Virtual reality for total hip arthroplasty rehabilitation: Kinect versus Nintendo Wii, a single-blind randomised controlled trial

Abstract

ObjectiveCompare the effectiveness of integrating virtual reality systems, Nintendo Wii and Microsoft Kinect, integrated with conventional physiotherapy versus conventional physiotherapy alone, in improving lower limb physical function in people over 60 years of age undergoing total hip arthroplasty.DesignRandomised, single-blind clinical trial.SettingSan Borja Arriaran Clinical Hospital, Santiago, Chile.Participants111 individuals over 60 years of age, divided into three groups (n = 37 each).InterventionsFor six weeks, the control group received conventional physiotherapy. The Wii and Kinect groups received the same physiotherapy programme plus 15 min of exercise using virtual reality platforms.Outcome measuresThe primary outcome was the function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included WOMAC pain, Berg Balance Scale, Six-Minute Walk Test, and weight-bearing.ResultsAll groups improved. For WOMAC function, the Wii group surpassed the Kinect group (mean difference: 40.48 points; p < 0.001; minimum clinically important difference MCID: 11.9 points) but not the control group. The Wii group also led in balance (Berg Balance Scale mean difference: 19.41 points; p < 0.001; MCID: 11.5 points). The Kinect group was superior in the Six-Minute Walk Test (mean difference: 133.10 metres; p = 0.001) and WOMAC pain reduction (mean difference: 11.45 points; p < 0.003) exceeding the MCID of 2.2 points. No significant changes were observed in weight-bearing.ConclusionVirtual reality combined with physiotherapy improves clinically meaningful outcomes following hip arthroplasty. The Wii favours balance, while Kinect enhances pain and gait, supporting personalised rehabilitation.Trial registrationThis research was registered in the Clinical Trials Registry of Australia and New Zealand (ACTRN12618001252202).

Keywords: Arthroplasty; exergaming; hip; physical therapy modalities; rehabilitation; replacement; virtual reality.