Y. Shukla1, A. Bhise1, M. Gohil1
1Government Physiotherapy College and Government Spine Institute, Civil Hospital, Physiotherapy, Ahmedabad, India
Background: Knee proprioception derives from the integration of afferent signals from the proprioceptive receptors in different structure of the knee like tendons, ligaments, meniscus, joint capsule and muscle. In knee osteoarthritis, proprioception impairments might be mediated by disruption of the mechanoreceptors in the diseased joint structures or changes in muscle receptors secondary to muscle changes. So, proprioception deficits may result in poorly controlled excess loading to the knee during gait, initiating or accelerating joint degeneration which also add to risk of falls in elderly patients. Virtual biofeedback provides visual feedback and enhances sensorimotor mapping of movement to the joint.
Purpose: Knee osteoarthritis is a prevalent musculoskeletal condition affecting older people causing pain, physical disability and reduce quality of life. Virtual biofeedback balance training works on the principle of closed loop motor learning theory. A recent development in rehabilitation is exercising in gaming or virtual reality environment, thus providing a novel form of immersive biofeedback. Hence the purpose of the study was to know the effect of virtual biofeedback exercise in patients with osteoarthritis on pain, proprioception and function.
Methods: Ethical clearance for this study was obtained by Institutional Ethical Committee. Written informed consent was taken from all patients. This was single blinded study. The study was conducted on 22 patients with knee osteoarthritis, who fulfilled inclusion and exclusion criteria. They were divided into 2 groups. Group A underwent conventional physiotherapy and Group B underwent conventional with proprioceptive training using virtual biofeedback. Treatment was given every alternate day. Both groups were assessed before starting of treatment and after eight weeks of treatment for pain, proprioception and function by using Numeric pain rating scale (NPRS), Joint position sense error and WOMAC respectively.
Results: At the end of the 8 weeks, patients in both the groups showed reduction in pain and improvement in joint position sense error and function. Here interventional group showed statistically significant improvement than control group. (p<0.05).
Conclusion(s): Virtual biofeedback exercise is effective in reduction of pain, improvement in proprioception and functions in patients with osteoarthritis of knee.
Implications: Virtual biofeedback helps in cognition of elderly people in proprioceptive exercises, which should be part of routine physiotherapy practice in treating patients with osteoarthritis knee. Improvement in proprioception will help elderly patients with osteoarthritis knee in reducing risk of falls, hence helping in preventing further complications due to falls which might be life threatening .
Funding, acknowledgements: The work done was Unfunded. Sincerely would like to thank patients and Government physiotherapy college and spine institute, Ahmedabad, Gujarat.
Keywords: Virtual biofeedback, Osteoarthritis knee, Proprioceptive training
Topic: Musculoskeletal: lower limb
Did this work require ethics approval? Yes
Institution: Government Physiotherapy College and Spine Institute, Civil Hospital, Ahmedabad, Gujarat, India
Committee: The Institutional Ethics Committee, B.J. Medical College and Civil Hospital, Ahmedabad
Ethics number: GSIIESC/04/16
All authors, affiliations and abstracts have been published as submitted.
