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Accepted for/Published in: JMIR Serious Games

Date Submitted: Apr 5, 2019
Date Accepted: May 14, 2019

The final, peer-reviewed published version of this preprint can be found here:

Improving Maximal Strength in the Initial Postoperative Phase After Anterior Cruciate Ligament Reconstruction Surgery: Randomized Controlled Trial of an App-Based Serious Gaming Approach

Clausen JD, Nahen N, Horstmann H, Lasch F, Krutsch W, Krettek C, Sanjay T

Improving Maximal Strength in the Initial Postoperative Phase After Anterior Cruciate Ligament Reconstruction Surgery: Randomized Controlled Trial of an App-Based Serious Gaming Approach

JMIR Serious Games 2020;8(1):e14282

DOI: 10.2196/14282

PMID: 32012046

PMCID: 7007586

An app based serious gaming approach in the initial postoperative phase after ACL reconstruction surgery to improve maximum strength – a randomized control trial

  • Jan-Dierk Clausen; 
  • Niclas Nahen; 
  • Hauke Horstmann; 
  • Florian Lasch; 
  • Werner Krutsch; 
  • Christian Krettek; 
  • Thomas Sanjay

ABSTRACT

Background:

None

Objective:

We designed a prospective randomized trial to evaluate whether an app based active muscle training program can improve the postoperative strength by starting rehabilitation immediately after primary ACL reconstruction surgery as already shown for patients who underwent total knee arthroplasty. To our knowledge this is the first study analyzing immediate postoperative serious gaming based training based on strength improvement.

Methods:

In total 26 patients receiving primary ACL reconstruction with a median age of 25 years were randomized into either the serious gaming training group or a conventional rehabilitation group. Except the serious gaming based training or at least three weeks both groups followed the same postoperative treatment protocol. Outcome parameters were absolute and relative change in maximum strength, as well as IKDC, KOOS and Lysholm score.

Results:

The Exergaming group showed a significant higher increase of the absolute maximum strength. Mean (±standard deviation) maximal strength pre-operatively are 155.1 (±79.2) N and 157.0 (±40.8) N in the experimental (N=14) and control group (N=12), respectively. Post-operatively mean maximal strength are 212.8 (±78.5) N and 154.5 (±27.1) N in the experimental (N=14) and the control group (N=11). Mean absolute changes in maximal strength are 57.7 (±95.2) N and -4.8 (±22.2) N in the experimental (N=14) and the control group (N=11). The ANCOVA-model with absolute change as dependent variable and treatment group and baseline maximal strength as covariates shows a significant difference in relative change between treatment groups (experimental – control) of 59.7 N with 95%-confidence interval of [10.1 N; 109.3 N] and p-value of 0.0204. Analogue to the absolute increase the relative change of maximum was significantly higher in the Exergaming group. Mean (±standard deviation) relative change in maximal strength are 1.7 (±1.17) and 1 (±0.13) in the experimental (N=14) and control group (N=11), respectively. No adverse events or problems at all have been reported during the study period.

Conclusions:

The implementation of an app based active muscle training program in the early postoperative therapy scheme significantly improves the level of maximal strength. Therefore, the use of GenuSport training after ACL reconstruction is considered as a helpful complement in the rehabilitation after ACL reconstruction surgery to improve strength in the early postoperative phase.


 Citation

Please cite as:

Clausen JD, Nahen N, Horstmann H, Lasch F, Krutsch W, Krettek C, Sanjay T

Improving Maximal Strength in the Initial Postoperative Phase After Anterior Cruciate Ligament Reconstruction Surgery: Randomized Controlled Trial of an App-Based Serious Gaming Approach

JMIR Serious Games 2020;8(1):e14282

DOI: 10.2196/14282

PMID: 32012046

PMCID: 7007586

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