Effectiveness of adding virtual reality to physiotherapeutic treatment in patients with total hip arthroplasty. A randomized controlled trial

Abstract

Objective To determine the clinical effectiveness of adding virtual reality via the Nintendo Wii console and its Wii Balance Board to physiotherapy treatment in patients with total hip arthroplasty. Design Randomized controlled trial. Setting Clinical Hospital San Borja Arriaran, Santiago, Chile. Participants A total of 73 patients over 50 years of age with total hip arthroplasty were randomly allocated to two groups. Interventions The control group (n = 37) received 6 weeks of physiotherapy treatment; the intervention group (n = 36) received the same treatment plus virtual reality exercises with the Nintendo Wii console. Outcome measures The two groups were assessed at baseline and after the 6 weeks of treatment. The primary outcome assessed was the function with the WOMAC questionnaire. The secondary outcomes were the Berg Balance Scale, distance covered with the six-minute walk test, and difference in weight load on the lower extremities. Results A total of 73 patients, 37 patients in the control group (20 women; mean age of 70.9 ± 9.16 years) and 36 patients in the intervention group (18 women; mean age of 70.39 ± 9.02 years) were analyzed. At the end of the treatment, the difference between groups for the total WOMAC score was −10.4 points ( p = 0.00), 4.7 points ( p = 0.00) for the Berg Balance Scale, and 45.2 mt ( p = 0.00) for the six-minute walk test All differences were in favor of the intervention group. Conclusions In the short term, the addition of virtual reality via the Nintendo Wii and its Wii Balance Board platform showed statistically significant differences in the function of patients with total hip replacement, but these differences were not minimally clinically important. Trial registration: This research was registered in the Clinical Trials Registry of Australia and New Zealand, with reference ACTRN12618001252202.

Application of Virtual and Augmented Reality Technology in Hip Surgery: Systematic Review

“…In addition, it has been reported that the weight load between the lower limbs changes, which increases the strength capacity of the hip joint–stabilizing muscle tissue and adversely affects the function of these patients. Zavala-González et al [ 37 ] explored the clinical effects of applying VR technology in the physical therapy of patients who underwent total hip arthroplasty by means of the Nintendo Wii game console and its Wii Balance Board. In the short term, the addition of VR by means of Nintendo Wii and its Wii Balance Board platform resulted in statistically significant differences in the functioning of patients who underwent total hip replacement, but these differences were not clinically important.…”

Effects of technology-assisted rehabilitation for patients with hip arthroplasty: A meta-analysis

“…After the full text was assessed, 10 articles were excluded because they did not conform to the eligibility criteria. Finally, 11 studies [16][17][18][19][20][21][22][23][24][25][26] were included in this study. Among these studies, a total of 1327 patients were included; there were 634 cases in the intervention group and 693 patients in the control group.…”

“…Ten RCTs [16][17][18][19][20][21][22][23][24][25] reported random sequence generation. Seven RCTs [16][17][18]20,21,23,25] reported allocation concealments. Four RCT [16][17][18]23] outcome assessors were blinded.…”

“…Based on the Cochrane Collaboration recommendation, the quality assessment of the included studies is summarized in Figure 2. Ten RCTs [16][17][18][19][20][21][22][23][24][25] reported random sequence generation. Seven RCTs [16][17][18]20,21,23,25] reported allocation concealments.…”

“…Eight studies [16,[19][20][21][22][23][24][25] had intervention groups that received telerehabilitation. Three studies [17,18,26] investigated video-assisted rehabilitation. The characteristics of the included studies are described in Table 1.…”