The Feasibility of a Home-Based Exergaming Telerehabilitation System on Improving Patients’ Joint Range of Motion

Research Objectives: To examine the feasibility of a home-based exergaming telerehabilitation system on improving patients’ joint range of motion (ROM) without medical personnel’s direct assistance.

Design: A prospective, longitudinal, observer-blind case series design was implemented.

Setting: The study took place in a general community home setting.

Participants: 6 patient volunteers took home the system and performed movement tasks assigned by their physical therapist that targeted their individual motor impairment. 4 patients (age: 72±6.46 years, male/female: 2/2) completed sufficient (>20) repetitions to be included in the study.

Interventions: An exergaming telerehabilitation system was used to facilitate patients’ upper- and lower-extremity training through a published software program that provides interactive tasks integrating 13 functional movements from January-June 2022. A 3D camera-computer was used to detect joint ROM and display automated, real-time feedback during movements without the wear of additional equipment.

Main Outcome Measures: Patients’ ROM across the shoulder (horizontal abduction, humerothoracic motion, flexion), elbow (flexion), hip (flexion), and knee (flexion) joints were measured. The Wilcoxon Signed-Rank test was conducted between the first and last ten measurements to assess post-usage effect, and large effect sizes (d>0.8) were noted. Linear regression was used to obtain correlations between measurements and dates collected to assess improvement consistency, and outliers were removed using Cook’s Distance.

Results: All patients improved significantly in joint ROM after use of the system (p < 0.05, d>1.2). Majority (3/4) experienced positive (p < 0.01, d>3.0) and linearly consistent (p < 0.001, r=0.36-0.73) effects on impaired joints’ ROM. However, one patient experienced a negative (p < 0.01, d>3.2) and linearly consistent (p < 0.001, r=0.46-0.67) effect on a non-impaired joint’s ROM due to lack of engagement. Post-study interviews indicate that the system’s interactive nature and ease of use incentivized patients to continue training.

Conclusions: Home-based exergaming telerehabilitation training could expedite improvements in patients’ joint ROM, especially those associated with their medical diagnosis. Our results support further integration of the proposed system into digital rehabilitation, as its wide patient acceptance reinforces rehabilitation frequency and improvement consistency.

Author(s) Disclosures: The authors declare no competing interests.