Virtual reality video games, activity monitors, and handheld computer devices can help people stand as well as walk, the largest trial worldwide into the effects of digital devices in rehabilitation has found. The study was undertaken at hospitals in Sydney and Adelaide, Australia, and had 300 participants ranging from 18 to 101 years old. Those who exercised using digital devices in addition to their usual rehabilitation were found to have better mobility (walking, standing up, and balance) after 3 weeks and after 6 months than those who just completed their usual rehabilitation. The results were published in PLOS Medicine.
Trial participants were recovering from strokes, brain injuries, falls, and fractures. Participants used on average 4 different devices while in hospital and 2 different devices when at home. Fitbits were the most used digital device but also tested were a suite of devices like Xbox, Wii, and iPads, making the exercises more interactive and enabling remote connection between patients and their physical therapists. Having a selection meant the physical therapist could tailor the choice of devices to meet the patient’s mobility problems while considering patient preferences.
Lead author Leanne Hassett, PhD, from the Faculty of Medicine and Health at the University of Sydney, said benefits reported by patients using the digital devices in rehabilitation included variety, fun, feedback about performance, cognitive challenge, that they enabled additional exercise, and the potential to use the devices with others, such as family, therapists, and other patients. “These benefits meant patients were more likely to continue their therapy when and where it suited them, with the assistance of digital healthcare,” she said.
Participants reported doing more walking at 6 months, meaning their rehabilitation was improved, but this was not detected in the physical activity measure (time spent upright) generally. In the younger age group, the devices also increased daily step count. Distinctions between physical activity were made through measurements with an activPAL, a small device attached to the thigh that records how much time is spent in different positions (sitting, standing, lying) as well as number of steps taken each day.
This study used research physical therapists to deliver the study; the next step will be to trial the approach in clinical practice by incorporating it into the work of physical therapists.