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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2022

19.02.2022 | KNEE

Virtual reality rehabilitation following total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

verfasst von: Aaron Gazendam, Meng Zhu, Yaping Chang, Steve Phillips, Mohit Bhandari

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 8/2022

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Abstract

Purpose

The use of virtual reality (VR) based rehabilitation has increased substantially within orthopedic surgery, particularly in the field of total knee arthroplasty (TKA). The objective of this systematic review and meta-analysis was to compare patient-reported outcomes and cost analyses from randomized controlled trials (RCT) utilizing VR-based rehabilitation in patients following TKA.

Methods

MEDLINE, EMBASE, and Cochrane databases were searched for RCTs involving VR-based rehabilitation following TKA. Quantitative synthesis was conducted for pain scores and functional outcomes. Narrative outcomes were reported for results not amenable to quantitative synthesis.

Results

A total of 9 RCTs with 835 patients were included with follow-up ranging from 10 days to 6 months postoperatively. No differences in pain scores were demonstrated between VR-based and traditional rehabilitation at 2 weeks and 3 months postoperatively. VR-based rehabilitation demonstrated improved functional outcomes at 12 weeks (n = 353) postoperatively [mean difference (MD) − 3.32, 95% confidence interval (CI) − 5.20 to − 1.45, moderate certainty evidence] and 6 months (n = 66) postoperatively [MD − 4.75, 95% CI − 6.69 to − 2.81, low certainty evidence], compared to traditional rehabilitation. One trial demonstrated significant cost savings with the use of VR-based rehabilitation.

Conclusions

VR-based rehabilitation for patients undergoing TKA represents an evolving field that may have advantages over traditional therapy for some patients. The current review is limited by the low quality of evidence in the literature. This is a rapidly evolving field with more trials needed to determine the impact of VR-based rehabilitation on patients undergoing TKA.

Level of evidence

Level I; meta-analysis of randomized controlled trials.
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Literatur
1.
Zurück zum Zitat Bettger JP, Green CL, Holmes DN, Chokshi A, Mather RC III, Hoch BT, de Leon AJ, Aluisio F, Seyler TM, Del Gaizo DJ (2020) Effects of virtual exercise rehabilitation in-home therapy compared with traditional care after total knee arthroplasty: VERITAS, a randomized controlled trial. J Bone Joint Surg Am 102:101–109CrossRef Bettger JP, Green CL, Holmes DN, Chokshi A, Mather RC III, Hoch BT, de Leon AJ, Aluisio F, Seyler TM, Del Gaizo DJ (2020) Effects of virtual exercise rehabilitation in-home therapy compared with traditional care after total knee arthroplasty: VERITAS, a randomized controlled trial. J Bone Joint Surg Am 102:101–109CrossRef
2.
Zurück zum Zitat Blasco J, Igual-Camacho C, Blasco M, Anton-Anton V, Ortiz-Lluecalvaro, Roig-Casasus S, (2021) The efficacy of virtual reality tools for total knee replacement rehabilitation: a systematic review. Physiother Theory Pract 37:682–692CrossRef Blasco J, Igual-Camacho C, Blasco M, Anton-Anton V, Ortiz-Lluecalvaro, Roig-Casasus S, (2021) The efficacy of virtual reality tools for total knee replacement rehabilitation: a systematic review. Physiother Theory Pract 37:682–692CrossRef
3.
Zurück zum Zitat Castrodad IMD, Recai TM, Abraham MM, Etcheson JI, Mohamed NS, Edalatpour A, Delanois RE (2019) Rehabilitation protocols following total knee arthroplasty: a review of study designs and outcome measures. Ann Transl Med 7:S255CrossRef Castrodad IMD, Recai TM, Abraham MM, Etcheson JI, Mohamed NS, Edalatpour A, Delanois RE (2019) Rehabilitation protocols following total knee arthroplasty: a review of study designs and outcome measures. Ann Transl Med 7:S255CrossRef
4.
Zurück zum Zitat Christiansen CL, Bade MJ, Davidson BS, Dayton MR, Stevens-Lapsley JE (2015) Effects of weight-bearing biofeedback training on functional movement patterns following total knee arthroplasty: a randomized controlled trial. J Orthop Sports Phys Ther 45:647–655CrossRef Christiansen CL, Bade MJ, Davidson BS, Dayton MR, Stevens-Lapsley JE (2015) Effects of weight-bearing biofeedback training on functional movement patterns following total knee arthroplasty: a randomized controlled trial. J Orthop Sports Phys Ther 45:647–655CrossRef
5.
Zurück zum Zitat Fung V, Ho A, Shaffer J, Chung E, Gomez M (2012) Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial. Physiotherapy 98:183–188CrossRef Fung V, Ho A, Shaffer J, Chung E, Gomez M (2012) Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial. Physiotherapy 98:183–188CrossRef
6.
Zurück zum Zitat Fusco F, Turchetti G (2016) Telerehabilitation after total knee replacement in Italy: cost-effectiveness and cost-utility analysis of a mixed telerehabilitation-standard rehabilitation programme compared with usual care. BMJ Open 6:e009964 Fusco F, Turchetti G (2016) Telerehabilitation after total knee replacement in Italy: cost-effectiveness and cost-utility analysis of a mixed telerehabilitation-standard rehabilitation programme compared with usual care. BMJ Open 6:e009964
7.
Zurück zum Zitat Garcia LM, Birckhead BJ, Krishnamurthy P, Sackman J, Mackey IG, Louis RG, Salmasi V, Maddox T, Darnall BD (2021) An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19. J Med Internet Res 23:e26292 Garcia LM, Birckhead BJ, Krishnamurthy P, Sackman J, Mackey IG, Louis RG, Salmasi V, Maddox T, Darnall BD (2021) An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19. J Med Internet Res 23:e26292
8.
Zurück zum Zitat Gianola S, Stucovitz E, Castellini G, Mascali M, Vanni F, Tramacere I, Banfi G, Tornese D (2020) Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: a randomized controlled trial. Medicine (Baltimore) 99 Gianola S, Stucovitz E, Castellini G, Mascali M, Vanni F, Tramacere I, Banfi G, Tornese D (2020) Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: a randomized controlled trial. Medicine (Baltimore) 99
9.
Zurück zum Zitat Guyatt GH, Thorlund K, Oxman AD, Walter SD, Patrick D, Furukawa TA, Johnston BC, Karanicolas P, Akl EA, Vist G (2013) GRADE guidelines: 13. Preparing summary of findings tables and evidence profiles—continuous outcomes. J Clin Epidemiol 66:173–183CrossRef Guyatt GH, Thorlund K, Oxman AD, Walter SD, Patrick D, Furukawa TA, Johnston BC, Karanicolas P, Akl EA, Vist G (2013) GRADE guidelines: 13. Preparing summary of findings tables and evidence profiles—continuous outcomes. J Clin Epidemiol 66:173–183CrossRef
10.
Zurück zum Zitat Hadamus A, Białoszewski D, Błażkiewicz M, Kowalska AJ, Urbaniak E, Wydra KT, Wiaderna K, Boratyński R, Kobza A, Marczyński W (2021) Assessment of the effectiveness of rehabilitation after total knee replacement surgery using sample entropy and classical measures of body balance. Entropy (Basel) 23:164CrossRef Hadamus A, Białoszewski D, Błażkiewicz M, Kowalska AJ, Urbaniak E, Wydra KT, Wiaderna K, Boratyński R, Kobza A, Marczyński W (2021) Assessment of the effectiveness of rehabilitation after total knee replacement surgery using sample entropy and classical measures of body balance. Entropy (Basel) 23:164CrossRef
11.
Zurück zum Zitat Inacio MCS, Paxton EW, Graves SE, Namba RS, Nemes S (2017) Projected increase in total knee arthroplasty in the United States–an alternative projection model. Osteoarthritis Cartilage 25:1797–1803CrossRef Inacio MCS, Paxton EW, Graves SE, Namba RS, Nemes S (2017) Projected increase in total knee arthroplasty in the United States–an alternative projection model. Osteoarthritis Cartilage 25:1797–1803CrossRef
12.
Zurück zum Zitat Jiang S, Xiang J, Gao X, Guo K, Liu B (2018) The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: a systematic review and meta-analysis. J Telemed Telecare 24:257–262CrossRef Jiang S, Xiang J, Gao X, Guo K, Liu B (2018) The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: a systematic review and meta-analysis. J Telemed Telecare 24:257–262CrossRef
13.
Zurück zum Zitat Jin C, Feng Y, Ni Y, Shan Z (2018) Virtual reality intervention in postoperative rehabilitation after total knee arthroplasty: a prospective and randomized controlled clinical trial. Int J Clin Exp Med 11:6119–6124 Jin C, Feng Y, Ni Y, Shan Z (2018) Virtual reality intervention in postoperative rehabilitation after total knee arthroplasty: a prospective and randomized controlled clinical trial. Int J Clin Exp Med 11:6119–6124
14.
Zurück zum Zitat Jinks C, Jordan K, Croft P (2002) Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain 100:55–64CrossRef Jinks C, Jordan K, Croft P (2002) Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain 100:55–64CrossRef
15.
Zurück zum Zitat Karasavvidis T, Hirschmann MT, Kort NP, Terzidis I, Totlis T (2020) Home-based management of knee osteoarthritis during COVID-19 pandemic: literature review and evidence-based recommendations. J Exp Orthop 7:52CrossRef Karasavvidis T, Hirschmann MT, Kort NP, Terzidis I, Totlis T (2020) Home-based management of knee osteoarthritis during COVID-19 pandemic: literature review and evidence-based recommendations. J Exp Orthop 7:52CrossRef
16.
Zurück zum Zitat Keshner EA (2004) Virtual reality and physical rehabilitation: a new toy or a new research and rehabilitation tool? BMC Med 14:215 Keshner EA (2004) Virtual reality and physical rehabilitation: a new toy or a new research and rehabilitation tool? BMC Med 14:215
17.
Zurück zum Zitat Li A, Montaño Z, Chen VJ, Gold JI (2011) Virtual reality and pain management: current trends and future directions. Pain Manag 1:147–157CrossRef Li A, Montaño Z, Chen VJ, Gold JI (2011) Virtual reality and pain management: current trends and future directions. Pain Manag 1:147–157CrossRef
18.
Zurück zum Zitat Marks R (2014) Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care. Health Psychol Open 1:2055102914564582PubMedPubMedCentral Marks R (2014) Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care. Health Psychol Open 1:2055102914564582PubMedPubMedCentral
19.
Zurück zum Zitat Mechanic R (2014) Post-acute care—the next frontier for controlling Medicare spending. N Engl J Med 370:692–694CrossRef Mechanic R (2014) Post-acute care—the next frontier for controlling Medicare spending. N Engl J Med 370:692–694CrossRef
20.
Zurück zum Zitat Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Belzile ÉL, Ranger P (2017) Patient satisfaction with in-home telerehabilitation after total knee arthroplasty: results from a randomized controlled trial. Telemed J E Health 23:80–87CrossRef Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Belzile ÉL, Ranger P (2017) Patient satisfaction with in-home telerehabilitation after total knee arthroplasty: results from a randomized controlled trial. Telemed J E Health 23:80–87CrossRef
21.
Zurück zum Zitat Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Ranger P, Belzile ÉL, Dimentberg R (2015) In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. J Bone Joint Surg Am 97:1129–1141CrossRef Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Ranger P, Belzile ÉL, Dimentberg R (2015) In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. J Bone Joint Surg Am 97:1129–1141CrossRef
22.
Zurück zum Zitat Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372 Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372
23.
Zurück zum Zitat Petursdottir U, Arnadottir SA, Halldorsdottir S (2010) Facilitators and barriers to exercising among people with osteoarthritis: a phenomenological study. Phys Ther 90:1014–1025CrossRef Petursdottir U, Arnadottir SA, Halldorsdottir S (2010) Facilitators and barriers to exercising among people with osteoarthritis: a phenomenological study. Phys Ther 90:1014–1025CrossRef
24.
Zurück zum Zitat Piqueras M, Marco E, Coll M, Escalada F, Ballester A, Cinca C, Belmonte R, Muniesa JM (2013) Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthroplasty: a randomized controlled trial. J Rehabil Med 45:392–396CrossRef Piqueras M, Marco E, Coll M, Escalada F, Ballester A, Cinca C, Belmonte R, Muniesa JM (2013) Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthroplasty: a randomized controlled trial. J Rehabil Med 45:392–396CrossRef
25.
Zurück zum Zitat Pozzi F, Snyder-Mackler L, Zeni J (2013) Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med 49:877PubMedPubMedCentral Pozzi F, Snyder-Mackler L, Zeni J (2013) Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med 49:877PubMedPubMedCentral
26.
Zurück zum Zitat Roig-Casasús S, Blasco JM, López-Bueno L, Blasco-Igual MC (2018) Balance training with a dynamometric platform following total knee replacement: a randomized controlled trial. J Geriatr Phys Ther 41:204–209CrossRef Roig-Casasús S, Blasco JM, López-Bueno L, Blasco-Igual MC (2018) Balance training with a dynamometric platform following total knee replacement: a randomized controlled trial. J Geriatr Phys Ther 41:204–209CrossRef
27.
Zurück zum Zitat Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96CrossRef Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96CrossRef
28.
Zurück zum Zitat Rutkowski S (2021) Management challenges in chronic obstructive pulmonary disease in the covid-19 pandemic: telehealth and virtual reality. J Clin Med 10:1261CrossRef Rutkowski S (2021) Management challenges in chronic obstructive pulmonary disease in the covid-19 pandemic: telehealth and virtual reality. J Clin Med 10:1261CrossRef
29.
Zurück zum Zitat Schünemann H, Brożek J, Guyatt G, Oxman A (2015) GRADE handbook. 2013. Schünemann H, Brożek J, Guyatt G, Oxman A (2015) GRADE handbook. 2013.
30.
Zurück zum Zitat Singh RP, Javaid M, Kataria R, Tyagi M, Haleem A, Suman R (2020) Significant applications of virtual reality for COVID-19 pandemic. Diabetes Metab Snydr 14:661–664CrossRef Singh RP, Javaid M, Kataria R, Tyagi M, Haleem A, Suman R (2020) Significant applications of virtual reality for COVID-19 pandemic. Diabetes Metab Snydr 14:661–664CrossRef
31.
Zurück zum Zitat Smits M, Staal JB, Van Goor H (2020) Could Virtual Reality play a role in the rehabilitation after COVID-19 infection? BMJ Open Sport Exerc Med 6:e000943 Smits M, Staal JB, Van Goor H (2020) Could Virtual Reality play a role in the rehabilitation after COVID-19 infection? BMJ Open Sport Exerc Med 6:e000943
32.
Zurück zum Zitat Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng H-Y, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:l4898 Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng H-Y, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:l4898
33.
Zurück zum Zitat Tousignant M, Moffet H, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Ranger P, Belzile ÉL (2015) Cost analysis of in-home telerehabilitation for post-knee arthroplasty. J Med Internet Res 17:e3844 Tousignant M, Moffet H, Nadeau S, Mérette C, Boissy P, Corriveau H, Marquis F, Cabana F, Ranger P, Belzile ÉL (2015) Cost analysis of in-home telerehabilitation for post-knee arthroplasty. J Med Internet Res 17:e3844
34.
Zurück zum Zitat Webster F, Perruccio AV, Jenkinson R, Jaglal S, Schemitsch E, Waddell JP, Venkataramanan V, Bytautas J, Davis AM (2015) Understanding why people do or do not engage in activities following total joint replacement: a longitudinal qualitative study. Osteoarthritis Cartilage 23:860–867CrossRef Webster F, Perruccio AV, Jenkinson R, Jaglal S, Schemitsch E, Waddell JP, Venkataramanan V, Bytautas J, Davis AM (2015) Understanding why people do or do not engage in activities following total joint replacement: a longitudinal qualitative study. Osteoarthritis Cartilage 23:860–867CrossRef
35.
Zurück zum Zitat Yoon S, Son H (2020) Effects of full immersion virtual reality training on balance and knee function in total knee replacement patients: a randomized controlled study. J Mech Med Biol 20:2040007CrossRef Yoon S, Son H (2020) Effects of full immersion virtual reality training on balance and knee function in total knee replacement patients: a randomized controlled study. J Mech Med Biol 20:2040007CrossRef
Metadaten
Titel
Virtual reality rehabilitation following total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
verfasst von
Aaron Gazendam
Meng Zhu
Yaping Chang
Steve Phillips
Mohit Bhandari
Publikationsdatum
19.02.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 8/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-06910-x

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