Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: May 13, 2022
Date Accepted: Dec 23, 2022
Gamified physical rehabilitation for older adults with musculoskeletal issues: a pilot non-inferiority randomized clinical trial
ABSTRACT
Background:
Developed countries are facing the challenge of aging societies, a high risk of dependence, and a high cost of care. Researchers attempted to address these issues by using cost-efficient, innovative technology to promote healthy aging and regain functionality. After an injury, efficient rehabilitation is crucial to promote returning home and prevent institutionalization. However, there is often a lack of motivation to carry out physical therapies. Consequently, there is a growing interest in testing new approaches like gamified physical rehabilitation to achieve functional targets and prevent re-hospitalization.
Objective:
To assess the effectiveness of a personal mobility device compared with standard care in the rehabilitation treatment of patients with musculoskeletal issues.
Methods:
57 patients aged 67-95 years were randomly assigned to the intervention group (n=35) using the gamified rehabilitation equipment 3 times a week or to a control group (n=22) receiving usual standard care. Due to dropout, only 41 patients were included in the post-intervention analysis. Outcome measures included Short Physical Performance Battery (SPPB), Isometric Hand Grip Strength (IHGS), Functional Independence Measure (FIM) and number of steps.
Results:
An indication of non-inferiority related to the primary outcome (SPPB) was identified during the hospital stay and no significant differences between the control and the intervention groups for any of the secondary outcomes (IHGS, FIM and steps) were found, which demonstrates the potential of the serious game-based intervention to be as effective as the standard physical rehabilitation at the hospital. The analysis by mixed-effects regression on SPPB showed an indication of a group x time interaction (SPPB_I_t1=-0.77, 95% CI -2.03-0.50, P=.23; SPPB_I_t2=0.21, 95% CI -1.07-0.48, P=.75). Although not significant, a positive IHGS improvement of more than 2kg (Right: 2.52 kg, 95% CI -0.72-5.37, P=.13; Left: 2.43 kg, 95% CI -0.18-4.23, P=.07) for the patient from the intervention group was observed.
Conclusions:
Serious game-based rehabilitation could potentially be an effective alternative for older patients to regain their functional capacities. Clinical Trial: ClinicalTrials.gov NCT03847454
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