Effectiveness of Early Rehabilitation with Exergaming in Virtual Reality on Gait in Patients after Total Knee Replacement

Abstract

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.

Effectiveness of Virtual Reality-Based Early Postoperative Rehabilitation after Total Knee Arthroplasty: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

“…However, it is important to consider that only two studies were included in the meta-analysis of each one. We cannot include the case-control study of Hadamus and colleagues (2022) for not being an RCT, but in this study, VRBR was not superior to CT in improving gait speed [79]. These three variables are not being assessed in the recent RCT, so it is important to include them in future RCTs to clarify if VRBR can affect them.…”

The Application of Virtual Reality in Shoulder Surgery Rehabilitation

“…Recently, there has been growing interest in the use of virtual reality (VR) for rehabilitation after orthopedic surgery in both clinical and home settings [ 3 ]. Among these advantages are enhanced patient motivation, accelerated training effects, and the potential to adjust movement strategies through the feedback features of activities [ 4 ].…”