Investigating the Effects of Exergame Training on Functional Activities Among Newly-Fitted Patients with Unilateral Transtibial Amputation: A Preliminary Study
-
Mohammed Abdul Hussein Jabbar
,
Zinat Ashnagar
,
Mohammad Reza Hadian
,
Shohreh Jalaie
,
Saeed Talebian Moghadam
Abstract
Introduction: This preliminary study investigates the effects of adding exergame (EG) training to conventional exercises on the functional activities of newly fitted patients with unilateral transtibial amputation.
Materials and Methods: A total of 22 newly fitted patients with unilateral transtibial amputation were equally and randomly divided into two groups as follows: the EG group who performed exercises and EG training and the control group who performed exercise only. The 2-min walk test, timed up and go test, amputee mobility predictor with prosthesis test, and physiological cost index were assessed at baseline and after 2 and 4 weeks of the intervention.
Results: Both interventions effectively improved the 2-min walk test distance, timed up-and-go test, and the amputee mobility predictor with prosthesis test scores in patients with newly fitted transtibial amputation (P<0.001). Additionally, a significant improvement was observed in the timed up-and-go test time in the EG group versus the control group after the 4-week intervention (P=0.04, effect size=0.53).
Conclusion: The findings of this preliminary study further support that adding EG to exercises significantly increases movement speed among amputee patients.
Kohler F, Cieza A, Stucki G, Geertzen J, Burger H, Dillon MP, et al. Developing Core Sets for persons following amputation based on the International Classification of Functioning, Disability and Health as a way to specify functioning. Journal of Prosthetics & Orthotics. 2009; 33(2):117-29. [DOI:10.1080/03093640802652029] [PMID]
Highsmith MJ, Andrews CR, Millman C, Fuller A, Kahle JT, Klenow TD, et al. Gait training interventions for lower extremity amputees: A systematic literature review. Technology and Innovation. 2016; 18(2-3):99-113. [DOI:10.21300/18.2-3.2016.99] [PMID]
McDonald CL, Westcott-McCoy S, Weaver MR, Haagsma J, Kartin D. Global prevalence of traumatic non-fatal limb amputation. Prosthetics and Orthotics International. 2021; 45(2):105-14. [DOI:10.1177/0309364620972258] [PMID]
Abbas. News from Iraqi Department of Mine Affair. Victim Assistance Statement. presented at: Second Review Conference of the Convention on the Prohibition of Cluster Munitions. 2020; Geneva, Switzerland. [Link]
World Health Organization. Improve access to specialized health services for people with physical disability in Iraq. Geneva: World Health Organization; 2020. [Link]
Steinberg N, Gottlieb A, Siev-Ner I, Plotnik M. Fall incidence and associated risk factors among people with a lower limb amputation during various stages of recovery-a systematic review. Disability and Rehabilitation. 2019; 41(15):1778-87. [DOI:10.1080/09638288.2018.1449258] [PMID]
Damayanti Sethy M, Kujur ES, Sau K. Effect of balance exercise on balance control in unilateral lower limb amputees. The Indian Journal of Occupational Therapy. 2009; 41(3):63-8. [Link]
Charkhkar H, Christie BP, Triolo RJ. Sensory neuroprosthesis improves postural stability during Sensory Organization Test in lower-limb amputees. Scientific Reports. 2020; 10(1):6984. [DOI:10.1038/s41598-020-63936-2] [PMID]
Eng JJ, Winter DA. Kinetic analysis of the lower limbs during walking: What information can be gained from a three-dimensional model? Journal of Biomechanics. 1995; 28(6):753-8. [DOI:10.1016/0021-9290(94)00124-M] [PMID]
MacKinnon CD, Winter DA. Control of whole body balance in the frontal plane during human walking. Journal of Biomechanics. 1993; 26(6):633-44. [DOI:10.1016/0021-9290(93)90027-C] [PMID]
Winter DA, Patla AE, Ishac M, Gage WH. Motor mechanisms of balance during quiet standing. Journal of Electromyography and Kinesiology. 2003; 13(1):49-56. [DOI:10.1016/S1050-6411(02)00085-8] [PMID]
Sjödahl C, Jarnlo G-B, Persson BM. Gait improvement in unilateral transfemoral amputees by a combined psychological and physiotherapeutic treatment. Journal of Rehabilitation Medicine. 2001; 33(3):114-8. [DOI:10.1080/165019701750165934] [PMID]
Ülger Ö, Yıldırım Şahan T, Çelik SE. A systematic literature review of physiotherapy and rehabilitation approaches to lower-limb amputation. Physiotherapy Theory and Practice. 2018; 34(11):821-34. [DOI:10.1080/09593985.2018.1425938] [PMID]
Gailey R, Gaunaurd I, Raya M, Kirk-Sanchez N, Prieto-Sanchez LM, Roach K. Effectiveness of an evidence-based amputee rehabilitation program: A pilot randomized controlled trial. Physical Therapy. 2020; 100(5):773-87. [DOI:10.1093/ptj/pzaa008] [PMID]
Wong CK, Ehrlich JE, Ersing JC, Maroldi NJ, Stevenson CE, Varca MJ. Exercise programs to improve gait performance in people with lower limb amputation: A systematic review. Prosthetics and Orthotics International. 2016; 40(1):8-17. [DOI:10.1177/0309364614546926] [PMID]
Khurana M, Walia S, Noohu MM. Study on the effectiveness of virtual reality game-based training on balance and functional performance in individuals with paraplegia. Topics in Spinal Cord Injury Rehabilitation. 2017; 23(3):263-70. [DOI:10.1310/sci16-00003] [PMID]
Barry G, Galna B, Rochester L. The role of exergaming in Parkinson’s disease rehabilitation: A systematic review of the evidence. Journal of Neuroengineering and Rehabilitation. 2014; 11:33. [DOI:10.1186/1743-0003-11-33] [PMID]
Rahman SA, Rahman A. Efficacy of virtual reality-based therapy on balance in children with Down syndrome. World Applied Sciences Journal. 2010; 10(3):254-61. [Link]
Staiano AE, Flynn R. Therapeutic uses of active videogames: A systematic review. Games for Health Journal. 2014; 3(6):351-65. [DOI:10.1089/g4h.2013.0100] [PMID]
Barry G, van Schaik P, MacSween A, Dixon J, Martin D. Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: A randomised controlled trial. BMC Sports Science, Medicine and Rehabilitation. 2016; 8(1):25. [DOI:10.1186/s13102-016-0050-0] [PMID]
Ditchburn JL, Ciobanu I. The effects of exergaming on individuals with limb loss: A systematic review. Health, Sports & Rehabilitation Medicine. 2021; 22(1):14-25. [DOI:10.26659/pm3.2021.22.1.14]
Abbas RL, Cooreman D, Al Sultan H, El Nayal M, Saab IM, El Khatib A. The effect of adding virtual reality training on traditional exercise program on balance and gait in unilateral, traumatic lower limb amputee. Games for Health Journal. 2021; 10(1):50-6. [DOI:10.1089/g4h.2020.0028] [PMID]
Turner S, Belsi A, McGregor AH. Issues faced by prosthetists and physiotherapists during lower-limb prosthetic rehabilitation: A thematic analysis. Frontiers in Rehabilitation Sciences. 2022; 2:795021. [DOI:10.3389/fresc.2021.795021] [PMID]
Ceo’d. Physiotherapy for amputees. The roehampton approach by Barbara Engstrom and Catherine van de Ven Churchill Livingstone. Pp 289, Illus. Clinical Biomechanics. 1987; 2(2):113-4. [PMID]
Meulenbelt HE, Geertzen JH, Dijkstra PU, Jonkman MF. Skin problems in lower limb amputees: An overview by case reports. Journal of the European Academy of Dermatology and Venereology. 2007; 21(2):147-55. [DOI:10.1111/j.1468-3083.2006.01936.x] [PMID]
El-Hayeck R, Baddoura R, Wehbé A, Bassil N, Koussa S, Abou Khaled K, et al. An Arabic version of the mini-mental state examination for the Lebanese population: Reliability, validity, and normative data. Journal of Alzheimer's Disease. 2019; 71(2):525-40. [DOI:10.3233/JAD-181232] [PMID]
Hanspal R, Fisher K, Nieveen R. Prosthetic socket fit comfort score. Disability and Rehabilitation. 2003; 25(22):1278-80. [DOI:10.1080/09638280310001603983] [PMID]
Engstrom B, Van de Ven C. Therapy for Amputees. London: Churchill Livingstone; 1999. [Link]
Gailey RS, Gailey AM. Stretching and strengthening for lower extremity amputees. Advanced Rehabilitation Therapy Incorporated. 1994. [Link]
Brooks D, Hunter JP, Parsons J, Livsey E, Quirt J, Devlin M. Reliability of the two-minute walk test in individuals with transtibial amputation. Archives of Physical Medicine and Rehabilitation. 2002; 83(11):1562-5. [DOI:10.1053/apmr.2002.34600] [PMID]
Connelly DM, Thomas BK, Cliffe SJ, Perry WM, Smith RE. Clinical utility of the 2-minute walk test for older adults living in long-term care. Physiotherapy Canada. 2009; 61(2):78-87. [DOI:10.3138/physio.61.2.78] [PMID]
Resnik L, Borgia M. Reliability of outcome measures for people with lower-limb amputations: Distinguishing true change from statistical error. Physical Therapy. 2011; 91(4):555-65. [DOI:10.2522/ptj.20100287] [PMID]
Jayakaran P, Johnson GM, Sullivan SJ. Reliability and concurrent validity of the step quick turn test in older persons with a unilateral transtibial amputation. Archives of Physical Medicine and Rehabilitation. 2011; 90(10):798-804. [DOI:10.1097/PHM.0b013e318228bd45] [PMID]
Dite W, Connor HJ, Curtis HC. Clinical identification of multiple fall risk early after unilateral transtibial amputation. Archives of Physical Medicine and Rehabilitation. 2007; 88(1):109-14. [DOI:10.1016/j.apmr.2006.10.015] [PMID]
Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy. 2000; 80(9):896-903. [PMID]
Gailey RS, Roach KE, Applegate EB, Cho B, Cunniffe B, Licht S, et al. The amputee mobility predictor: An instrument to assess determinants of the lower-limb amputee’s ability to ambulate. Archives of Physical Medicine and Rehabilitation. 2002; 83(5):613-27. [DOI:10.1053/apmr.2002.32309] [PMID]
Cole M, Cumming J, Golland N, Hayes S, Ostler C, Scopes J, et al. Bacpar toolbox of outcome measures. British Association of Chartered Physiotherapists in Amputee Rehabilitation (BACPAR); 2014. [Link]
Graham RC, Smith NM, White CM. The reliability and validity of the physiological cost index in healthy subjects while walking on 2 different tracks. Archives of Physical Medicine and Rehabilitation. 2005; 86(10):2041-6. [DOI:10.1016/j.apmr.2005.04.022] [PMID]
Hagberg K, Häggström E, Brånemark R. Physiological cost index (PCI) and walking performance in individuals with transfemoral prostheses compared to healthy controls. Clinical Rehabilitation. 2007; 21(8):643-9. [DOI:10.1080/09638280600902869] [PMID]
MacGregor J. The evaluation of patient performance using longterm ambulatory monitoring technique in the domiciliary environment. Physiotherapy. 1981; 67(2):30-3. [PMID]
Nene A. Physiological cost index of walking in able-bodied adolescents and adults. Clinical Rehabilitation. 1993; 7(4):319-26. [DOI:10.1177/026921559300700408]
Rau B, Bonvin F, De Bie R. Short-term effect of physiotherapy rehabilitation on functional performance of lower limb amputees. Prosthetics and Orthotics International. 2007; 31(3):258-70. [DOI:10.1080/03093640600994615] [PMID]
De Pessemier T, Martens L. Heart rate monitoring, activity recognition, and recommendation for e-coaching. Multimedia Tools and Applications. 2018; 77:23317-34. [DOI:10.1007/s11042-018-5640-2]
Zhang X, Fiedler G, Liu Z. Evaluation of gait variable change over time as transtibial amputees adapt to a new prosthesis foot. BioMedical Research International. 2019; 2019:9252368. [DOI:10.1155/2019/9252368] [PMID]
Andrysek J, Klejman S, Steinnagel B, Torres-Moreno R, Zabjek KF, Salbach NM, et al. Preliminary evaluation of a commercially available videogame system as an adjunct therapeutic intervention for improving balance among children and adolescents with lower limb amputations. Archives of Physical Medicine and Rehabilitation. 2012; 93(2):358-66. [DOI:10.1016/j.apmr.2011.08.031] [PMID]
Claret CR, Herget GW, Kouba L, Wiest D, Adler J, von Tscharner V, et al. Neuromuscular adaptations and sensorimotor integration following a unilateral transfemoral amputation. Journal of Neuroengineering and Rehabilitation. 2019; 16(1):115. [DOI:10.1186/s12984-019-0586-9] [PMID]
Geurts AC, Mulder TW, Nienhuis B, Rijken RA. Reorganisation of postural control following lower limb amputation: Theoretical considerations and implications for rehabilitation. Physiotherapy Theory and Practice. 1992; 8(3):145-57. [Link]
Kaluf B. Evaluation of mobility in persons with limb loss using the Amputee Mobility Predictor and the Prosthesis Evaluation Questionnaire-Mobility Subscale: A six-month retrospective chart review. Journal of Prosthetics & Orthotics. 2014; 26(2):70-6. [DOI:10.1097/JPO.0000000000000020]
Vllasolli TO, Zafirova B, Orovcanec N, Poposka A, Murtezani A, Krasniqi B. Energy expenditure and walking speed in lower limb amputees: A cross sectional study. Prosthetics and Orthotics International. 2014; 16(4):419-26. [DOI:10.5604/15093492.1119619] [PMID]
| Issue | Vol 18 No 3 (2024) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v18i3.16424 | |
| Keywords | ||
| Amputation Rehabilitation Virtual reality exercise Exergames (EG) Active-video games | ||
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