University of Oulu

Janhunen M, Katajapuu N, Paloneva J, et al. Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial. BMJ Open Sport & Exercise Medicine 2023;9:e001416. doi: 10.1136/bmjsem-2022-001416

Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults : a randomised controlled trial

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Author: Janhunen, Maarit1,2; Katajapuu, Niina2; Paloneva, Juha3;
Organizations: 1Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
2Faculty of Health and Well-being, Turku University of Applied Sciences, Turku, Finland
3Department of Surgery, Central Finland Healthcare District and University of Eastern Finland, Jyväskylä, Finland
4Department of Orthopedics, Coxa Hospital for Joint Replacement, Tampere, Finland
5Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland
6Faculty of Business and Engineering, Turku University of Applied Sciences, Turku, Finland
7Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
8Center for Life Course Health Research, University of Oulu, Oulu, Finland
9Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
10Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
11Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
12Folkhälsan Research Center, Helsinki, Finland
13Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: BMJ, 2023
Publish Date: 2023-09-22


Objectives: To investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement (TKR) compared with standard exercise protocol.

Methods: In this non-blinded randomised controlled trial, 52 individuals aged 60–75 years undergoing TKR were randomised into an exergaming (intervention group, IG) or a standard exercising group (control group, CG). Primary outcomes were physical function and pain measured before and after (2 months and 4 months) surgery using the Oxford Knee Score (OKS) and Timed Up and Go (TUG) test. Secondary outcomes included measures of the Visual Analogue Scale, 10m walking, short physical performance battery, isometric knee extension and flexion force, knee range of movement and satisfaction with the operated knee.

Results: Improvement in mobility measured by TUG was greater in the IG (n=21) at 2 (p=0.019) and 4 months (p=0.040) than in the CG (n=25). The TUG improved in the IG by −1.9 s (95% CI, −2.9 to −1.0), while it changed by −0.6 s (95% CI −1.4 to 0.3) in the CG. There were no differences between the groups in the OKS or secondary outcomes over 4 months. 100% of patients in the IG and 74% in the CG were satisfied with the operated knee.

Conclusion: In patients who have undergone TKR, training at home with customised exergames was more effective in mobility and early satisfaction and as effective as standard exercise in pain and other physical functions. In both groups, knee-related function and pain improvement can be considered clinically meaningful.

Trial registration number: NCT03717727.

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Series: BMJ open sport & exercise medicine
ISSN: 2055-7647
ISSN-E: 2055-7647
ISSN-L: 2055-7647
Volume: 9
Issue: 1
Article number: e001416
DOI: 10.1136/bmjsem-2022-001416
Type of Publication: A1 Journal article – refereed
Field of Science: 315 Sport and fitness sciences
Funding: This research was supported by the Päivikki and Sakari Sohlberg Foundation (personal grant to M. Janhunen), the Business Finland (grant numbers: 5794/31/2016, 5941/31/2016, 6057/31/2016) and Finnish partner companies: SE Innovations Oy (Senior Some Oy), Suunto Oy, Physiotools Oy, GoodLife Technology Oy, Lingsoft Oy, eSeteli Palveluverkko Oy, PN Turku Oy, Ade Animations Design & Effects Oy, Adesante Oy, 4FeetUnder, Intechso and Realmax Oy.
Copyright information: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.