Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty

Abstract

Abstract-This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/-0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

The Effectiveness of Virtual Reality in Patients With Spinal Pain: A Systematic Review and Meta‐Analysis

“…Another strength of this systematic review is the completion of a meta‐analysis for neck pain studies. Many of the previously published reviews on VR were not systematic reviews, 6,9 and the few previously published systematic reviews did not include a meta‐analysis 10–13 . Therefore, the quality and value of the current systematic review and meta‐analysis are favorable.…”

“…VR can be operationally defined as “simulations that make use of various combinations of interaction devices and sensory display systems.” 3 VR has been explored in a variety of fields and clinical applications, such as in treating phobias, akinesia in patients with Parkinson’s disease, and phantom limb syndrome in patients with amputations 3–5 . Additional patient populations that have demonstrated benefit from VR interventions include individuals with higher pain and physical dysfunction levels, 6 those with higher anxiety, 7 and those with a desire for an alternative to opioid analgesics 7,8 . Overall, previous systematic reviews investigating the effectiveness of VR have suggested its usefulness in treating a variety of pain‐related problems 9–11 .…”

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

“…Goal setting is a well-recognized behavior change technique that supports self-regulation skills in the change process [35,36]. In previous orthopedic studies, digital goal setting facilitated personal fulfillment and provided patients with a sense of control and accomplishment during the perioperative period [37,38]. Combining goal setting with performance feedback and the review of goals (akin to milestones within the recovery journey) has been associated with both short-and long-term intervention effectiveness [39,40].…”

Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance

“…Games may provide an avatar that represents the patient's body movements [7]. Numerous publications report that exercises in VR can increase patient motivation, especially in children and the elderly, and help to document their progress [7,[10][11][12]. Additionally, VR games can be used as an affordable tool for home exercise in older adults [11,13].…”