journal article·2023-01-09Open access

Comparison of Physical Activity Training Using Augmented Reality and Conventional Therapy on Physical Performance following a Total Knee Replacement: A Randomized Controlled Trial

Jae-Ho Yu, Daekook M. Nekar, Hye-Yun Kang, Jae-Won Lee, Sung-Yeon Oh

Applied Sciences· Volume 13· Issue 2

Abstract

There is growing interest in using augmented reality (AR)-based training for rehabilitation programs, while it remains unclear whether physical exercises using AR can be more effective than conventional therapy for patients with total knee replacement (TKR). This study, therefore, aimed to compare the effects of AR-based training to conventional therapist-based training on the physical performance of early-stage rehabilitation in patients after a TKR. It was a double-blind randomized controlled trial with repeated measures (pre-surgery, post-surgery, and post-intervention). Twenty-four participants with TKR were allocated to either AR-based training or therapist-based training. Both groups received a training program for 30 min per session, three sessions per week, for four weeks. The outcome measures included the range of motion (ROM), muscle strength, balance, and perceived pain. The results showed significant improvements in all measured outcomes in both groups (p < 0.05). However, despite our hypothesis that ART would be more effective than the TKR, no significant differences in all the outcomes were found between the two groups. While there was some evidence showing that performing physical exercises using AR could improve physical performance in patients with TKR after surgery, a comparison with conventional therapy did not show superior effectiveness. However, AR could be used to provide real-time feedback and motivation appropriate for home-training programs.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Total Knee Arthroplasty Outcomes · Shoulder Injury and Treatment · Knee injuries and reconstruction techniques

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Physical Therapy, Sunmoon University, Asan 31460, Republic of Korea

Funding

National Research Foundation of Korea · Culture, Sports and Tourism R&D Program

References (30)

Show source-provided references
1. Prevalence of obesity and the associated risk among patients with total knee arthroplasty in Alberta10.1016/j.joca.2019.02.661 ↗
2. Rates of total joint replacement in the United States: Future projections to 2020–2040 using the national inpatient sample10.3899/jrheum.170990 ↗
3. Epidemiology of osteoarthritis: Literature update10.1097/BOR.0000000000000479 ↗
4. Osteoarthritis, obesity and weight loss: Evidence, hypotheses and horizons–a scoping review10.1111/obr.12173 ↗
5. Indicators, O.E. (2015). Health at a Glance, OECD Publishing.
6. Knee manipulation for reduced flexion after Total Knee Arthroplasty. Is timing critical?10.1016/j.jcot.2017.11.017 ↗
7. Rehabilitation protocols following total knee arthroplasty: A review of study designs and outcome measures10.21037/atm.2019.08.15 ↗
8. A randomized controlled trial of exercise to improve mobility and function after elective knee arthroplasty. Feasibility, results and methodological difficulties10.1191/0269215502cr483oa ↗
9. Men and women demonstrate differences in early functional recovery after total knee arthroplasty10.1016/j.apmr.2016.03.007 ↗
10. Psychological factors, rehabilitation adherence, and rehabilitation outcome after anterior cruciate ligament reconstruction10.1037/0090-5550.45.1.20 ↗
11. Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction: Expect and motivate to satisfy10.1007/s00167-016-4294-8 ↗
12. Influences of psychological factors and rehabilitation adherence on the outcome post anterior cruciate ligament injury/surgical reconstruction
13. Improvements of Physical Activity Performance and Motivation in Adult Men through Augmented Reality Approach: A Randomized Controlled Trial10.1155/2022/3050424 ↗
14. Kinect-based rehabilitation exercises system: Therapist involved approach10.3233/BME-141077 ↗
15. A Study on the Effectiveness of the Image Recognition Technique of Augmented Reality Contents10.7230/KOSCAS.2015.41.337 ↗
16. Berton, A., Longo, U.G., Candela, V., Fioravanti, S., Giannone, L., Arcangeli, V., Alciati, V., Berton, C., Facchinetti, G., and Marchetti, A. (2020). Virtual reality, augmented reality, gamification, and telerehabilitation: Psychological impact on orthopedic patients’ rehabilitation. J. Clin. Med., 9.10.3390/jcm9082567 ↗
17. The use of augmented reality for limb and component alignment in total knee arthroplasty: Systematic review of the literature and clinical pilot study10.1186/s40634-021-00374-7 ↗
18. Mixed Reality Technology in Total Knee Arthroplasty: An Updated Review With a Preliminary Case Report10.3389/fsurg.2022.804029 ↗
19. Jeon, S., and Kim, J. (2020). Effects of augmented-reality-based exercise on muscle parameters, physical performance, and exercise self-efficacy for older adults. Int. J. Environ. Res. Public Health, 17.10.3390/ijerph17093260 ↗
20. The Influence of Augmented Reality based Knee Exercise in Short Period on Range of Motion and Balance-Pilot study10.24332/aospt.2018.14.2.01 ↗
21. Comparison of reliabilities and validity between AR based motion capture system and physical therapist: Preliminary study
22. Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: A randomized controlled trial10.1097/MD.0000000000019136 ↗
23. The effect of virtual reality on pain and range of motion in adults with burn injuries10.1097/BCR.0b013e3181b485d3 ↗
24. Spiegel, B., Fuller, G., Lopez, M., Dupuy, T., Noah, B., Howard, A., Albert, M., Tashjian, V., Lam, R., and Ahn, J. (2019). Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial. PLoS ONE, 14.10.1371/journal.pone.0219115 ↗
25. Effects of virtual reality-based distraction of pain, fear, and anxiety during needle-related procedures in children and adolescents
26. The role of the thalamus in modulating pain
27. The effect of Virtual Reality on evoked potentials following painful electrical stimuli and subjective pain10.1038/s41598-020-66035-4 ↗
28. Virtual reality in health system: Beyond entertainment. a mini-review on the efficacy of VR during cancer treatment10.1002/jcp.25117 ↗
29. Sex-based differences in pain perception and treatment10.1111/j.1526-4637.2008.00558.x ↗
30. Effects of an immersive virtual reality environment on muscle strength, proprioception, balance, and gait of a middle-aged woman who had total knee replacement: A case report10.12659/AJCR.918521 ↗