Movement characteristics during customized exergames after total knee replacement in older adults

Maarit Janhunen; Antti Löppönen; Simon Walker; Taavi Punsár; Niina Katajapuu; Sulin Cheng; Juha Paloneva; Konsta Pamilo; Mika Luimula; Raija Korpelainen; Timo Jämsä; Ari Heinonen; Eeva Aartolahti

doi:10.3389/fspor.2022.915210

Movement characteristics during customized exergames after total knee replacement in older adults

Front Sports Act Living. 2022 Jul 27:4:915210. doi: 10.3389/fspor.2022.915210. eCollection 2022.

Authors

Maarit Janhunen¹, Antti Löppönen^{2

3}, Simon Walker⁴, Taavi Punsár¹, Niina Katajapuu⁵, Sulin Cheng^{1

6}, Juha Paloneva^{7

8}, Konsta Pamilo⁹, Mika Luimula¹⁰, Raija Korpelainen^{11

12

13}, Timo Jämsä^{13

14

15}, Ari Heinonen¹, Eeva Aartolahti¹⁶

Affiliations

¹ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
² Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.
³ Department of Movement Sciences, Physical Activity, Sports and Health Research Group, Katholieke Universiteit Leuven, Leuven, Belgium.
⁴ Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Jyväskylä, Finland.
⁵ Health and Well-being, Turku University of Applied Sciences, Turku, Finland.
⁶ Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.
⁷ Department of Orthopedics and Traumatology, Hospital Nova of Central Finland, Jyväskylä, Finland.
⁸ Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
⁹ Department of Orthopedics, Coxa Hospital for Joint Replacement, Tampere, Finland.
¹⁰ Faculty of Business and Engineering, Turku University of Applied Sciences, Turku, Finland.
¹¹ Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland.
¹² Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.
¹³ Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
¹⁴ Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
¹⁵ Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
¹⁶ Institute of Rehabilitation, Jyväskylä University of Applied Sciences, Jyväskylä, Finland.

Abstract

Introduction: There is limited understanding of how older adults can reach kinematic goals in rehabilitation while performing exergames and conventional exercises, and how similar or different the kinematics during exergaming are when compared with conventional therapeutic exercise with similar movement. The aim of this study was to describe the movement characteristics performed during exercise in custom-designed exergames and conventional therapeutic exercises among patients who have undergone unilateral total knee replacement (TKR). In addition, the secondary aim was to assess the relation of these exercise methods, and to assess participants' perceived exertion and knee pain during exergaming and exercising.

Materials and methods: Patients up to 4 months after the TKR surgery were invited in a single-visit exercise laboratory session. A 2D motion analysis and force plates were employed to evaluate movement characteristics as the volume, range, and intensity of movement performed during custom-designed knee extension-flexion and weight shifting exergames and conventional therapeutic exercises post TKR. The perceived exertion and knee pain were assessed using the Borg Rating of Perceived Exertion and Visual Analog Scale, respectively.

Results: Evaluation of seven patients with TKR [age median (IQR), 65 (10) years] revealed that the volume and intensity of movement were mostly higher during exergames. Individual goniometer-measured knee range of motion were achieved either with exergames and conventional therapeutic exercises, especially in knee extension exercises. The perceived exertion and knee pain were similar after exergames and conventional therapeutic exercises.

Conclusions: During custom-designed exergaming the patients with TKR achieve the movement characteristics appropriate for post-TKR rehabilitation without increasing the stress and pain experienced even though the movement characteristics might be partly different from conventional therapeutic exercises by the volume and intensity of movement. Physical therapists could consider implementing such exergames in rehabilitation practice for patients with TKR once effectiveness have been approved and they are widely available.

Keywords: exercise therapy; kinematics; musculoskeletal system; physical therapy; rehabilitation; video games.