Video-Game–Based Exercises for Older People With Chronic Low Back Pain: A Randomized Controlledtable Trial (GAMEBACK)

Abstract

Background Video game technology increases adherence to home exercise and could support self-management for older people with chronic low back pain (LBP). Objective The objective was to investigate the effects of home-based video game exercises on pain self-efficacy and care-seeking in older people with chronic LBP. Design The study was a randomized controlled trial. Setting The setting was a community and waiting list. Participants Sixty participants, aged > 55 years with chronic LBP, were randomized (1:1) to Wii Fit U exercises or to continue their usual activities for 8 weeks. Intervention The intervention was home-based Wii Fit U flexibility, strengthening, and aerobic exercises for 60 minutes, 3 times per week, with fortnightly calls from a physical therapist. Measurements Measurements included pain self-efficacy and care-seeking (primary outcomes), and physical activity, pain, function, disability, fear of movement/reinjury, falls efficacy, recruitment and response rates, adherence, experience with the intervention, and adverse events (secondary outcomes). Results The mean age of participants was 67.8 (standard deviation = 6.0) years. Adherence to the total recommended exercise time was 70.8%, and no adverse events were reported. Participants completing Wii Fit U exercises had significantly higher pain self-efficacy at 6 months, but not immediately postintervention or at 3 months; there were no between-group differences in care-seeking. Compared with the control group, participants completing Wii Fit U exercises demonstrated significantly greater improvements in pain and function at 8 weeks and were more likely to engage in flexibility exercises at 6 months. There were no significant between-group differences for the remaining outcomes. Limitations Participants and therapists were not blinded. Conclusions Wii Fit U exercises improved pain self-efficacy at 6 months, and pain and function immediately postintervention in older people with chronic LBP, but the clinical importance of these changes is questionable. Wii Fit U exercises had no effect on care-seeking, physical activity, disability, fear of movement/reinjury, or falls efficacy.

Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis

“…The examination of titles and abstracts resulted in the retrieval of 808 full-text records. Following full-text review, 89 studies were included in qualitative analysis 23–25 27–35 37 38 40 41 43 45–47 49–51 75–140. Of these studies, 55 (62%)24 25 27–29 31 32 35 37 41 49 77 78 80 83–87 92–95 98–108 110–113 115–117 119–121 123 125 126 128 130 132 133 135 138–140 were deemed eligible for the pairwise meta-analyses and 82 (92%)23–25 27–33 35 37 38 41 47 49 75–140 were, in total, suitable for the network meta-analyses.…”

“…A detailed summary of each included study (n=89)23–25 27–35 37 38 40 41 43 45–47 49–51 75–140 is presented in online supplementary table 3. Sample size ranged from 20 to 240 patients (mean age range, 20–70 years; one study38 did not report age) and study duration ranged from 4 to 24 weeks.…”

“…Among the 89 studies included (patients: n=5578), there were 131 exercise training interventions (patients: n=3924) and 59 non-exercise training comparators (patients: n=1654; online supplementary table 3). Exercise training interventions included: aerobic (studies: n=5, patients: n=127),33 83 100 113 127 other (studies: n=12, patients: n=290),77 87 96 103 108 112 116 119 120 122 135 140 McKenzie (studies: n=7, patients: n=114),40 47 76 94 97 111 120 multimodal (studies: n=23, patients: n=756),23–25 32 38 40 45 50 75 82 88 91 99 102 109 114 118 124 129 131 134 137 138 Pilates (studies: n=13, patients: n=350),23 27 29 30 33 34 51 86 94 105 111 131 139 resistance (studies: n=12, patients: n=472),43 78 79 81 90 92 93 100 101 127 130 134 stabilisation/motor control (studies: n=39, patients: n=1062),25 28 38 43 49 50 75 76 79–82 84 85 89–91 95–98 103–106 108–110 115 118 122–125 128 129 134 136 140 stretching (studies: n=8, patients: n=222),31 37 89 107 117 121 126 136 water-based (studies: n=6, patients: n=144)37 41 45 88 120 137 and yoga (studies: n=6, patients: n=387) 35 46 114 126 132 133. Non-exercise training interventions included: true control (studies: n=33, patients: n=733),27 28 31 34 35 37 41 49 77 78 80 86 87 93–95 100 104 105 108 110–112 115–117 120 121 125 135 138–140 therapist hands-on control (studies: n=14, patients: n=506)25 30 47 83 85 92 98 99 101 106 113 123 128 130 and therapist hands-off control (studies: n=12, patients: n=415) 24 29 32 46 51 84 102 107 119 126 132 133.…”

Effect of a Multimodal Movement Intervention in Patients With Neurogenic Claudication Based on Lumbar Spinal Stenosis and/or Degenerative Spondylolisthesis—A Pilot Study

“…Against our expectations, the perception of pain (BPI) and the pain-related disabilities in performing activities of daily living (ODI) have remained unchanged for both groups in our pilot study. Other studies applying a belly dance program (46), exercise therapy (47), or a videogame-based exercise program (48) were able to demonstrate reduced pain perception in chronic LBP patients. Moreover, we could observe a group effect, suggesting that the MTC variability was significantly lower in the MI compared to the PI group at the end of the intervention (see Table 2).…”

Acceptability and Attitude towards a Mobile-Based Home Exercise Program among Stroke Survivors and Caregivers: A Cross-Sectional Study

“…Mobile-based home exercises could be delivered in the form of video games for exercises [16], music software for gait training [17], or videos of exercises using mobile app [18]. The implementation of any intervention requires not only the effectiveness of an intervention but also high acceptability and sustainability [19].…”