Effect of Video-based Game and Aerobic Exercise on Knee Osteoarthritis

NCT06885008 | Completed

• 1 other identifier: 2024/05
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial was conducted by the CONSORT guidelines for non-pharmacological treatments. Participants were randomly assigned to control, gaming, or aerobic groups using the closed-envelope randomization method. All groups received conventional physiotherapy for 8 weeks. In addition, the gaming group played active video games 3 days per week, while the aerobic group engaged in cycling-based aerobic exercise (20 minutes per session) 3 days per week. The control group received only conventional physiotherapy and continued their daily activities. Evaluations were performed by the same assessor at the baseline and after eight weeks.

Conditions

Osteoarthritis of Knee

Keywords

Knee Osteoarthritis; Video Games; Aerobic Exercise; Pain; Disabilitiy

Outcome Measures

Primary Outcomes (4)

• Knee disability

  The WOMAC index was used to assess functional disability in patients with knee osteoarthritis. It consists of 24 items divided into three subcategories: pain severity, stiffness, and physical function. Each item is scored on a 5-point Likert scale ranging from 0 to 4. The total score is calculated as a percentage, with higher scores indicating increased pain and stiffness and reduced physical function.

  8 weeks

• Functional capacity

  The 6MWT was used to measure patients' functional capacity. Two cones were placed 30 meters apart, and participants were instructed to walk as quickly as possible without running. The total distance walked in six minutes was recorded in (m) meters.

  8 weeks

• Functional Performance

  The TUG test was administered to assess dynamic balance, walking speed, and functional performance. Participants were seated in a fixed chair without armrests, with their hips and knees positioned at a 90-degree angle. Upon the "START" command, they were instructed to stand up, walk three meters, turn around a designated cone, and return to the starting position. The total time (seconds) required to complete the task was recorded.

  8 weeks

• Balance

  The modified Y-Balance test was used to assess dynamic balance. In this test, the maximum distances reached in the Anterior (A), Posteromedial (PM), and Posterolateral (PL) directions were recorded. The assessment was conducted using a specialized platform with Y-shape. Participants were instructed to position the foot being tested at the center of the platform while reaching as far as possible with the opposite foot in the A, PM, and PL directions. Measurements were taken bilaterally, ensuring that the participant's balance was maintained throughout the procedure. The test was repeated three times, and the average distances were recorded in (cm) centimeters.

  8 weeks

Secondary Outcomes (1)

• Limb strength

  8 weeks

Study Arms (3)

Gaming

EXPERIMENTAL

The gaming group played active video games via Xbox kinect 3 days per week, addition to conventional physiotherapy for 8 weeks.

Other: Active video game; Other: Conventional treatment

Aerobic

EXPERIMENTAL

The aerobic group engaged in cycling-based aerobic exercise (20 minutes per session) 3 days per week addition to conventional physiotherapy for 8 weeks.

Other: Aerobic exercise; Other: Conventional treatment

Control

EXPERIMENTAL

The control group received only conventional physiotherapy and continued their daily activities.

Other: Conventional treatment

Interventions

Active video game OTHER

The participants played the video game using an Xbox 360 Kinect console connected to a 55-inch Full HD television. The video games were planned with the assistance of a physiotherapist, 3 days per week, with 8 repetitions during the first 4 weeks and 12 repetitions during the final 4 weeks. The warm-up and cool-down periods were designed and applicated.

Gaming

Aerobic exercise OTHER

Aerobic exercise training was performed on a stationary bike, 3 days per week, for 20 minutes per session. The intensity of the aerobic exercise was determined using the Karvonen method. For the first 4 weeks, the intensity was set at 30-50% of the maximum heart rate (MHR), corresponding to light intensity, and was then increased to 50-70% (moderate intensity) for the following 4 weeks. A pulse oximeter (ChoiceMMed, China) was used to monitor the target heart rate. During both the warm-up and cool-down phases of the aerobic exercise, participants performed hip abduction and adduction, hip-knee flexion, heel raises, and mini squats while standing for 3-5 minutes.

Aerobic

Conventional treatment OTHER

Convetional treatment included Hotpack, Transcutaneous Electrical Nerve Stimulation (TENS), and Ultrasound (US) modalities, were applied to the symptomatic knee(s) for a total duration of 30 minutes. Following this, the exercise program outlined below was performed with 3 sets of 10 repetitions each. The session lasted approximately 45 minutes.

Aerobic; Control; Gaming

Eligibility Criteria

• Age: 30 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants, aged 30-65 years who were diagnosed with unilateral or bilateral osteoarthritis based on the clinical and radiological criteria of the American College of Rheumatology.
• The severity of osteoarthritis was classified as stage 2-3 according to the Kellgren-Lawrence grading system for gonarthrosis.
• Participants were required to be able to walk independently for at least 15 meters and to refrain from using non-steroidal anti-inflammatory drugs (NSAIDs) during the study period.

You may not qualify if:

• A history of lower extremity surgery within the past 6 months,
• The presence of neurological or systemic diseases,
• Other inflammatory joint diseases,
• Getting classic physiotherapy and rehabilitation within the past month,
• Intra-articular corticosteroid injections within the past 3 months,
• Severe joint deformities or movement restrictions,
• Severe visual impairments.

Sponsors & Collaborators

• Hasan Kalyoncu University: lead
• The Scientific and Technological Research Council of Turkey: collaborator

Study Sites (1)

Hasan Kalyoncu University, Department of Physiotherapy and Rehabilitation

Şahinbey, Gaziantep, 27300, Turkey (Türkiye)

Location

Related Publications (4)

• Kong H, Wang XQ, Zhang XA. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front Aging Neurosci. 2022 May 3;14:854026. doi: 10.3389/fnagi.2022.854026. eCollection 2022.

  PMID: 35592699 BACKGROUND

• Cicek A, Ozdincler AR, Tarakci E. Interactive video game-based approaches improve mobility and mood in older adults: A nonrandomized, controlled tri̇al. J Bodyw Mov Ther. 2020 Jul;24(3):252-259. doi: 10.1016/j.jbmt.2020.01.005. Epub 2020 Feb 6.

  PMID: 32825997 BACKGROUND

• Oiestad BE, Aroen A, Rotterud JH, Osteras N, Jarstad E, Grotle M, Risberg MA. The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up. BMC Musculoskelet Disord. 2023 Sep 8;24(1):714. doi: 10.1186/s12891-023-06831-x.

  PMID: 37684597 BACKGROUND

• Lange B, Flynn S, Proffitt R, Chang CY, Rizzo AS. Development of an interactive game-based rehabilitation tool for dynamic balance training. Top Stroke Rehabil. 2010 Sep-Oct;17(5):345-52. doi: 10.1310/tsr1705-345.

  PMID: 21131259 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Pain

Interventions

Exercise

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Serkan Usgu, Ass Prof

  Hasan Kalyoncu University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ass. Prof.

Study Record Dates

• First Submitted: March 13, 2025
• First Posted: March 19, 2025
• Study Start: November 1, 2023
• Primary Completion: May 30, 2024
• Study Completion: June 26, 2024
• Last Updated: March 24, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)