Movement characteristics during customized exergames after total knee replacement in older adults

Abstract

IntroductionThere is limited understanding of how older adults can reach kinematic goals in rehabilitation while performing exergames and conventional exercises, and how similar or different the kinematics during exergaming are when compared with conventional therapeutic exercise with similar movement. The aim of this study was to describe the movement characteristics performed during exercise in custom-designed exergames and conventional therapeutic exercises among patients who have undergone unilateral total knee replacement (TKR). In addition, the secondary aim was to assess the relation of these exercise methods, and to assess participants' perceived exertion and knee pain during exergaming and exercising.Materials and methodsPatients up to 4 months after the TKR surgery were invited in a single-visit exercise laboratory session. A 2D motion analysis and force plates were employed to evaluate movement characteristics as the volume, range, and intensity of movement performed during custom-designed knee extension-flexion and weight shifting exergames and conventional therapeutic exercises post TKR. The perceived exertion and knee pain were assessed using the Borg Rating of Perceived Exertion and Visual Analog Scale, respectively.ResultsEvaluation of seven patients with TKR [age median (IQR), 65 (10) years] revealed that the volume and intensity of movement were mostly higher during exergames. Individual goniometer-measured knee range of motion were achieved either with exergames and conventional therapeutic exercises, especially in knee extension exercises. The perceived exertion and knee pain were similar after exergames and conventional therapeutic exercises.ConclusionsDuring custom-designed exergaming the patients with TKR achieve the movement characteristics appropriate for post-TKR rehabilitation without increasing the stress and pain experienced even though the movement characteristics might be partly different from conventional therapeutic exercises by the volume and intensity of movement. Physical therapists could consider implementing such exergames in rehabilitation practice for patients with TKR once effectiveness have been approved and they are widely available.

Effectiveness of a sensorimotor exercise program on proprioception, balance, muscle strength, functional mobility and risk of falls in older people

“… Chu et al (2022) report that despite being a very promising activity, more robust studies are needed to determine the effects of exergaming on physical health, as well as cognitive and quality of life outcomes. However, Janhunen et al (2022) and Cikajlo et al (2020) showed significant results about the importance of exergames for our physical health, included related to balance.…”

“…Chu et al (2022) report that despite being a very promising activity, more robust studies are needed to determine the effects of exergaming on physical health, as well as cognitive and quality of life outcomes. However, Janhunen et al (2022) and Cikajlo et al (2020) showed significant results about the importance of exergames for our physical health, included related to balance. Treml et al (2013), when analyzing the effectiveness of conventional proprioceptive training in the control group (trampoline, skateboard, board, swing and twist disc) and modified proprioceptive training (adapted and differentiated exercises) associated with the Nintendo Wii in the interventional group, have not reported significant changes in fear of falling (FES-I), and balance in the intervention group.…”

Use of serious games with older adults: systematic literature review

“…These prototypes, called 'Reach Game', 'Hit-it' and 'Watch-Out', required users to complete coordinated upper and lower limb movements, trunk movements and lateral displacements to achieve the goals set in the games. Similarly, Janhunen et al, (2022) also present ten exergames custom-designed for older users who needed rehabilitation for post-operative knee replacement. Each exercise included a story explaining the goal of the game and the participants' body movements, tracked by the Kinect sensor, which acted as a game controller and was translated to the screen to move the avatar.…”

Effectiveness of Gamification in Knee Replacement Rehabilitation: Protocol for a Randomized Controlled Trial With a Qualitative Approach

“…We conducted a pilot study with laboratory loading measurements before RCT to ensure safe and reasonable exergaming for patients recovering from TKR [ 44 ]. The universities insured the participants of the duration of laboratory measurements and trips directly related to them.…”