Investigation of the Effectiveness of Wii-Based Exercise Play Therapy in Knee Osteoarthritis Rehabilitation
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      Osteoarthritis (OA) is a slowly progressive, chronic and degenerative joint disease
      frequently seen in the knee and hip joints. OA is not only involved in degenerative changes
      of cartilage, but can also be a result of capsular hypertrophy, osteophytes, subchondral bone
      sclerosis, ulcerations, fibrillations. It progressively impairs the patient's independence,
      mobility and participation in social life, thus reducing the overall quality of life. Edema,
      stiffness, instability, decreased muscle strength, impaired range of motion and
      proprioceptive sensation, increased incidence of falls are seen together with the main
      symptom of pain. In OA, treatment options are available to manage symptoms and optimize
      quality of life. In clinical guidelines, evidence-based treatment for Osteoarthritis may
      include patient education and self-management programs that integrate weight management,
      structured exercise, and physical activity. Closed kinetic chain exercises have gained
      importance in the rehabilitation of many musculoskeletal problems in the last 20 years and
      have become one of the most preferred exercises. In addition, the virtual reality treatment
      approach, which is the most common example of technology use in rehabilitation, has also
      started to take place in rehabilitation studies. The aim of this project is to investigate
      the effects of Wii-based video-based exercise game therapy on muscle strength,
      proprioception, postural control and functional level in knee osteoarthritis rehabilitation.
    

Detailed description: 
      Osteoarthritis (OA) is a slowly progressive, chronic and degenerative joint disease
      frequently seen in the knee and hip joints. OA is not only involved in degenerative changes
      of cartilage, but can also be a result of capsular hypertrophy, osteophytes, subchondral bone
      sclerosis, ulcerations, fibrillations. It progressively impairs the patient's independence,
      mobility and participation in social life, thus reducing the overall quality of life. Edema,
      stiffness, instability, decreased muscle strength, impaired range of motion and
      proprioceptive sensation, increased incidence of falls are seen together with the main
      symptom of pain. In OA, treatment options are available to manage symptoms and optimize
      quality of life. In clinical guidelines, evidence-based treatment for Osteoarthritis may
      include patient education and self-management programs that integrate weight management,
      structured exercise, and physical activity. Closed kinetic chain exercises have gained
      importance in the rehabilitation of many musculoskeletal problems in the last 20 years and
      have become one of the most preferred exercises. In addition, the virtual reality treatment
      approach, which is the most common example of technology use in rehabilitation, has also
      started to take place in rehabilitation studies. The aim of this project is to investigate
      the effects of Wii-based video-based exercise game therapy on muscle strength,
      proprioception, postural control and functional level in knee osteoarthritis rehabilitation.

      Method: 56 volunteers diagnosed with bilateral knee OA, who underwent routine electrotherapy
      and conventional exercise program in the laboratory of Istanbul Rumeli University and were
      directed to exercise according to the inclusion criteria, will be included in the study.
      Patients with knee pain due to OA for at least 6 months, diagnosed with primary OA according
      to the criteria of the American College of Rheumatology, Stage 2-3 knee OA according to the
      Kellgren-Lawrence classification, aged 55-65, without any neurological disease Individuals
      who volunteered to participate and had a Mini Mental State Scale score ≥23 will be included.
      Diagnosed with secondary OA, Operated on the knee, hip and/or spine, Severe knee trauma or
      physical therapy for the knee in the last year, Presence of neurological disease that may
      affect balance and proprioception, Vertigo, hearing and vision problems, Genu varum and Genu
      valgum and Individuals with scoliosis, Body Mass Index (BMI) ≥40 kg/m2 and Visual analog
      scale ≥8/10 will be excluded from the study. Pain with Visual Analog Scale, pain threshold
      with algometer, range of motion with goniometer, muscle strength with dynamometer, functional
      level with Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne knee
      index, postural control with Berg balance scale, functional performance with timed get up and
      go test, 10 meters walking test and 10 steps climbing test, and proprioception with digital
      goniometer will be evaluated for all participants before and after treatment and at the 8th
      week of treatment. All individuals participating in the study will be randomly divided into 2
      groups. All individuals participating in the study will receive 15 sessions of electrotherapy
      and conventional exercise program, 5 days a week for 3 weeks. In the first group, besides
      electrotherapy and conventional exercise program applications, structured proprioception and
      closed kinetic chain exercises will be applied for 3 weeks under the supervision of a
      physiotherapist. A rest period of 10 seconds will be given between exercises. The second
      group will be given a wii-based balance training program for 3 weeks, 5 days a week, in
      addition to the electrotherapy and conventional exercise program. It was aimed to find an
      effective treatment method in individuals with knee osteoarthritis by comparing the groups at
      the end of the treatment and at the 8th week.
    

Intervention name(s): Structured Proprioception and Closed Kinetic Chain Exercises Group; Wii Based Balance Training Program Group
Intervention type(s): Other; Other
Intervention description(s): In this group, an exercise program consisting of 3 stages, ranging from simple to difficult and including closed kinetic chain exercises and proprioceptive exercises, will be applied.; In addition to electrotherapy and conventional exercise program, wii-based balance training program will be applied 5 days a week for 3 weeks. "Balance Surf", which includes lateral weight transfer, "Balance Adventure", which includes versatile balance exercises, and "balance bowling" for static and dynamic postural control will be implemented in the Fizyosoft Balance System. Each game will be practiced under the supervision of a physiotherapist for a total of 3 minutes, respectively, Balance surf, Balance adventure, Balance surf, Balance bowling and Balance surf, for a total of 15 minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Virtual Reality; Exercise; Knee Osteoarthritis