Gamification in Knee Replacement Rehabilitation

Not Applicable

Completed

• Conditions: Knee Osteoarthritis
• Interventions: Other: Control; Other: Exergame

• Registration Number: NCT03717727
• Lead Sponsor: University of Jyvaskyla

Brief Summary

After total knee arthroplasty (TKA), knee is usually swollen, painful, and stiff. The main goal of post-operative physical rehabilitation is to achieve full extension and flexion of the knee to avoid contractures and stiffness. Also strengthening of quadriceps muscle and balance to help activities of daily living and overall mobility are important. The post-operative knee replacement rehabilitation includes the standard protocol in hospital phase and the standard home exercise instructions. Computer based exercising games (exergames) may be new method to increase training adherence and volume after TKA and thus improve results and effectiveness of the rehabilitation. However, evidence of effectiveness of rehabilitative exergaming on physical functioning is sparse and more research is needed to conduct evidence-based rehabilitation practices.

Therefore the present study examines the effectiveness of a 16-week gamified physiotherapy on physical functioning, life satisfaction and pain for patients after TKA compared to treatment as usual home exercise. The second objective is to validate the psychometric properties of WHODAS 2.0 (WHO Disability Assessment Schedule) and brief ICF (International classification of functioning, disability and health) core set of osteoarthritis questionnaire. Other objectives are to find out, what kind of understanding and experiences the participants have about the rehabilitation with exergames and to evaluate the usability and user experience of exergames.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2018-10-08
• Study First Submitted QC: 2018-10-23
• Study First Posted: 2018-10-24
• Study Start: 2018-11-27
• Primary Completion: 2021-03-24
• Study Completion: 2022-01-17
• Status Verified: 2023-07
• Last Update Submitted: 2023-07-10
• Last Update Posted: 2023-07-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 52

Inclusion Criteria

• first primary (M17.0, M17.1) unilateral TKA
• mechanical axis of the limb in varus
• model of the TKA is posterior stabilizing (PS) or cruciate retaining (CR) prosthesis
• normal vision with or without eyeglasses

Exclusion Criteria

• fractures, rheumatoid arthritis, or other biomechanical disruptions in affected lower limb within one year before operation
• diagnosed memory disorder or cognitive impairment
• neurological condition as Parkinson's disease, multiple sclerosis or stroke

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control	Control	Home-exercise by standard protocol and usual treatment.
Exergame	Exergame	Home-based exergame intervention and usual treatment.

Primary Outcome Measures

Name	Time	Method
Change in Function and pain related to knee	Change from pre-operative baseline at 2 and 4 months post-operative.	Oxford Knee Score
Change in Mobility	Change from pre-operative baseline at 2 and 4 months post-operative.	Timed Up and Go

Secondary Outcome Measures

Name	Time	Method
Change in Disability	pre-operative baseline and 2, 4 and 12 months post-operative	WHO disability scale (WHODAS 2.0.)
Change in other symptoms such as swelling, restricted range of motion and mechanical symptoms	pre-operative baseline and 2, 4 and 12 months post-operative	Knee injury and Osteoarthritis Outcome Score (KOOS) subscale on symptoms
Change in activities of daily living (ADL) Function	pre-operative baseline and 2, 4 and 12 months post-operative	Knee injury and Osteoarthritis Outcome Score (KOOS) subscale on ADL
Change in Function and pain related to knee	Change from pre-operative baseline at 12 months post-operative.	Oxford knee score
Change in Walking	pre-operative baseline and 2, 4 and 12 months post-operative	10-m Walking speed
Change in Lower extremity performance	pre-operative baseline and 2, 4 and 12 months post-operative	Short Physical Performance Battery
Change in Pain	pre-operative baseline and 2, 4 and 12 months post-operative	Knee injury and Osteoarthritis Outcome Score (KOOS) subscale on pain.
Change in quality of life (QOL)	pre-operative baseline and 2, 4 and 12 months post-operative	Knee injury and Osteoarthritis Outcome Score (KOOS) subscale on QOL
Change in Muscle strength	pre-operative baseline and 2, 4 and 12 months post-operative	Isometric knee extension and flexion strength
Change in Knee range of motion	pre-operative baseline and 2, 4 and 12 months post-operative	Goniometer
Change in Mobility	Change from pre-operative baseline at 12 months post-operative.	Timed Up and Go
Change in knee pain (VAS)	pre-operative baseline and 2, 4 and 12 months post-operative	Visual analogue scale (0 to 100 mm), Constant score (0 to 100 points)
Change in Sport and Recreation Function	pre-operative baseline and 2, 4 and 12 months post-operative	Knee injury and Osteoarthritis Outcome Score (KOOS) subscale on Sport and Recreation Function

Trial Locations

Locations (4)

Central Finland Central Hospital; 🇫🇮 Jyväskylä, Finland

Turku University of Applied Sciences; 🇫🇮 Turku, Finland

Turku University Hospital; 🇫🇮 Turku, Finland

University of Jyväskylä; 🇫🇮 Jyväskylä, Finland