Effects of Virtual Reality Exercises on Chronic Low Back Pain: Quasi-Experimental Study

BACKGROUND

Low back pain is a common health problem globally. Based on the duration of pain, it is classified as acute, subacute, or chronic low back pain. Different treatment strategies are available to reduce chronic low back pain. Virtual reality (VR) is a novel approach in back pain rehabilitation.

OBJECTIVE

This study aimed to compare the effects of VR games on chronic low back pain.

METHODS

This quasi-experimental study was conducted among 40 patients with chronic low back pain. The data were collected using a nonprobability, convenient sampling technique. Patients visiting the Department of Physiotherapy, Government Services Hospital, Lahore, Pakistan, were recruited and equally divided into 4 groups. Group A received the Reflex Ridge game; group B received the Body Ball game; group C combined the 2 games without back-strengthening exercises; and group D combined the 2 games with back-strengthening exercises. The participants received 8 treatment sessions, with 3 sessions/wk. The outcomes were pre- and posttest measurements of pain intensity, low back disability, and lumbar range of motion. The repeated measurement ANOVA was used for inter- and intragroup comparison, with significance at P≤.05.

RESULTS

The study comprised a sample of 40 patients with low back pain; 12 (40%) were female and 28 (60%) were male, with a mean age of 37.85 (SD 12.15) years. The pre- and posttest mean pain scores were 7.60 (SD 1.84) and 4.20 (SD 1.62) in group A, 6.60 (SD 1.776) and 5.90 (SD 1.73) in group B, 6.90 (SD 1.73) and 5.40 (SD 1.07) in group C, and 7.10 (SD 1.53) and 3.60 (SD 0.97) in group D, respectively. The mean pain score differences of group D (combining the Reflex Ridge and Body Ball games with back-strengthening exercises) compared to groups A, B, and C were -.60 (P=.76), -2.30 (P<.001), and -1.80 (P=.03), respectively. Regarding the range of motion, the forward lumbar flexion mean differences of group D compared to groups A, B, and C were 3.80 (P=.21), 4.80 (P=.07), and 7.40 (P<.001), respectively. Similarly, the right lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P=.04), 5.20 (P<.001), and 4.80 (P<.001), respectively. The left lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P<.001), 4.80 (P=.02), and 2.20 (P<.001). respectively, showing significant pre- and posttreatment effects.

CONCLUSIONS

VR exercises had statistically significant effects on improving pain, low back disability, and range of motion in all groups, but the combination of Reflex Ridge and Body Ball games with back-strengthening exercises had dominant effects compared to the other groups.

TRIAL REGISTRATION

Iranian Registry of Clinical Trial IRCT20200330046895N1; https://en.irct.ir/trial/46916.

Effects of exergaming in older individuals with mild cognitive impairment and dementia: A systematic review and meta-analysis

BACKGROUND

Non-pharmaceutical interventions have been implemented for people with dementia or mild cognitive impairment (MCI). Researchers have used exergaming in dementia to alleviate cognitive decline in patients with dementia.

AIMS

We assessed the effects of exergaming interventions on MCI and dementia.

METHODS

We conducted a systematic review and meta-analysis (PROSPERO [CRD42022347399]). PubMed, Cochrane Library, Web of Science, CINAHL, and Embase electronic databases were searched for randomized controlled trials (RCTs). The impact of exergaming on cognitive function, physical performance, and quality of life in patients with MCI and dementia was investigated.

RESULTS

Ten RCTs met the eligibility criteria and were included in our systematic review. The results of the meta-analysis demonstrated a statistically significant difference in the Mini-mental State Examination, Montreal Cognitive Assessment, Trail Making Test, Chinese version of the Verbal Learning Test, Berg Balance Scale, Short Physical Performance Battery, and Physical Activity Scale for the Elderly in people with dementia and MCI who participated in exergaming. However, there were no significant improvements in the Activities of Daily Living, Instrumental Activity of Daily Living or Quality of Life.

CONCLUSION

Although there were significant differences in cognitive and physical functions, these results should be interpreted with caution because of heterogeneity. The additional benefits of exergaming remain to be confirmed in future studies.

The Effects of Exergames on Physical and Psychological Health in Young Adults

Objective: This study aims to examine the effects of Kinect-based exergaming on physical (balance and reaction time) and psychosocial health factors (mental well-being and subjective happiness level) in young adults. Materials and Methods: A total of 22 men aged between 18 and 40, who play sedentary videogames at least once a week, were randomly divided into 2 groups to participate in either a Kinect-based exergame program (experimental group, n = 11) or to continue playing sedentary videogames without making any changes (control group, n = 11). The Kinect-based exergame program, including three exergames (Kinect Adventure: Reflex Ridge, Dance Central 3, Kinect Sports: Volleyball), was implemented with the experimental group for 5 weeks, three times a week, and 45 minutes per session. Balance and reaction time were assessed using SportKAT® 4000 Kinesthetic Ability Trainer and FitLight Trainer™ devices, respectively. To measure mental well-being and subjective happiness level, scales with proven psychometric qualities, whose validity and reliability studies were conducted, were used. Results: Results of the study showed statistically significant improvement for the experimental group on the measures of reaction time [t(10) = -4.69, P = 0.001], subjective happiness [t(10) = 8.94, P = 0.000], and mental well-being [t(10) = 4.62, P = 0.001]. In addition, the difference between the groups in reaction time [t(20) = 1.66, P = 0.01], right leg static balance [t(20) = -2.96, P = 0.008], mental well-being [t(20) = 2.77, P = 0.012], and subjective happiness levels (U = 0.50, P = 0.000) was found to be statistically significant in favor of the experimental group. Conclusion: The findings suggest that Kinect-based exergaming positively supports adults' reaction time, mental well-being, and subjective happiness.

Effects of Classical Breathing Exercises on Posture, Spinal and Chest Mobility among Female University Students Compared to Currently Popular Training Programs

Worldwide, university students’ physical health and posture are declining due to a sedentary lifestyle. The aim of our study was to evaluate the effectiveness of physiotherapeutic breathing exercises on posture and spinal mobility among healthy female university students compared to other training methods. Sixty-one female students of the University of Debrecen were assigned to breathing exercise (BE; n = 15), yoga (Y; n = 16), Pilates (P; n = 15) programmes and interval-training (IT; n = 15). Each training session lasted one hour, performed twice a week for 7 weeks. Students were assessed using standardized clinical tests. All programmes resulted in significant improvement in chest expansion. Results of Schober’s test showed substantial improvement using BE (p < 0.05), Y, P (p ≤ 0.01) programmes. Significant changes in occiput-to-wall distance (Y, P p ≤ 0.01) (BE p ≤ 0.001) were observed in three groups except the IT group. Fingertip-to-floor test (Y, P p < 0.05) results showed significant changes in two groups. The most outstanding effects on lateral flexion were achieved using BE (right, left p ≤ 0.001) programme. A comparison with results achieved using yoga and Pilates revealed that the physiotherapeutic breathing exercise programme is an equally effective method to significantly improve spinal mobility and correct postural problems in healthy young women.

The Effects of Health Consideration on Exergaming Behavior in College Students: A Structural Equation Perspective

Purpose: Exergaming play is associated with positive health benefits and increased engagement in physical activity outcomes in players. Research also indicates that factors such as enjoyment and entertainment drive users' exergame activities. However, despite advances in the area, little is known about whether health consideration and physical activity impact college students' exergaming behavior. Method: A cross-sectional online survey of open-ended and fixed questions was completed by 403 college students (Mage = 20.02, SD = 2.3; Range: 17-35; 73.2% female) from a large southwestern university. Descriptive analyses and structural equation modeling techniques were used to draw insights from the data. Results: Among the participants, nearly 87.6% of them reported participating in exergaming behavior. Both measurement and structural models showed good model fits. Health consideration (Std.β = .30, p < .01) and leisure-time physical activity (Std.β = .28, p < .01) were positively associated with exergaming behavior while health consideration was not significantly associated with leisure-time physical activity (Std.β = .05, p = .38). The mediation analysis revealed that the indirect effect from health consideration to exergaming behavior through leisure-time physical activity was not statistically significant (Std.β = .01, p = .38). Leisure-time physical activity could not mediate the relationship between health consideration and exergaming behavior. Conclusions: By pointing out the important role of health consideration and physical activity in college students' exergaming play, findings of this study can help exergame developers and gamification interventionists to design more effective programs and, in turn, facilitate positive intervention outcomes.