Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty

Gianola, Silvia; Stucovitz, Elena; Castellini, Greta; Mascali, Mariangela; Vanni, Francesco; Tramacere, Irene; Banfi, Giuseppe; Tornese, Davide

doi:10.1097/md.0000000000019136

Cited by 67 publications

(192 citation statements)

References 59 publications

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“…The methodological quality of the analysed research rated on the PEDro scale ranged from moderate quality—4 points [ 22 , 29 ]—to high quality—8 points [ 24 ]—with a mean score of 5.9 points (moderate quality). Four studies were high quality above 7 points on the PEDro scale [ 22 , 23 , 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…In most physiotherapy research, blinding is difficult due to the specifics of carrying out interventions. However, blinding all test assessors is possible and should be used in RCT, which concerned about half of the included studies [ 23 , 24 , 26 , 28 , 30 ]. The highest quality in evidence-based medicine and evidence-based practice is obtained by randomized double-blind or triple-blind control trials.…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, eight described games and virtual reality training in patients after TKA and THA. Gianola et al [ 23 ] used the Virtual Reality Rehabilitation System (VRRS, Khymeia, Italy) in rehabilitation after TKA. The VRRS is a device that allows the correct performance of exercises based on visual and auditory biofeedback and a system of interactive games focused on body balance.…”

Section: Resultsmentioning

confidence: 99%

“…Among the most commonly used scales [ 24 , 25 , 26 , 27 ] was the WOMAC scale (The Western Ontario and McMaster Universities Osteoarthritis Index), which includes the assessment of pain, stiffness, and physical functioning [ 39 ]. Two studies [ 23 , 25 ] showed a statistically greater improvement of knee condition in the VR training group than in the controls for patients after TKA. However, in one trial [ 23 ], improvement was obtained only in reducing joint stiffness.…”

Section: Resultsmentioning

confidence: 99%

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The Effectiveness of Virtual Reality Rehabilitation in Patients with Knee and Hip Osteoarthritis

Byra

Czernicki

2020

JCM

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Osteoarthritis (OA) is a common health problem leading to pain, limitation in physical function, a decrease in the quality of life and disability. OA affects 60–70% of the population above 65 years of age all over the world, and is associated with a high cost of healthcare. The main method of treatment of OA, apart from pharmacotherapy and surgery, is comprehensive rehabilitation. Advances in medical technology have resulted in the possibility of using computer-assisted interventions in rehabilitation. The present narrative review is aimed at investigating the effectiveness of virtual reality (VR) in the rehabilitation of elderly patients with knee or hip osteoarthritis, including patients after arthroplasty. This literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out in five databases: PubMed, Medline, Web of Science, Scopus and PEDro. It includes ten randomized controlled trials focused on the application of games and biofeedback in the rehabilitation of patients with knee and hip osteoarthritis. There are no conclusive reports that interventions based on VR are more effective than standard physical therapy. Moreover, evidence regarding patients after total hip arthroplasty (THA) is very scarce. The effectiveness of VR-based rehabilitation is unclear, although interventions based on VR are promising in view of pain management, postural and proprioception training. However, this evidence is not sufficient to create clinical guidelines and further high-quality studies are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Effectiveness of Virtual Reality Rehabilitation in Patients with Knee and Hip Osteoarthritis

Byra

Czernicki

2020

JCM

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“…One study that investigated postoperative function in patients after total knee arthroplasty (TKA) indicated that postoperative pain and lack of effectiveness exercise are key causes of prolonged recovery following joint arthroplasty [ 10 ]. Among these adversities are exposure to deficits in the proprioceptive system, and thus, it is difficult to main postural control [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of proprioceptive training on the recovery of total joint arthroplasty patients: a meta-analysis

Zhang

Deng

2020

J Orthop Surg Res

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Background Optimal balance control is of paramount importance for function recovery after total joint arthroplasty (TJA). The study objective of this meta-analysis was to assess the short- and mid-term effects of proprioceptive and balance training for patients undergoing TJA. Methods Electronic searches were conducted from PubMed, Cochrane library, and Embase databases to identify eligible RCTs through May 2020. Standard mean difference (SMD) with 95% confidence interval (95%CI) was applied to calculate pooled effect estimates between proprioceptive and balance training and control group. Main outcomes were self-reported functionality, balance, pain, quality of life, and function (range of motion). Results Seven randomized controlled trials were finally included in this meta-analysis. Pooled results found that balance and proprioceptive trainings have a positive role in improving self-reported functionality at short-term after TJA. Moreover, balance and proprioceptive trainings were associated with an increase of the balance at short- and mid-term after TJA. These results were further confirmed by subgroup analysis between preoperative and postoperative administration of balance and proprioceptive trainings. Conclusion Our meta-analysis suggests that balance and proprioceptive trainings after TJA improved self-reported functionality and balance. These improvements were maintained at mid-terms. More research is needed to confirm balance and proprioceptive trainings for pain and quality of life for TJA.

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“It's Not My Knee”: Understanding Ongoing Pain and Discomfort After Total Knee Replacement Through Re‐Embodiment

Moore

Eccleston

Gooberman-Hill

2022

Arthritis Care & Research

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Objective. Up to 20% of people who undergo total knee replacement surgery have ongoing pain and discomfort. The aim of this study was to understand what role the concepts of embodiment (of both having a body and experiencing the world through one's body) and incorporation (integrating something into one's body) might have in understanding experiences of pain and discomfort after total knee replacement.Methods. We conducted semistructured interviews with 34 people who had received total knee replacement at either of 2 National Health Service hospitals in the UK, and who had chronic postsurgical pain (n = 34, ages 55-93 years). Data were audiorecorded, transcribed, and analyzed thematically.Results. Two main themes were identified: 1) when describing chronic postsurgical pain, some participants also described sensations of discomfort, including heaviness, numbness, pressure, and tightness associated with the prosthesis; 2) participants reported a lack of felt connection with and agency over their replaced knee, often describing it as alien or other, and lacked confidence in the knee.Conclusion. Participants' experiences indicate that some people do not achieve full incorporation of the prosthesis. Our study emphasizes the importance of physicians treating patients as whole people and moving beyond clinical and procedural ideas of success. Our findings suggest that to optimize postoperative outcomes, rehabilitation must focus not only on strengthening the joint and promoting full recovery to tasks but on modifying a person's relationship to the new joint and managing sensations of otherness to achieve full incorporation of the joint or re-embodiment.The views expressed herein are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty

Cited by 67 publications

References 59 publications

The Effectiveness of Virtual Reality Rehabilitation in Patients with Knee and Hip Osteoarthritis

The Effectiveness of Virtual Reality Rehabilitation in Patients with Knee and Hip Osteoarthritis

Efficacy of proprioceptive training on the recovery of total joint arthroplasty patients: a meta-analysis

“It's Not My Knee”: Understanding Ongoing Pain and Discomfort After Total Knee Replacement Through Re‐Embodiment

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