Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy.
Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy.
Ann Phys Rehabil Med. 2022 Nov;65(6):101609. doi: 10.1016/j.rehab.2021.101609. Epub 2022 Sep 29.
Virtual reality (VR) and serious games (SGs) are widespread in rehabilitation for many orthopedic and neurological diseases. However, few studies have addressed the effects of rehabilitation with VR-based SGs on clinical, gait, and postural outcomes in individuals with total knee replacement (TKR).
The primary objective was the efficacy of balance training using non-immersive VR-based SGs compared to conventional therapy in TKR patients on the Time Up and Go test. Secondary objectives included the efficacy on clinical, gait, and postural outcomes.
We randomly allocated 56 individuals with unilateral TKR to the experimental group (EG) or control group (CG) for 15 sessions (45 min; 5 times per week) of non-immersive VR-based SGs or conventional balance training, respectively. The primary outcome was functional mobility measured by the Timed Up and Go test; secondary outcomes were walking speed, pain intensity, lower-limb muscular strength, independence in activities of daily living as well as gait and postural parameters.
We found significant within-group differences in all clinical outcomes and in a subset of gait (p<0.0001) and postural (p ≤ 0.05) parameters. Analysis of the stance time of the affected limb revealed significant between-group differences (p = 0.022): post-hoc analysis revealed within-group differences in the EG (p = 0.002) but not CG (p = 0.834). We found no significant between-group differences in other outcomes.
Balance training with non-immersive VR-based SGs can improve clinical, gait, and postural outcomes in TKR patients. It was not superior to the CG findings but could be considered an alternative to the conventional approach and can be added to a regular rehabilitation program in TKR patients. The EG had a more physiological duration of the gait stance phase at the end of the treatment than the CG.
GOV: NCT03454256.
虚拟现实（VR）和严肃游戏（SG）在许多骨科和神经系统疾病的康复中得到广泛应用。然而，很少有研究探讨基于 VR 的 SG 康复对全膝关节置换（TKR）患者的临床、步态和姿势结果的影响。
主要目的是比较非沉浸式基于 VR 的 SG 平衡训练与 TKR 患者传统治疗在“计时起身行走测试”中的疗效。次要目标包括临床、步态和姿势结果的疗效。
我们将 56 名单侧 TKR 患者随机分配到实验组（EG）或对照组（CG），分别接受 15 次非沉浸式基于 VR 的 SG 或传统平衡训练（45 分钟；每周 5 次）。主要结果是通过计时起身行走测试衡量的功能性移动能力；次要结果是行走速度、疼痛强度、下肢肌肉力量、日常生活活动的独立性以及步态和姿势参数。
我们发现所有临床结果以及部分步态（p<0.0001）和姿势（p≤0.05）参数都存在组内差异。对患侧的支撑时间分析显示存在组间差异（p=0.022）：事后分析显示 EG 存在组内差异（p=0.002），但 CG 没有（p=0.834）。我们在其他结果中没有发现组间差异。
非沉浸式基于 VR 的 SG 平衡训练可以改善 TKR 患者的临床、步态和姿势结果。它并不优于 CG 组的发现，但可以被视为传统方法的替代方案，并可以添加到 TKR 患者的常规康复计划中。治疗结束时，EG 的步态支撑阶段持续时间比 CG 更接近生理时长。
GOV：NCT03454256。
