Investigating Current Notion on Virtual Reality Rehabilitation Approach on Post Operative Lower Extremity Conditions: A Narrative Review
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Abstract
Introduction: Lower extremity surgeries, such as total knee arthroplasty, total hip arthroplasty (THA), and anterior cruciate ligament reconstruction require extensive rehabilitation to restore mobility and function. Traditional rehabilitation faces various challenges, such as patient adherence and access to care. Virtual reality (VR) has emerged as a promising tool to enhance rehabilitation outcomes by offering interactive, engaging environments that improve patient motivation.
Materials and Methods: A narrative review was conducted to evaluate the current literature on VR-based rehabilitation for post-operative lower extremity conditions. Relevant studies from 2019 to 2024 were selected from online databases, such as PubMed, Scopus, and Cochrane, focusing on VR’s application in patients recovering from total knee arthroplasty, THA, ACL reconstruction, and traumatic lower limb amputations.
Results: VR interventions significantly improved proprioception, balance, and patient engagement compared to traditional rehabilitation methods. VR’s interactive nature provided real-time feedback and enhanced patient motivation. However, mixed results were reported regarding VR’s superiority in pain management and overall functional outcomes. VR was shown to complement traditional therapy rather than replace it.
Conclusion: VR-based rehabilitation offers a promising adjunct to traditional methods, improving patient engagement and specific functional outcomes. While VR enhances recovery, further research is needed to establish standardized protocols and determine its long-term efficacy in post-operative rehabilitation.
Gianola S, Stucovitz E, Castellini G, Mascali M, Vanni F, Tramacere I, et al. Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: A randomized controlled trial. Medicine. 2020; 99(7):e19136. [DOI:10.1097/MD.0000000000019136] [PMID]
Gsangaya MR, Htwe O, Selvi Naicker A, Md Yusoff BAH, Mohammad N, Soh EZF, et al. Comparison between the effect of immersive virtual reality training versus conventional rehabilitation on limb loading and functional outcomes in patients after anterior cruciate ligament reconstruction: A prospective randomized controlled trial. Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology. 2023; 34:28-37. [DOI:10.1016/j.asmart.2023.09.002] [PMID]
Fascio E, Vitale JA, Sirtori P, Peretti G, Banfi G, Mangiavini L. Early virtual-reality-based home rehabilitation after total hip arthroplasty: A randomized controlled trial. Journal of Clinical Medicine. 2022; 11(7):1766. [DOI:10.3390/jcm11071766] [PMID]
Elgendy MH, Helal MM, Habib AA. The influence of virtual reality approach on phantom pain in trans-tibial amputation: A randomized control trail. International Journal of Health Sciences. 2024; 8(S1):436-57. [doi:10.53730/ijhs.v8nS1.14796]
Pournajaf S, Goffredo M, Pellicciari L, Piscitelli D, Criscuolo S, Le Pera D, et al. Effect of balance training using virtual reality-based serious games in individuals with total knee replacement: A randomized controlled trial. Annals of Physical and Rehabilitation Medicine. 2022; 65(6):101609. [DOI:10.1016/j.rehab.2021.101609] [PMID]
Papalia R, Campi S, Vorini F, Zampogna B, Vasta S, Papalia G, et al. The role of physical activity and rehabilitation following hip and knee arthroplasty in the elderly. Journal of Clinical Medicine. 2020; 9(5):1401. [DOI:10.3390/jcm9051401] [PMID]
Byra J, Czernicki K. The effectiveness of virtual reality rehabilitation in patients with knee and hip osteoarthritis. Journal of Clinical Medicine. 2020; 9(8):2639. [DOI:10.3390/jcm9082639] [PMID]
Abbas RL, Cooreman D, Al Sultan H, El Nayal M, Saab IM, El Khatib A. The The effect of adding virtual reality training on traditional exercise program on balance and gait in unilateral, traumatic lower limb amputeeputee. Games for Health Journal. 2021; 10(1):50-6. [DOI:10.1089/g4h.2020.0028] [PMID]
Mazurek J, Cieślik B, Wrzeciono A, Gajda R, Szczepańska-Gieracha J. Immersive virtual reality therapy is supportive for orthopedic rehabilitation among the elderly: A randomized controlled trial. Journal of Clinical Medicine. 2023; 12(24):7681. [DOI:10.3390/jcm12247681] [PMID]
Mohammadi N, Hadian MR, Olyaei GR. Compare the effect of traditional and virtual reality training on subjective-sense of instability and balance in basketball-players with functional ankle instability: Matched randomized clinical trial. Journal of Biomedical Physics & Engineering. 2023; 13(3):26. [DOI:10.31661/jbpe.v0i0.2007-1146]
Peng L, Zeng Y, Wu Y, Si H, Shen B. Virtual reality-based rehabilitation in patients following total knee arthroplasty: A systematic review and meta-analysis of randomized controlled trials. Chinese Medical Journal. 2022; 135(2):153-63. [DOI:10.1097/CM9.0000000000001847] [PMID]
Kim K, Choi B, Lim W. The efficacy of virtual reality assisted versus traditional rehabilitation intervention on individuals with functional ankle instability: A pilot randomized controlled trial. Disability and Rehabilitation. Assistive Technology. 2019; 14(3):276-80. [DOI:10.1080/17483107.2018.1429501] [PMID]
Abbas RL, Cooreman D, Sultan HA, Nayal ME, Saab IM, Khatib AE, et al. Effect of adding virtual reality training to traditional exercise program on pain, mental status and psychological status in unilateral traumatic lower limb amputees: a randomized controlled trial. Games for Health Journal. 2024; 13(4):245-51. [DOI:10.1089/g4h.2023.0164] [PMID]
Hadamus A, Błażkiewicz M, Wydra KT, Kowalska AJ, Łukowicz M, Białoszewski D, et al. Effectiveness of early rehabilitation with exergaming in virtual reality on gait in patients after total knee replacement. Journal of Clinical Medicine. 2022; 11(17):4950. [DOI:10.3390/jcm11174950] [PMID]
Prvu Bettger J, Green CL, Holmes DN, Chokshi A, Mather RC 3rd, Hoch BT, et al. Effects of virtual exercise rehabilitation in-home therapy compared with traditional care after total knee arthroplasty: VERITAS, a randomized controlled trial. The Journal of Bone and Joint Surgery. American Volume. 2020; 102(2):101-9. [DOI:10.2106/JBJS.19.00695] [PMID]
Kim SH, Cho SH. Benefits of virtual reality program and motor imagery training on balance and fall efficacy in isolated older adults: A randomized controlled trial. Medicina. 2022; 58(11):1545. [DOI:10.3390/medicina58111545] [PMID]
Nambi G, Abdelbasset WK, Elsayed SH, Alrawaili SM, Abodonya AM, Saleh AK, et al. Comparative effects of Isokinetic training and virtual reality training on sports performances in university football players with chronic low back pain-randomized controlled study. Evidence-Based Complementary and Alternative Medicine. 2020; 2020:2981273. [DOI:10.1155/2020/2981273] [PMID]
Elaraby AER, Shahien M, Jahan AM, Etoom M, Bekhet AH. The efficacy of virtual reality training in the rehabilitation of orthopedic ankle injuries: A systematic review and meta-analysis. Advances in Rehabilitation Science and Practice. 2023; 12:11795727231151636. [DOI:10.1177/11795727231151636] [PMID]
Yildirim Şahan T, Erbahçeci F. Effects of virtual reality on transtibial amputation rehabilitation outcomes: A randomized study. Games for Health Journal. 2023; 12(6):459-67. [DOI:10.1089/g4h.2023.0052] [PMID]
Flórez Fonnegra JP, Pino Prestan AC, López LL, Yepes JC, Pérez VZ. Rehabilitation of patients with Arthrogenic muscular inhibition in pathologies of knee using virtual reality. Sensors. 2023; 23(22):9114. [DOI:10.3390/s23229114] [PMID]
Gür O, Başar S. The effect of virtual reality on pain, kinesiophobia and function in total knee arthroplasty patients: A randomized controlled trial. The Knee. 2023; 45:187-97. [DOI:10.1016/j.knee.2023.09.012] [PMID]
Zavala-González J, Martínez D, Gutiérrez-Espinoza H. Effectiveness of adding virtual reality to physiotherapeutic treatment in patients with total hip arthroplasty. A randomized controlled trial. Clinical rehabilitation. 2022; 36(5):660-8. [DOI:10.1177/02692155221080546] [PMID]
Gumaa M, Rehan Youssef A. Is virtual reality effective in orthopedic rehabilitation? A systematic review and meta-analysis. Physical therapy. 2019; 99(10):1304-25. [DOI:10.1093/ptj/pzz093] [PMID]
Fuchs L, Kluska A, Novak D, Kosashvili Y. The influence of early virtual reality intervention on pain, anxiety, and function following primary total knee arthroplasty. Complementary Therapies in Clinical Practice. 2022; 49:101687. [DOI:10.1016/j.ctcp.2022.101687] [PMID]
Jabbar MAH, Ashnagar Z, Hadian MR, Jalaie S, Moghadam ST. Investigating the effects of exergame training on functional activities among newly-fitted patients with unilateral transtibial amputation: a preliminary study. Journal of Modern Rehabilitation. 2024; 18(3):371-82. [DOI:10.18502/jmr.v18i3.16424]
Hong S, Lee G. Effects of an immersive virtual reality environment on muscle strength, proprioception, balance, and gait of a middle-aged woman who had total knee replacement: A case report. The American Journal of Case Reports. 2019; 20:1636-42. [DOI:10.12659/AJCR.918521] [PMID]
Shin D, Hong S. A Study on the effectiveness of VR rehabilitation training content for older individuals with total knee replacement: Pilot study. Healthcare. 2024; 12(15):1500. [DOI:10.3390/healthcare12151500] [PMID]
Yoon S, Son H. Effects of full immersion virtual reality training on balance and knee function in total knee replacement patients: A randomized controlled study. Journal of Mechanics in Medicine and Biology. 2020; 20(9):2040007. [DOI:10.1142/S0219519420400072]
Gazendam A, Zhu M, Chang Y, Phillips S, Bhandari M. Virtual reality rehabilitation following total knee arthroplasty: A systematic review and meta-analysis of randomized controlled trials. Knee Surgery, Sports Traumatology, Arthroscopy. 2022; 30(8):2548-55. [DOI:10.1007/s00167-022-06910-x] [PMID]
Blasco J, Igual-Camacho C, Blasco M, Antón-Antón V, Ortiz-Llueca L, Roig-Casasús S. The efficacy of virtual reality tools for total knee replacement rehabilitation: A systematic review. Physiotherapy Theory and Practice. 2021; 37(6):682-92. [DOI:10.1080/09593985.2019.1641865] [PMID]
Ambron E, Buxbaum LJ, Miller A, Stoll H, Kuchenbecker KJ, Coslett HB. Virtual reality treatment displaying the missing leg improves phantom limb pain: A small clinical trial. Neurorehabilitation and Neural Repair. 2021; 35(12):1100-11. [DOI:10.1177/15459683211054164] [PMID]
| Files | ||
| Issue | Vol 19 No 2 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v19i2.18346 | |
| Keywords | ||
| Virtual reality Rehabilitation Lower limb arthroplasty Lower limb soft tissue injuries | ||
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