Nintendo Wii ® Egzersizlerinin Diz Cerrahileri Sonrası Etkinliği: Sistematik İnceleme ve Meta-analiz

Öz

Amaç: Bu sistematik inceleme ve meta-analizin amacı diz cerrahisi geçirmiş hastalarda Nintendo Wii’nin (NW) etkinliğinin belirlenmesidir. Yöntem: Bu sistematik inceleme ve meta-analiz için literatür taramasında Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, OVID, Science Direct, Scopus, Academic Search Complete ve Google Scholar veri tabanları kullanılmıştır. Güncel çalışmaların dahil edilebilmesi için veri tabanı araştırması 2006 yılı ile 2021 yılı ağustos ayı arasıyla sınırlandırılmıştır. Sonuçlar: Tarih ve dil kısıtlamaları ile tarama gerçekleştirildi ve başlangıçta 203 ilişkili çalışmaya ulaşıldı. 41 çalışma başlangıç kriterlerini sağlayıp incelemeye dahil edilirken bu çalışmaların 4 tanesi nihai kriterleri sağladı. Tüm çalışmaların ortalama metodolojik kalitesi PEDro skalasına göre 10 üzerinden 4,25 olarak belirlendi. Meta-analiz standart fizyoterapi programına eklenen NW eğitiminin ağrıyı azaltma (SMD=-0.746; 95% CI=-1.333,-0.160; p = 0.013) ve fonksiyonellik (SMD=-0.744; 95% CI=0.260, 1.228; p = 0.003) üzerinde etkisinin sadece konvansiyonel fizyoterapiye göre istatistiksel açıdan daha etkili olduğunu göstermiştir. Tartışma: NW eğitimleri diz cerrahisi geçirmiş hastalarda ağrı, fonksiyonellik, denge, koordinasyon ve propriosepsiyon açısından umut vadeden bir araç olabilir. NW’nin etkinliğinin belirlenmesi için gelecekte yüksek kalitede çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• diz
• Diz replasman artroplastisi
• Anterior cruciate ligaman yeniden yapılandırılması
• Video oyunları
• Sanal gerçeklik maruz kalma terapisi

The Effectiveness of Nintendo Wii ® Exercises in Rehabilitation Following Knee Surgery: A Systematic Review and Meta-analysis

Öz

Aim: This systematic review and meta-analysis were aimed to determine the efficacy of Nintendo Wii (NW) in patients who have undergone knee surgery. Methods: In literature search of this systematic review and meta-analysis, Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, OVID, Science Direct, Scopus, Academic Search Complete, and Google Scholar databases were used. The database search was limited to the period from 2006 until August 2021 so as to capture more recent publications. Results: The search strategy was applied with the limitation of date and language and this initial electronic search resulted in 203 relevant studies. Of these, 41 full-text articles met the initial criteria and were retrieved for review, with 4 studies meeting the final inclusion criteria. The mean methodological quality of all the studies was determined as 4.25 out of 10 on the PEDro scale. The meta-analysis indicated that NW training in addition to conventional therapy was statistically more effective than only conventional physiotherapy in reducing pain (SMD=-0.746; 95% CI=-1.333, -0.160; p = 0.013) and functionality (SMD=-0.744; 95% CI=0.260, 1.228; p = 0.003). Discussion: NW training can be a promising tool on the pain, functionality, balance, co-ordination and proprioception of patients who have undergone knee surgery. There is a need for further studies of high quality to examine the efficacy of NW in rehabilitation.

Anahtar Kelimeler

• knee
• knee replacement arthroplasty
• anterior cruciate ligament reconstruction
• video games
• virtual reality therapy

Kaynakça

1. Baltaci, G., Harput, G., Haksever, B., Ulusoy, B., & Ozer, H. (2013). 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 surgery, sports traumatology, arthroscopy, 21(4), 880-887.
2. Clapp, J. (2008). Illegal GMO releases and corporate responsibility: Questioning the effectiveness of voluntary measures. Ecological Economics, 66(2), 348-358.
3. Cone, B. L., Levy, S. S., & Goble, D. J. (2015). Wii Fit exer-game training improves sensory weighting and dynamic balance in healthy young adults. Gait & posture, 41(2), 711-715.
4. DerSimonian R, Laird N. Meta-analysis in clinical trials.Control Clin Trials. 1986;7(3):177–188.https://doi.org/10.1016/0197-2456(86)90046-2.
5. Ficklscherer, A., Stapf, J., Meissner, K. M., Niethammer, T., Lahner, M., Wagenhäuser, M., . . . Pietschmann, M. F. (2016). Testing the feasibility and safety of the Nintendo Wii gaming console in orthopedic rehabilitation: a pilot randomized controlled study. Arch Med Sci., 12(6): 1273–1278.
6. Fung, V., Ho, A., Shaffer, J., Chung, E., & Gomez, M. (2012). Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial. Physiotherapy, 98(3), 183-188.
7. Gunel, M. K., Kara, O. K., Ozal, C., & Turker, D. (2014). Virtual Reality in Rehabilitation of Children with Cerebral Palsy. Cerebral Palsy-Challenges for the Future, 273-301.
8. Günther, K., Stürmer, T., Sauerland, S., Zeissig, I., Sun, Y., Kessler, S., . . . Puhl, W. (1998). Prevalence of generalised osteoarthritis in patients with advanced hip and knee osteoarthritis: the Ulm Osteoarthritis Study. Annals of the rheumatic diseases, 57(12), 717-723.

9. Heick, J. D., Flewelling, S., Blau, R., Geller, J., & Lynskey, J. V. (2012). Wii fit and balance: Does the wii fit improve balance in community-dwelling older adults? Topics in Geriatric Rehabilitation, 28(3), 217-222.
10. Karakoc, Z. B., Colak, T. K., Zubeyir, S., & Polat, M. G. (2019). The Effect of Virtual Rehabilitation Added to an Accelerated Rehabilitation Program After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. Clinical and Experimental Health Sciences, 9(2), 124-129.
11. Kim, G. J. (2005). A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence: Teleoperators and Virtual Environments, 14(2), 119-146.
12. Lange, B., Flynn, S., Proffitt, R., Chang, C.-Y., & “Skip” Rizzo, A. (2010). Development of an interactive game-based rehabilitation tool for dynamic balance training. Topics in stroke rehabilitation, 17(5), 345-352.
13. Levinger, P., Zeina, D., Teshome, A. K., Skinner, E., Begg, R., & Abbott, J. H. (2016). A real time biofeedback using Kinect and Wii to improve gait for post-total knee replacement rehabilitation: a case study report. Disability and Rehabilitation: Assistive Technology, 11(3), 251-262.
14. Miyasaka, K., Daniel, D., Stone, M., & Hirshman, P. (1991). The incidence of knee ligament injuries in the general population. Am J Knee Surg, 4(1), 3-8.
15. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS med, 6(7), e1000097, 336-341.
16. Moseley, A. M., Herbert, R. D., Sherrington, C., & Maher, C. G. (2002). Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). Australian Journal of Physiotherapy, 48(1), 43-49.
17. Negus, J., Cawthorne, D., Chen, J., Scholes, C., Parker, D., & March, L. (2015). Patient outcomes using Wii-enhanced rehabilitation after total knee replacement–The TKR-POWER study. Contemporary clinical trials, 40, 47-53.
18. Nitz, J., Kuys, S., Isles, R., & Fu, S. (2010). Is the Wii Fit™ a new-generation tool for improving balance, health and well-being? A pilot study. Climacteric, 13(5), 487-491.
19. Puh, U., Majcen, N., Hlebš, S., & Rugelj, D. (2014). Effects of Wii balance board exercises on balance after posterior cruciate ligament reconstruction. Knee surgery, sports traumatology, arthroscopy, 22(5), 1124-1130.
20. Wiemeyer, J., & Kliem, A. (2011). Serious games in prevention and rehabilitation—a new panacea for elderly people? European Review of Aging and Physical Activity, 9(1), 41-50.