Gamification in Knee Replacement Rehabilitation (BEE-RCT)

Effectiveness of Gamification in Knee Replacement Rehabilitation. Randomized Controlled Trial and Qualitative Approach

Turku University Hospital, Turku University of Applied Sciences, Jyväskylä Central Hospital, University of Oulu

After total knee arthroplasty (TKA), knee is usually swollen, painful, and stiff. The main goal of post-operative physical rehabilitation is to achieve full extension and flexion of the knee to avoid contractures and stiffness. Also strengthening of quadriceps muscle and balance to help activities of daily living and overall mobility are important. The post-operative knee replacement rehabilitation includes the standard protocol in hospital phase and the standard home exercise instructions. Computer based exercising games (exergames) may be new method to increase training adherence and volume after TKA and thus improve results and effectiveness of the rehabilitation. However, evidence of effectiveness of rehabilitative exergaming on physical functioning is sparse and more research is needed to conduct evidence-based rehabilitation practices. Therefore the present study examines the effectiveness of a 16-week gamified physiotherapy on physical functioning, life satisfaction and pain for patients after TKA compared to treatment as usual home exercise. The second objective is to validate the psychometric properties of WHODAS 2.0 (WHO Disability Assessment Schedule) and brief ICF (International classification of functioning, disability and health) core set of osteoarthritis questionnaire. Other objectives are to find out, what kind of understanding and experiences the participants have about the rehabilitation with exergames and to evaluate the usability and user experience of exergames.

Total knee replacement, Exergame, Total knee arthroplasty, Exercise, Physiotherapy, Physical functioning

Inclusion Criteria: first primary (M17.0, M17.1) unilateral TKA mechanical axis of the limb in varus model of the TKA is posterior stabilizing (PS) or cruciate retaining (CR) prosthesis normal vision with or without eyeglasses Exclusion Criteria: fractures, rheumatoid arthritis, or other biomechanical disruptions in affected lower limb within one year before operation diagnosed memory disorder or cognitive impairment neurological condition as Parkinson's disease, multiple sclerosis or stroke

Sensitive parts of the data cannot be anonymized and thus cannot be openly published. Sensitive data will be stored in JYX (Jyväskylä University Digital Repository), only the metadata will be public, and access to the data can be requested and granted on certain conditions. Metadata published in the Jyväskylä University Digital Repository. Heinonen A, Janhunen M, Aarto-lahti E, et al. Metadata from: Gamification in Knee Replacement Rehabilitation (BEE-RCT). V.2.2.2023 doi:10.17011/jyx/dataset/85350

Aartolahti E, Janhunen M, Katajapuu N, Paloneva J, Pamilo K, Oksanen A, Keemu H, Karvonen M, Luimula M, Korpelainen R, Jamsa T, Makela K, Heinonen A. Effectiveness of Gamification in Knee Replacement Rehabilitation: Protocol for a Randomized Controlled Trial With a Qualitative Approach. JMIR Res Protoc. 2022 Nov 28;11(11):e38434. doi: 10.2196/38434.

Janhunen M, Katajapuu N, Paloneva J, Pamilo K, Oksanen A, Keemu H, Karvonen M, Luimula M, Korpelainen R, Jamsa T, Kautiainen H, Makela K, Heinonen A, Aartolahti E. Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial. BMJ Open Sport Exerc Med. 2023 Mar 3;9(1):e001416. doi: 10.1136/bmjsem-2022-001416. eCollection 2023.

Metadata published in the Jyväskylä University Digital Repository. Heinonen A, Janhunen M, Aartolahti E, et al. Metadata from: Gamification in Knee Replacement Rehabilitation (BEE-RCT)