Gamified virtual environments are increasingly applied in rehabilitation engineering to improve patient motivation and adherence to repetitive therapeutic training. In such systems, auditory feedback contributes to immersion, task guidance, and reinforcement of motor actions. This paper examines the role of sounds and spatial audio in screen-based virtual reality (VR) exergaming applications used for motor rehabilitation. The audio architecture of game-engine-based systems is discussed with emphasis on realtime spatialization techniques typically limited to stereo panning and distance-based attenuation rather than full acoustic simulation. Three motion-controlled training games-Reflex Ridge, Space Pop, and Just Dance-were used in randomized clinical studies involving patients with Parkinson s disease and poststroke conditions. Results indicate that VR-based exergaming interventions produced significant improvements in motor function, balance, and mobility, while simple spatial audio cues provided sufficient feedback to support engagement and immersive interaction in rehabilitation tasks.