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  • Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial

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Original research
Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial
  1. Maarit Janhunen1,2,
  2. Niina Katajapuu2,
  3. Juha Paloneva3,
  4. Konsta Pamilo4,
  5. Airi Oksanen5,
  6. Hannes Keemu5,
  7. Mikko Karvonen5,
  8. Mika Luimula6,
  9. Raija Korpelainen7,8,9,
  10. Timo Jämsä9,10,
  11. Hannu Kautiainen11,12,
  12. Keijo Mäkelä5,
  13. Ari Heinonen1,
  14. Eeva Aartolahti13
  1. 1Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
  2. 2Faculty of Health and Well-being, Turku University of Applied Sciences, Turku, Finland
  3. 3Department of Surgery, Central Finland Healthcare District and University of Eastern Finland, Jyväskylä, Finland
  4. 4Department of Orthopedics, Coxa Hospital for Joint Replacement, Tampere, Finland
  5. 5Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland
  6. 6Faculty of Business and Engineering, Turku University of Applied Sciences, Turku, Finland
  7. 7Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
  8. 8Center for Life Course Health Research, University of Oulu, Oulu, Finland
  9. 9Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
  10. 10Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
  11. 11Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
  12. 12Folkhälsan Research Center, Helsinki, Finland
  13. 13Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
  1. Correspondence to Maarit Janhunen; maarit.janhunen{at}turkuamk.fi

Abstract

Objectives To investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement (TKR) compared with standard exercise protocol.

Methods In this non-blinded randomised controlled trial, 52 individuals aged 60–75 years undergoing TKR were randomised into an exergaming (intervention group, IG) or a standard exercising group (control group, CG). Primary outcomes were physical function and pain measured before and after (2 months and 4 months) surgery using the Oxford Knee Score (OKS) and Timed Up and Go (TUG) test. Secondary outcomes included measures of the Visual Analogue Scale, 10m walking, short physical performance battery, isometric knee extension and flexion force, knee range of movement and satisfaction with the operated knee.

Results Improvement in mobility measured by TUG was greater in the IG (n=21) at 2 (p=0.019) and 4 months (p=0.040) than in the CG (n=25). The TUG improved in the IG by −1.9 s (95% CI, −2.9 to −1.0), while it changed by −0.6 s (95% CI −1.4 to 0.3) in the CG. There were no differences between the groups in the OKS or secondary outcomes over 4 months. 100% of patients in the IG and 74% in the CG were satisfied with the operated knee.

Conclusion In patients who have undergone TKR, training at home with customised exergames was more effective in mobility and early satisfaction and as effective as standard exercise in pain and other physical functions. In both groups, knee-related function and pain improvement can be considered clinically meaningful.

Trial registration number NCT03717727.

  • rehabilitation
  • exercise
  • osteoarthritis
  • knee surgery

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Metadata has been published in the Jyväskylä University Digital Repository (http://dx.doi.org/10.17011/jyx/dataset/85350).

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsem-2022-001416

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information. Metadata has been published in the Jyväskylä University Digital Repository (http://dx.doi.org/10.17011/jyx/dataset/85350).

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    Footnotes

    • Contributors All authors substantially contributed to the conception and design of the work. MJ, NK, JP, KP, HK, MK, KM and EA participated in the recruitment of participants. MJ, NK and EA collected the data. MJ, HK, AH and EA analysed and interpreted the data. MJ drafted the manuscript. All authors commented on the drafted manuscript and critically revised it. All authors approved the final version of the manuscript. AH is responsible for the overall content as guarantor.

    • Funding This research was supported by the Päivikki and Sakari Sohlberg Foundation (personal grant to M. Janhunen), the Business Finland (grant numbers: 5794/31/2016, 5941/31/2016, 6057/31/2016) and Finnish partner companies: SE Innovations Oy (Senior Some Oy), Suunto Oy, Physiotools Oy, GoodLife Technology Oy, Lingsoft Oy, eSeteli Palveluverkko Oy, PN Turku Oy, Ade Animations Design & Effects Oy, Adesante Oy, 4FeetUnder, Intechso and Realmax Oy.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.