Video game physiotherapy could help with back pain in older patients: research
An Australian study has found that a unique video game physiotherapy program is effective in improving pain and function in older patients with chronic lower back pain.
The randomised controlled trial, published in Physical Therapy, is the first of its kind and recruited 60 participants, aged 55 years or older, with chronic lower back pain. Patients were randomised to receive the video game exercise program or to continue their usual activities for 8 weeks. The video game operates through the Nintendo Wii Fit U.
The authors measured the primary outcomes of pain self-efficacy and care seeking, in addition to the secondary outcomes of physical activity, pain, function, disability, fear of movement/re-injury, falls-efficacy, recruitment and response rates, experience with the intervention, and adverse events.
Participants receiving the video game intervention practised flexibility, strengthening and aerobic exercises at home for 60-minute sessions three times a week, without the supervision of a physiotherapist.
Physiotherapist and post-doctoral research fellow from the University of Sydney’s School of Public Health, Dr Joshua Zadro, led the study and told doctorportal that the results were encouraging. The research revealed that total adherence to the total recommended exercise time was 70.8%, and no adverse events were reported.
“What our trial showed was that a video game exercise program, performed in the comfort of older peoples’ homes, reduced their pain and improved their function.”
“Participants on average experienced a 27% reduction in pain, and 23% increase in function”, he said.
While those completing Wii Fit U exercises demonstrated significantly greater improvements in pain efficacy and function, and were more likely to engage in flexibility exercises at 6 months, there were no significant between-group differences for the remaining outcomes.
The benefits of video game physiotherapy – compliance, convenience and cost-effective
Dr Zadro said that one of the benefits of this program over conventional approaches to back pain is that video game exercise is interactive and provides patients with video and audio instructions. While playing the video game, participants also get feedback on their technique and scores on their performance.
“So, these patients are quite good at maintaining adherence to the exercise program over time, which is often a limitation of existing programs where people are asked to self-manage.” Similarly, the program would have a great advantage for patients living in rural and remote areas, where service access is an issue.
Dr Zadro said another benefit of the program was its potential to effectively operate within the MBS, which currently covers only five physiotherapy sessions – despite traditional exercise programs generally requiring many more sessions.
“As you’d need only one session for the physiotherapist to set up the video program and teach how to use it, participants could then manage their exercise independently, in the comfort of their own home, without needing regular follow up.”
“They can really do as many video game sessions as they feel is necessary to get the benefit.”
Looking ahead, Dr Zadro is keen to investigate how effective the video game approach is in different groups of patient populations.
“It would be good to see if this same program could be applied to other patients – maybe younger people or even the very old people with chronic lower back pain.”