SilverFit 3D

The SilverFit has been designed specifically for use by older people. It is a virtual therapy system to train gross motor skills and ADL tasks during rehabilitation sessions or supervised exercise programmes. The exercises are presented in games and provide direct positive feedback and motivate the older person to push their boundaries. The exercises can be accommodated to suit both the physical and cognitive level, even if it is at a very low level. An advisory menu including clinical protocols helps the therapist to select the right exercise. The development of the protocols and exercises are based on scientific research and clinical practice. By now more than 20.000 people are training with the SilverFit each week.

The SilverFit employs a 3D camera that registers movements, even very small movements can be detected. The movements are linked to a game. At the end, the client can see the progress of the game and the final results on a display screen, and carries out the requested exercise.

Exercise of vital importance

Exercise is important for rehabilitation and health. The SilverFit exercises can be used for rehabilitation purposes, ADL activities and for encouraging movement in general. The exercises are always based on scientific guidelines and clinical practice.

Games motivate

The continuous feedback on the screen is a source of motivation. The game offers distraction and challenges the user to achieve objectives. Because people immerse themselves in the game, they often turn out to be able to do things which they did not deem themselves capable of in advance. They shift their borders and increase their self-confidence. 

Designed specifically for elderly care

The SilverFit has been developed specifically for elderly care. All exercises can be tailored to the capabilities of the client. The exercises are adjustable in terms of physical movement, cognitive challenge, and vision.

Starting from very low level

A client may already participate from a very low level. Many exercises can be done from a seated position and the client does not have to hold anything. The high-tech camera is able to detect very small movements. 

More than 1 million possibilities

With SilverFit, it is possible to elicit 40 unique movements with more than 30 different visualisations and hundreds of game variations. When you take all different adjustments into account, there are about 1.2 million unique settings in total.

Easy to use 

The SilverFit is easy to use. You can start an exercise with a few mouse clicks. The advisory menu makes it really easy to find the right setting for every participant.

Medical outcomes tracking

It is possible to measure every participant's progress over a period of time. This allows the therapist to document and review the performance of patients over time in an effective way. 

Reviewing performance on video

Participants can record their performance and review these afterwards. This also enables the therapist and patients to view and discuss performance. It is also possible to view a series of video's from different sessions in order to provide insight to the progress made. 

Motor learning and feedback

These following elements are of interest for learning motor skills during treatment (Stroke 2014 Guideline by KNGF): 

  • the exercise should be tailored to the client
  • the exercises must have sufficient repetition
  • verbal and non-verbal feedback must be given on implementation 
  • the motivation to learn should be increased by informing the client of the purpose, by coaching and by giving (positive) feedback


A review by Holden (2005) shows that games enhance the motivation of the client. This allows the client to practice longer and much more often, without it being experienced as a burden. The continuous feedback from the games enhances motivation. This includes both direct feedback (am I doing well or not) as well as insight into long-term performance improvement. 

why does adding games

Therapy adherence 

Rhodes et al. (2009) showed that exercising with video games leads to higher therapy adherence than exercise without video games. The research shows that higher therapy adherence is caused because participants have more fun training with video games than without. Lohse et al. (2013) described that video games lead to voluntary participation, extension of practice time and a high possibility of repeating the exercise. These factors increase motivation and could once again contribute to greater therapy adherence.

Intrinsic motivation is high when using SilverFit

In cooperation with Leiden University Medical Centre (LUMC) we examined levels of motivation when using the SilverFit. This showed that rehabilitation patients especially experienced intrinsic motivation; they trained not to achieve something, but because they enjoyed it. This type of motivation usually leads to the highest compliance. The therapists also indicated that the SilverFit caused more enthusiasm and more movement during therapy sessions (Oudheusden, 2013). 

Balance and mobility

Darekar et al. (2015) wrote a review on the effect of virtual therapy on balance and mobility after a stroke. The results of the review showed that interventions with virtual therapy had significant positive effects on dynamic balance, walking speed and waking quality in comparison to interventions without virtual therapy. 

Silverfit exercise is the best balance game

At the University of Trondheim in Norway, Skjaeret et al. (2014) compared three different games to train balance. One of those games was a SilverFit game, the mole game. The study looked at 5 movement aspects of balance. Of the three games that were tested, the mole game scored best on all aspects. The mole game also scored highest on the System Usability Scale (SUS; Nawaz et al. 2014).

skaejeret EN

Fall prevention protocol on SilverFit

Van Gastel & van der Burgt (2012) developed a fall prevention protocol for the SilverFit with the goal of improving balance, gait and muscle strength in the lower extremities. After a period of 6 weeks in which 1-hour training sessions with the SilverFit took place twice a week, they saw progress in the results of each participant for tests such as the Timed Up & Go, the Berg Balance Scale, and the Timed Chair Stand test. The fall prevention protocol is one of the protocols that are included in the SilverFit.

Encouraging exercise in the ward

In the study of Van Wijngaarden (2014), one of the goals was to increase the number of training moments for the geriatric orthopaedic rehabilitant to two moments daily of 20 to 30 minutes. These training moments occurred at the physiotherapist’s and in the ward under the direction of caregivers and occupational therapists.  After a period of 6 weeks, the percentage of clients that trained 2 times a day increased from 0 to 60%.


  • Braam, M. (2014). Een nieuwe output voor het mollenspel: Een onderzoek naar fysieke parameters geschikt voor het waarnemen van vooruitgang van spelers en te registreren zijn tijdens het mollenspel. The Hague University of Applied Sciences, unpublished BSc-thesis work
  • Darekar, A., McFadyen, B.J., Lamonagne, A. & Fung, J. (2015). Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review. Journal of NeuroEngineering and Rehabilitation, 12:46
  • De Deugd, J., Willemse, J. & Rademaker, R. (2010). SilverFit virtual reality game as an evaluation tool for hip function. Avans University of Applied Sciences 2010, poster publication in Brussel
  • Faatz, T., Kerstens Y., Sipkes, N. & van Wensveen, R. (2015). Hoe serieus is serious gaming? Avans University of Applied Sciences, unpublished BSc- thesis work
  • Griswold, D., Rockwell, K., Killa, C., Maurer, M., Landgraff, N. & Learman, K. (2014). Establishing the reliability and concurrent validity of physical performance tests using virtual reality equipment for community-dwelling healthy elders. Disability and Rehabilitation, 37(12):1097-1101 
  • Holden, M.K. (2005). Virtual environments for motor rehabilitation: review. Cyberpsychology & Behavior: The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society 8, no. 3: 187-211; discussion 212-9
  • Lohse, K., Shirzad, N., Verster, A., Hodges, N. & Van der Loos, M. (2013). Video games games and rehabilitation: Using design principles to enhance engagement in physical therapy. Journal of Neurologic Physical Therapy, 37:166-175
  • Nawaz, A., Skjaeret, N., Ystmark, K., Helbostad, J.L., Vereijken, B. & Svanaes, D. (2014). Assessing senior's user experience (UX) of exergames for balance training. In Proceeding of NordiCHI, pp. 578-587
  • Rhodes, R.E., Warburton, D.E.R. & Bredin, S.S.D. (2009). Predicting the effect of interactive video bikes on exercise adherence: an efficacy trial. Psychology, Health & Medicine, 14 (6), 631-640
  • Richtlijn Beroerte (2014). Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF)
  • Skjaeret, N., Nawaz, A., Ystmark, K., Dahl, Y., Helbostad, J.L., Svanaes, D. & Vereijken, B. (2014). Designing for movement quality in exergames: lessons learned from observing senior citizens playsing stepping games. Gerontology, online first: 1-9
  • Van Gastel, M. & van der Burgt, R. (2011). Verminderen van vallen met de SilverFit. Fysiotherapie & Ouderenzorg, 26(1): 11-17
  • Van Oudheusden, P. (2013). Virtual reality in de ouderenrevalidatie. University of Applied Sciences Leiden, unpublished MSc-thesis work
  • Van Wijngaarden, J. (2013). Kan therapeutisch gamen gebruikt worden als extra trainingsmoment bij de geriatrische orthopedische revalidant? Avans Plus University of Applied Sciences, unpublished MSc-thesis work


Fox GameIconSmall  balance upper body
Bingo GameIconSmall  sit-stand transfer
Puzzle GameIconSmall  bend over forwards and sideways, sit-stand
Picnic GameIconSmall  lower extremity


Mole GameIconSmall   dynamic balance in standing, lunging
Vegetable GameIconSmall  squatting and bending
Puzzle GameIconSmall  bending from standing position


Fox GameIconSmall   walking sideways
Wolf GameIconSmall  walking forwards and backwards
Flower GameIconSmall  walking in all directions
Walking GameIconSmall

walking on the spot


Puzzle GameIconSmall reaching
Chicken GameIconSmall  moving and lifting arm
Volley GameIconSmall  timing arm movements
Funfair GameIconSmall  throwing
BeachBallGameSmall general movement
fishinggameSmall elevation of the shoulders
divergameSmall strenght training arms

Wheelchair proficiency

Wolf GameIconSmall 

accelerating and braking wheelchair 

Flower GameIconSmall manoevring in the wheelchair

Cognition (various movement options)

Memory GameIconSmall short term memory 
ArithmeticButtonSmall calculations
VisualSearchButtonSmall abstract figures
PictureRecognitionButtonSmall object-object recognition
WordAssociationButtonSmall word-image recognition
SoundRecognitionButtonSmall sound-image recognition

ADL exercises

RoomSearching GameThumbnailSmall  everyday environments 
Sequence GameThumbnailSmall sequences


FunctionalReachSmall functional reach 
SitToStandSmall sit to stand test 
TimedUpAndGoSmall timed up and go 

The SilverFit provides many different exercise options. We have built in a “treatment advice” menu with treatment protocols and exercise programs. This menu will guide you to the right exercises based on your objectives. You first select a particular diagnosis. ADL task or exercise programme, then the system will subsequently suggest to you a set of exercises. These exercises are an advice: the therapist can always decide to choose differently or adjust settings.


  • COPD
  • CVA
  • Hip arthrosis
  • Knee arthrosis
  • Total hip arthroplasty
  • Total knee arthroplasty

In development:

  • Parkinson's
  • Heart failure
  • Amputation
  • Osteoporosis 

Activities of Daily Life

  • Sit-stand transfers
  • Picking up objects
  • Single step up/down (sidewalk)
  • Planning sequential tasks
  • Assessing situations

In development: 

Training motor functions related to:

  • Chair-chair transfer (toilet transfer)
  • Eating
  • Using toilet
  • Getting dressed (lower extremity)
  • Washing

Exercise programmes/prevention

  • COPD
  • Dementia
  • Fall prevention
  • Frail elderly

In development:

  • Multiple disabilities
  • Active Ageing

Standard components

SilverFit software suite 

SilverFit software suite

A professional and complete set of exercises and settings

SilverFit verrijdbare standaard

Mobile stand

The SilverFit is situated on a mobile stand. Please see other assembly options below



A pre-installed computer system



A 42" flat screen mounted on the sandard or on the wall

3D camera

3D camera

The 3D camera is integrated in the system

professionele afstandsbediening

Professional remote control

SilverFit is standard-equipped with a remote control for the therapist

SilverFit vereenvoudigde afstandsbediening

Simplified remote control

A simplified remote control can be supplied for use by patients or volunteers


Service package (1 year, extendable)

On-site installation, training of all potential users, 1year hardware guarantee, quick service in caes of any problems, software updates

Alternative assembly options


Wall mount

The SilverFit can be mounted on to the wall if system mobility is not required