The Effect of Virtual Rehabilitation Added to an Accelerated Rehabilitation Program After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Year 2019, Volume: 9 Issue: 2, 124 - 129, 30.06.2019

Zehra Betul Karakoc , Tugba Kuru Colak Zubeyir Sari Mine Gulden Polat

https://doi.org/10.33808/clinexphealthsci.564273

Cited By: 7

Abstract

Objective: This study aimed to
determine the effectiveness of virtual rehabilitation on balance and
functionality in patients with anterior cruciate ligament (ACL) reconstruction.

Methods: A total of 22 males who had
undergone ACL reconstruction were divided into Nintendo and control groups.
Both of the groups received six week accelerated rehabilitation in our
department, and the Nintendo Wii^© (Nintendo, Washington, USA)
balance games were added to Nintendo group after three weeks for forty minutes
a day, three times a week. Patients were evaluated for pain (visual analog
scale), functionality (Lower Extremity Functional Scale), center of gravity
(COG) and balance (Nintendo Wii^©) at the baseline and end of the 3th
and 6th week of rehabilitation program.

Results: Similar improvements were
determined in the pain, functionality, COG and balance scores of the two groups
at the end of the treatment program and there were no significant differences
between the groups in the amount of change in all parameters (p= 0.256, 0.393,
0.707, 1.000).

Conclusion: According to the results of
this study the Nintendo Wii^© balance games applied in the clinic
under physiotherapist supervision did not change the outcome of the
rehabilitation in early period after ACL reconstruction.

Keywords

Anterior Cruciate Ligament, Nintendo Wii©, Postural Balance.

References

• 1. Spindler KP, Wright RW. Anterior cruciate ligament tear. New Engl J Med 2008; 359 (20): 2135 - 2142.
• 2. Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. J Athl Training 2002; 51 (4): 80 - 84.
• 3. Vathrakokilis K, Malliou P, Giofsidou A, Beneka A, Godolias G. Effects of a balance training protocol on knee joint proprioception after anterior cruciate ligament reconstruction. J Back Musculoskelet 2008; 21 (4): 233 - 237.
• 4. Gokeler A, Benjaminse A, Hewett TE, Lephart SM, Engebretsen L, Ageberg E, Engelhardt M, Arnold MP, Postema K, Otten E, Dijkstra PU. Proprioceptive deficits after ACL injury: are they clinically relevant? Brit J Sport Med 2012; 46 (3): 180 - 192.
• 5. Clark RA, Howells B, Pua Y-H, Feller J, Whitehead T, Webster KE. Assessment of standing balance deficits in people who have undergone anterior cruciate ligament reconstruction using traditional and modern analysis methods. J Biomech 2014; 47 (5): 1134 - 1137.
• 6. Schroeder MJ, Krishnan C, Dhaher YY. The influence of task complexity on knee joint kinetics following ACL reconstruction. Clin Biomech 2015; 30 (8): 852 - 859.
• 7. Howells BE, Clark RA, Ardern CL, Bryant AL, Feller JA, Whitehead TS, Webster KE. The assessment of postural control and the influence of a secondary task in people with anterior cruciate ligament reconstructed knees using a Nintendo Wii Balance Board. Brit J Sport Med 2013; 47 (14): 914 - 919.
• 8. Mikkelsen C, Werner S, Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow- up study. Knee Surg Sport Tr A 2000; 8 (6): 337 - 342.
• 9. Van Grinsven S, Van Cingel REH, Holla CJM, Van Loon CJM. Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surg Sport Tr A 2010; 18 (8): 1128 - 1144.
• 10. Cooper R, Taylor N, Feller JA. Systematic review of the effect of proprioceptive and balance exercises on people with an injured or reconstructed anterior cruciate ligament. Res Sports Med 2005; 13 (2): 163 - 178.
• 11. Graves LE, Ridgers ND, Stratton G. The contribution of upper limb and total body movement to adolescents’ energy expenditure whilst playing Nintendo Wii. Eur J Appl Physiol 2008; 104 (4): 617.
• 12. Laver K, Ratcliffe J, George S, Burgess L, Crotty M. Is the Nintendo Wii Fit really acceptable to older people?: a discrete choice experiment. BMC Geriatr 2011; 11 (1): 64.
• 13. Bryanton C, Bosse J, Brien M, Mclean J, Mccormick A, Sveistrup H. Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy. Cyberpsychol Behav 2006; 9 (2): 123 - 128.
• 14. Available from: https://www.randomizer.org/. Accessed Date: 10.01.2016.
• 15. Shelbourne KD, Nitz P. Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sport Med 1990; 18 (3): 292 - 299.
• 16. Kouvelioti V, Kellis E, Kofotolis N, Amiridis I. Reliability of single-leg and double-leg balance tests in subjects with anterior cruciate ligament reconstruction and controls. Res Sports Med 2015; 23 (2): 151 - 166.
• 17. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001; 8 (12): 1153 - 1157.
• 18. Binkley JM, Stratford PW, Lott SA, Riddle DL. The lower extremity functional scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther 1999; 79 (4): 371 - 83.
• 19. Pigford T, Andrews WA. Feasibility and benefit of using the Nintendo Wii Fit for balance rehabilitation in an elderly patient experiencing recurrent falls. J Stud Phys Ther Res 2010: 2.
• 20. Wasserstein D, Huston LJ, Nwosu S, MOON Group, Spindler KP. KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study. Osteoarthr Cartilage 2015; 23 (10): 1674 - 1684.
• 21. Mikkelsen C, Werner S, Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sport Tr A 2000; 8 (6): 337 - 342.
• 22. Puh U, Majcen N, Hlebs S, Rugelj D. Effects of Wii balance board exercises on balance after posterior cruciate ligament reconstruction. Knee Surg Sport Tr A 2014; 22 (5): 1124 - 1130.
• 23. Baltacı G, Harput G, Haksever B, Ulusoy B, Özer H. Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction: prospective, randomized, controlled, double-blind clinical trial. Knee Surg Sport Tr A 2013; 21 (4): 880 - 887.
• 24. Kartus J, Magnusson L, Stener S, Brandsson S, Eriksson BI, Karlsson J. Complications following arthroscopic anterior cruciate ligament reconstruction A 2–5 -year follow-up of 604 patients with special emphasis on anterior knee pain. Knee Surg Sport Tr A 1999; 7 (1): 2 - 8.
• 25. Gülbahar S, Akgün B, Karasel S, Baydar M, El O, Pınar H. The effect of anterior knee pain on strength, functional tests, proprioception and balance after anterior cruciate ligament reconstruction. Türk Fiz Tıp Rehab D 2013; 59 (2): 90 - 97.
• 26. Acevedo R, Rivera-Vega A, Miranda G, Micheo W. Anterior cruciate ligament ınjury: identification of risk factors and prevention strategies. Curr Sport Med Rep 2014; 13 (3): 186 - 191.
• 27. Bryant AL, Kelly J, Hohmann E. Neuromuscular adaptations and correlates of knee functionality following ACL reconstruction. J Orthop Res 2008; 26 (1): 126 - 135.
• 28. Clark RA, McGough R, Paterson K. Reliability of an inexpensive and portable dynamic weight bearing asymmetry assessment system incorporating dual Nintendo Wii Balance Boards. Gait Posture 2011; 34 (2): 288 - 291.
• 29. Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Hewett TE. Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sport Med 2010; 38 (10): 1968 - 1978.
• 30. Brunetti O, Filippi GM, Lorenzini M, Liti A, Panichi R, Roscini M, Pettorossi VE, Cerulli G. Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction. Knee Surg Sport Tr A 2006; 14 (11): 1180 - 1187.
• 31. Swanson LR, Lee TD. Effects of aging and schedules of knowledge of results on motor learning. J Gerontol 1992; 47 (6): 406 - 411.
• 32. Ma Y, Deie M, Iwaki D, Asaeda M, Fujita N, Adachi N, Ochi Mitsuo. Balance ability and proprioception after single-bundle, single-bundle augmentation, and double- bundle ACL reconstruction. Sci World J 2014; 2014:1-8.
• 33. Smith MD, Bell DR. Negative effects on postural control after anterior cruciate ligament reconstruction as measured by the balance error scoring system. J Sport Rehabil 2013; 22 (3): 224 - 228.
• 34. Molka AZ, Lisiński P, Huber J. Visual biofeedback exercises for improving body balance control after anterior cruciate ligament reconstruction. J Phys Ther Sci 2015; 27 (7): 2357 - 2360.