.
“I hesitate to say that I would recommend the game, since many kids already use electronic devices excessively,” Tseng said. “But if it helps kids who wouldn’t otherwise get enough exercise, that’s a good thing.”
The researchers are curious to see what the next Pokémon Go–like trend will be. In particular, they wonder whether activities involving virtual reality headsets will have notable, large-scale medical effects. “I’m also interested in the kinds of policies and laws that will be implemented to limit risks from augmented reality games,” Tseng said, noting a recent ban in Honolulu on distracted use of cellphones in crosswalks.
Joetta Maier, MD, of The Permanente Medical Group at Kaiser Permanente Santa Clara Medical Center also contributed to the study. Funding was provided by the Kaiser Permanente Northern California Residency Research Program, which is supported by the Kaiser Permanente Community Benefit Program.
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