None listed
Conditions
Brief summary
All patients who undergo total knee arthroplasty (TKA) in Singapore General Hospital (SGH) are managed using a coordinated clinical pathway to ensure standardised medical, pharmacologic and rehabilitation care. Most TKA patients receive standard physiotherapy intervention daily as per protocol from postoperative day 1 (POD 1) onwards, which include knee range-of-motion (ROM) and muscle strengthening exercises. Considering the replicated protocol-based nature of standard physiotherapy care delivered by physiotherapists, the study team will introduce a game-based application, SuperGramps, to deliver equivalent exercises for TKA patients. SuperGramps was developed in the 2017 SIngHealth Hackathon to aid in the rehabilitation of patients in the hospital. It is expected that TKA patients will improve their knee ROM and strength by playing the game. The study will evaluate the effectiveness of the game play versus standard physiotherapy intervention for TKA patients in terms of clinical outcomes as well as patient satisfaction. If the game-based application is feasible to provide non-inferior rehabilitation for TKA patients, physiotherapists will therefore be freed up to attend more complex cases. This will address the increasing manpower needs for therapists and demand for healthcare services in Singapore.
Interventions
In the intervention group, patients will receive the standard physiotherapy intervention by attending physiotherapist and be taught how to play the game on post op day 1. The exercises taught via the game (straight leg raise and heel slides), will not be taught in the traditional manner. Apart from the 2 exercises, all standard physiotherapy interventions will be carried out.
From day 2 onwards, patients will play the supergramps game for knee ranging and muscle strengthening exercises without
In the intervention group, patients will receive the standard physiotherapy intervention by attending physiotherapist and be taught how to play the game on post op day 1. The exercises taught via the game (straight leg raise and heel slides), will not be taught in the traditional manner. Apart from the 2 exercises, all standard physiotherapy interventions will be carried out. From day 2 onwards, patients will play the supergramps game for knee ranging and muscle strengthening exercises without standard physiotherapy intervention. These patients will continue to be seen once daily by the physiotherapist to be assessed and ambulated with an appropriate walking aid during their inpatient stay. They would be advised to play the game 3x a day. Patients in the intervention group will be provided with an inertial measurement unit (IMU) which is a triangular device which they are to put on. The device will be taped onto silicon belts, which the participants are required to place around their thigh and calf. The device will be able to communicate with the game on a tablet provided in order to facilitate participation of the patient. The game will require the patient to control the character either by bending their knees or lifting their legs, similar to the exercises done post-total knee arthroplasty surgeries. Patients will be encouraged to do these exercises 3x/day, as per usual protocol. The game should take about 10-15 minutes to complete. The participants are required to play the game for 3 days post surgery, after which the inertial measurement units and tablets will be collected back. We will monitor adherence to the game by checking their game results on a separate portal.
Sponsors
Samantha Koh
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
The inclusion criteria for research participants are: 1. Age between 50-85 years 2. Had undergone primary unilateral TKA for knee osteoarthritis 3. Premorbid ambulant 4. Able to follow game instructions 5. Able to use an electronic device (e.g. iPad) other than making a phone call
Exclusion criteria
The exclusion criteria for research participants are: 1. Had revision TKA 2. Had a history of lower limb fracture 3. Had a history of stroke or other neurological disorders (e.g. Parkinson's disease, dementia) 4. Had developed intra- or post-operative medical or surgical complications 5. Required knee brace post-operation 6. Had visual or auditory impairment 7. Colour blind 8. Sensitive to silicone 9. With Multidrug-Resistant Organisms (MDRO)
Outcome results
None listed