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Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial

BACKGROUND: Interactive videogames, virtual reality, and robotics represent a new opportunity for multimodal treatments in many rehabilitation contexts. However, several commercial videogames are designed for leisure and are not oriented toward definite rehabilitation goals. Among the many, Playball...

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Autores principales: Rizzato, Alex, Pizzichemi, Martina, Gobbi, Erica, Gerardi, Adriana, Fortin, Claudia, Copcia, Ancuta, Paoli, Antonio, Marcolin, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10329366/
https://www.ncbi.nlm.nih.gov/pubmed/37420268
http://dx.doi.org/10.1186/s12984-023-01188-7
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author Rizzato, Alex
Pizzichemi, Martina
Gobbi, Erica
Gerardi, Adriana
Fortin, Claudia
Copcia, Ancuta
Paoli, Antonio
Marcolin, Giuseppe
author_facet Rizzato, Alex
Pizzichemi, Martina
Gobbi, Erica
Gerardi, Adriana
Fortin, Claudia
Copcia, Ancuta
Paoli, Antonio
Marcolin, Giuseppe
author_sort Rizzato, Alex
collection PubMed
description BACKGROUND: Interactive videogames, virtual reality, and robotics represent a new opportunity for multimodal treatments in many rehabilitation contexts. However, several commercial videogames are designed for leisure and are not oriented toward definite rehabilitation goals. Among the many, Playball(®) (Playwork, Alon 10, Ness Ziona, Israel) is a therapeutic ball that measures both movement and pressure applied on it while performing rehabilitation games. This study aimed: (i) to evaluate whether the use of this novel digital therapy gaming system was clinically effective during shoulder rehabilitation; (ii) to understand whether this gaming rehabilitation program was effective in improving patients’ engagement (perceived enjoyment and self-efficacy during therapy; attitude and intention to train at home) in comparison to a control non-gaming rehabilitation program. METHODS: A randomized controlled experimental design was outlined. Twenty-two adults with shoulder pathologies were recruited for a rehabilitation program of ten consecutive sessions. A control (CTRL; N = 11; age: 62.0 ± 10.9 yrs) and an intervention group (PG; N = 11; age: 59.9 ± 10.2 yrs) followed a non-digital and a digital therapy, respectively. The day before (T(0)) and after (T(1)) the rehabilitation program, pain, strength, and mobility assessments were performed, together with six questionnaires: PENN shoulder Score, PACES-short, Self-efficacy, Attitudes to train at home, Intention to train at home, and System usability scale (SUS). RESULTS: MANOVA analysis showed significant improvements in pain (p < 0.01), strength (p < 0.05), and PENN Shoulder Score (p < 0.001) in both groups. Similarly, patients’ engagement improved, with significant increments in Self-efficacy (p < 0.05) and attitude (p < 0.05) scores in both groups after the rehabilitation. Pearson correlation showed significant correlations of the Δ scores (T(1) - T(0)) between PACES and Self-efficacy (r = 0.623; p = 0.041) and between PACES and Intention to train at home (r = 0.674; p = 0.023) only in the PG. SUS score after the rehabilitation (74.54 ± 15.60) overcame the cut-off value of 68, representative of good usability of a device. CONCLUSIONS: The investigated digital therapy resulted as effective as an equivalent non-digital therapy in shoulder rehabilitation. The reported positive relationship between the subject’s enjoyment during digital therapy and intention to train at home suggests promising results in possible patient’s exercise engagement at home after the rehabilitation in the medical center. RETROSPECTIVELY REGISTERED: NCT 05230056.
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spelling pubmed-103293662023-07-09 Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial Rizzato, Alex Pizzichemi, Martina Gobbi, Erica Gerardi, Adriana Fortin, Claudia Copcia, Ancuta Paoli, Antonio Marcolin, Giuseppe J Neuroeng Rehabil Research BACKGROUND: Interactive videogames, virtual reality, and robotics represent a new opportunity for multimodal treatments in many rehabilitation contexts. However, several commercial videogames are designed for leisure and are not oriented toward definite rehabilitation goals. Among the many, Playball(®) (Playwork, Alon 10, Ness Ziona, Israel) is a therapeutic ball that measures both movement and pressure applied on it while performing rehabilitation games. This study aimed: (i) to evaluate whether the use of this novel digital therapy gaming system was clinically effective during shoulder rehabilitation; (ii) to understand whether this gaming rehabilitation program was effective in improving patients’ engagement (perceived enjoyment and self-efficacy during therapy; attitude and intention to train at home) in comparison to a control non-gaming rehabilitation program. METHODS: A randomized controlled experimental design was outlined. Twenty-two adults with shoulder pathologies were recruited for a rehabilitation program of ten consecutive sessions. A control (CTRL; N = 11; age: 62.0 ± 10.9 yrs) and an intervention group (PG; N = 11; age: 59.9 ± 10.2 yrs) followed a non-digital and a digital therapy, respectively. The day before (T(0)) and after (T(1)) the rehabilitation program, pain, strength, and mobility assessments were performed, together with six questionnaires: PENN shoulder Score, PACES-short, Self-efficacy, Attitudes to train at home, Intention to train at home, and System usability scale (SUS). RESULTS: MANOVA analysis showed significant improvements in pain (p < 0.01), strength (p < 0.05), and PENN Shoulder Score (p < 0.001) in both groups. Similarly, patients’ engagement improved, with significant increments in Self-efficacy (p < 0.05) and attitude (p < 0.05) scores in both groups after the rehabilitation. Pearson correlation showed significant correlations of the Δ scores (T(1) - T(0)) between PACES and Self-efficacy (r = 0.623; p = 0.041) and between PACES and Intention to train at home (r = 0.674; p = 0.023) only in the PG. SUS score after the rehabilitation (74.54 ± 15.60) overcame the cut-off value of 68, representative of good usability of a device. CONCLUSIONS: The investigated digital therapy resulted as effective as an equivalent non-digital therapy in shoulder rehabilitation. The reported positive relationship between the subject’s enjoyment during digital therapy and intention to train at home suggests promising results in possible patient’s exercise engagement at home after the rehabilitation in the medical center. RETROSPECTIVELY REGISTERED: NCT 05230056. BioMed Central 2023-07-08 /pmc/articles/PMC10329366/ /pubmed/37420268 http://dx.doi.org/10.1186/s12984-023-01188-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Rizzato, Alex
Pizzichemi, Martina
Gobbi, Erica
Gerardi, Adriana
Fortin, Claudia
Copcia, Ancuta
Paoli, Antonio
Marcolin, Giuseppe
Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
title Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
title_full Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
title_fullStr Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
title_full_unstemmed Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
title_short Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
title_sort effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10329366/
https://www.ncbi.nlm.nih.gov/pubmed/37420268
http://dx.doi.org/10.1186/s12984-023-01188-7
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