Impact of Gamification on Pain, Range of Motion, Muscle Strength, And Functional Independence Post Distal Radius Fracture

Research Objectives: To assess the comparative efficacy of gamification and conventional physiotherapy rehabilitation on pain, range of motion, muscle strength, and upper limb functional independence in distal radial fracture patients.

Design: Randomised controlled single-blind superiority clinical trial

Setting: Department of Physiotherapy

Participants: A total of 146 patients aged 18-65 years with an A3 extraarticular multi fragmentary distal radius fractures (DRF), treated with closed reduction internal fixation and immobilized for at least four weeks, willing to participate, and with a mini-mental score of more than 26 were recruited for the study. A trial session of the Oculus Quest was undertaken to check the tolerance of individual patients for the device before enrolment. 73 patients in each group were allocated using computer-generated randomization.

Interventions: Group A underwent a gamification protocol using the Oculus Quest involving three games namely Racket:NX game, Until You Fall game, and Holofit game imitating the wrist movement in all axes and planes; however, Group B received conventional physiotherapy involving Maitland approach grade I or II during the first 2 weeks, Grade III for next 1 week, and Grade IV for the last week with a dosage of 1cps (cycle per second) for 1 minute. The strengthening technique included exercises with theraband. Both treatments were performed for 60 mins per day 5 days a week for 4 weeks.

Main Outcome Measures: The primary outcome measures were Visual Analog Scale (VAS) for pain intensity and Universal goniometer for range of motion (ROM), and the secondary outcome measures were grip strength measured using a hand dynamometer and DASH questionnaire for functional independence.

Results: The pain intensity, wrist ROM, grip strength, and functional independence showed a significant (p < 0.01) difference when assessed at the baseline, at the end of the second week, and at the end of the fourth week of treatment.

Conclusions: The research presented evidence that Oculus Quest-induced gamification has promising potential in reducing pain and improving ROM, grip strength, and functional independence in post-DRF patients.

Author(s) Disclosures: The authors declares no competing interest