D. Manlapaz1, Z.M. Sicat1, A. Chiong Maya1, A. Bolintiam1, I.J. De Guzman1, D.D. Duro1, R. Menor1, E. Panga1, J.M. Ramos1, N. Sasazawa1
1University of Santo Tomas, Department of Physical Therapy, Manila, Philippines
Background:In rehabilitation using exergaming (exercise + gaming), ergonomic consideration includes the provision of grip-assist gloves for patients who found it difficult to grasp the motion controller and instructions to focus on trunk control to maintain balance. However, most studies have limited ergonomic considerations or protocol, with little attention paid to the risk of injuries brought about by poor posture while utilizing exergaming and the long-term effects of being immersed in a virtual environment.
Purpose: This systematic review aimed to identify the ergonomic considerations in the delivery of exergaming (exercise and gaming) in rehabilitation and review commonly used outcome measures.
Methods: A comprehensive electronic search was done on different databases from July 8, 2021, and updated last August 3, 2021. The protocol was registered and published in PROSPERO with the registration number CRD42021232420 and was published in a peer-reviewed journal (
https://doi.org/10.1080/10833196.2021.1957640). The Randomized Controlled Trial Critical Appraisal Sheet of the Centre for Evidence-Based Medicine of Oxford University was used to appraise the published articles written in English, with adult participants utilizing exergaming as an intervention to improve balance, muscle strength, or muscle endurance. The Mendeley and Rayyan applications were used in the inclusion, critical appraisal, and data gathering processes.
Results: The electronic data search yielded 1247 studies. After removing the duplicates and excluding articles screened through their title and abstract the remaining 277 articles underwent full-text screening, 209 of which were excluded due to the following reasons: not a published RCT written in English, did not involve participants 30 years old, and above with orthopedic or neurologic conditions, did not use commercially available exergaming device, and irrelevant outcomes. A total of 68 studies were included, with 61 (89.71%) reporting safety or health considerations, 36 (52.94%) of which reported ergonomic considerations. The studies have reported most ergonomic considerations under environment control (n = 31, 20.13%), with 13 (8.44%) for tasks and 12 (7.79%) for individuals. Balance was the most focused outcome measured for both conditions, with Berg Balance Scale (BBS) and Timed Up and Go (TUG) being the top outcome measure tools. Ergonomic considerations alongside physical and safety hazard considerations were found in the literature.
Conclusions:Although already proven to be effective in rehabilitation, the recent emergence of exergaming owes to the scarcity of protocols in its implementation, including ergonomics. It is found that most studies have considerations in ergonomics alongside physical and safety hazards, ensuring safety and effectiveness. Most primarily deal with neurologic conditions, specifically stroke, with balance as the most common outcome addressed in these studies and TUG and BBS as the most used outcome measures.
Implications: The current review highlights the need for therapists to heed these considerations as it precludes injuries, making this intervention more effective in rehabilitation. The study's findings may contribute to developing standards and guidelines for optimal ergonomics and the development of safer commercially available exergaming equipment.
Funding acknowledgements: Not applicable
Keywords:
Exergaming
Ergonomics
Rehabilitation
Topics:
Occupational health & ergonomics
Older people
Did this work require ethics approval? No
Reason: This study did not use humans as participants. This is a secondary study (systematic review)
All authors, affiliations and abstracts have been published as submitted.
