The Use of Gaming Technology in the Rehabilitation of Patients Following Total Knee Replacement Surgery

Abstract

Home-based rehabilitation following total knee replacement (TKR) surgery can be as effective as clinic-based or in-patient rehabilitation. The use of the Nintendo Wii, Wii Balance Board and Wii-fit software was postulated as a novel rehabilitation tool that could add additional focus on balance and proprioception. The aim of this thesis was to investigate the effectiveness of this novel rehabilitation tool, both as a device for measuring balance outcomes and for rehabilitation following TKR surgery. The pilot studies investigated the validity and reliability of the Nintendo Wii-fit software, the relationship of balance with function in the arthritic population and the ability of this elderly population to use computer technology. The RCT-POWER study was a trial of 128 patients undergoing primary total knee replacement, randomised at 6 weeks post-TKR surgery to 3 months of usual care or using the Wii-Fit at home. The primary outcome was the change in WOMAC total score from week 6 to 18 weeks and 1 year. The results of this thesis are relevant for clinical practice, providing evidence for the use of affordable technology for the rehabilitation of patients at home. The intervention improved functional outcomes as measured by WOMAC and also adherence to the rehabilitation protocol.