Hadamus Anna, Błażkiewicz Michalina, Wydra Kamil T, Kowalska Aleksandra J, Łukowicz Małgorzata, Białoszewski Dariusz, Marczyński Wojciech
Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland.
Faculty of Rehabilitation, The Józef Piłsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland.
J Clin Med. 2022 Aug 23;11(17):4950. doi: 10.3390/jcm11174950.
Total knee replacement (TKR) is the treatment of choice for advanced stages of osteoarthritis but it requires good postoperative rehabilitation. This study aimed to assess the effectiveness of exercises using virtual reality to improve gait parameters in patients after TKR. Fifty-nine patients 7−14 days after TKR surgery were divided into a study group (VRG, n = 38) and a control group (CG, n = 21). Both groups underwent the same 4-week rehabilitation protocol. The VRG group had 12 additional nonimmersive virtual reality game sessions on the Virtual Balance Clinic prototype system at 30 min each, focusing on gait and balance improvement. Spatiotemporal, force and foot plantar pressure parameters were collected on an instrumented treadmill during a 30 s walk. The most significant improvement was in the symmetry indices of forefoot force, maximum forefoot force, loading response time, and preswing time (p < 0.05) in both groups. Gait speed increased by 31.25% and 44% in the VRG and CG groups, respectively (p < 0.005). However, the extra exergaming sessions did not significantly improve rehabilitation outcomes. Therefore, additional VR training does not improve gait better than standard rehabilitation alone, but the improvement of gait, especially its symmetry, is significant within the first six weeks after surgery.
全膝关节置换术（TKR）是骨关节炎晚期的首选治疗方法，但术后需要良好的康复治疗。本研究旨在评估使用虚拟现实进行锻炼对改善TKR术后患者步态参数的有效性。59例TKR术后7 - 14天的患者被分为研究组（VRG，n = 38）和对照组（CG，n = 21）。两组均接受相同的4周康复方案。VRG组在虚拟平衡诊所原型系统上额外进行了12次非沉浸式虚拟现实游戏训练，每次30分钟，重点是改善步态和平衡。在仪器化跑步机上进行30秒步行时，收集时空、力和足底压力参数。两组在前足力对称指数、最大前足力、负荷反应时间和摆动前期时间方面均有最显著改善（p < 0.05）。VRG组和CG组的步态速度分别提高了31.25%和44%（p < 0.005）。然而，额外的游戏训练并未显著改善康复结果。因此，额外的VR训练并不比单独的标准康复更好地改善步态，但步态的改善，尤其是其对称性，在术后六周内是显著的。
