Knee Osteoarthritis
Conditions
Keywords
Total knee replacement, Exergame, Total knee arthroplasty, Exercise, Physiotherapy, Physical functioning
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.
Interventions
OTHERExergame
16-week home-based exercise intervention with exergaming system and usual treatment.
OTHERControl
16-week home-based exercise by standard protocol and usual treatment.
Sponsors
Turku University Hospital
Turku University of Applied Sciences
Jyväskylä Central Hospital
University of Oulu
University of Jyvaskyla
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to 75 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mobility | Change from pre-operative baseline at 2 and 4 months post-operative. | Timed Up and Go |
| Change in Function and pain related to knee | Change from pre-operative baseline at 2 and 4 months post-operative. | Oxford Knee Score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mobility | Change from pre-operative baseline at 12 months post-operative. | Timed Up and Go |
| 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 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 Disability | pre-operative baseline and 2, 4 and 12 months post-operative | WHO disability scale (WHODAS 2.0.) |
| 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 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 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 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 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 |
| 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 Function and pain related to knee | Change from pre-operative baseline at 12 months post-operative. | Oxford knee score |
Other
| Measure | Time frame | Description |
|---|---|---|
| Physical activity | Through study completion, an average of 1 year | Physical activity diary |
| Satisfaction with the operated knee | 2, 4 and 12 months post-operative | Questionnaire |
Countries
Finland
Outcome results
None listed