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Active video games for knee osteoarthritis improve mobility but not WOMAC score: a randomized controlled trial [with consumer summary]
Lin Y-T, Lee W-C, Hsieh R-L
Annals of Physical and Rehabilitation Medicine 2020 Nov;63(6):458-465
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Active video games (AVGs) have become popular and have been investigated for their therapeutic purposes. However, the effect of AVGs on patients with knee osteoarthritis (OA) remains uncertain. OBJECTIVE: We aimed to compare the effects of AVGs with those of traditional therapeutic exercise on patients with knee OA. METHOD: This was a prospective single-blind, randomized controlled trial. Participants (n = 80) with knee OA were allocated to the AVGs group (n = 40) or therapeutic exercise group (n = 40). Both groups received treatment 3 times a week for 4 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and secondary outcome measures were the World Health Organization Quality of Life-Brief Vision, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, physical functional performance (including time for 10-m walking and for ascending and descending stairs), Biodex Stability System, Chronic Pain Grade Questionnaire, and Work Ability Index. The patients were evaluated at baseline, 2 and 4 weeks after treatment, and 1 and 3 months after treatment completion. RESULTS: Both groups showed significant time effect in the pain subcategory of the WOMAC (p = 0.047). However, we found no significant group x time interaction effect between the groups at any follow-up assessments for pain (p = 0.066), stiffness (p = 0.284), or physical function (p = 0.179) for the WOMAC. Among the secondary outcomes, we found significant group x time effects favoring the AVG group in dynamic balance (p = 0.020), and physical functional performance including 10-m walking time (p = 0.002) and stair ascent time (p = 0.005), and the physical domain of health (p = 0.032). CONCLUSIONS: Therapeutic exercises and playing AVGs similarly improved the pain of patients with knee OA; however, playing AVGs improved dynamic balance, physical functional performance, and physical health more than therapeutic exercises did.

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