Feasibility of a Novel Video Game-Based Electromyography Biofeedback System in Patients With Knee Osteoarthritis

in Journal of Sport Rehabilitation

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Eileen Krepkovich Barron Associates Inc, Charlottesville, VA, USA

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Mandeep Kaur Northern Arizona University, Phoenix Biomedical Campus, Phoenix, AZ, USA

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L. Colby Mangum University of Central Florida, Orlando, FL, USA

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Susan Saliba Department of Kinesiology, University of Virginia, Charlottesville, VA, USA

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Matthew Lichter Barron Associates Inc, Charlottesville, VA, USA

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Aaron Olowin Barron Associates Inc, Charlottesville, VA, USA

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Neal Richardson Barron Associates Inc, Charlottesville, VA, USA

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Joseph Hart University of North Carolina, Chapel Hill, NC, USA

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DOI:
https://doi.org/10.1123/jsr.2021-0397
Keywords:
EMG biofeedback; video game-based interventions; exercise therapy
First Published Online:
10 Jun 2022
In Print:
Volume 31: Issue 7
Page Range:
937–942
Restricted access

Context: A novel virtual game system Knee Biofeedback Rehabilitation Interface for game-based home therapy (KneeBright) was developed for strength training using integrated electromyography biofeedback of the quadriceps muscle to control the game. The study aimed to compare the KneeBright and electromyography biofeedback interface among patients with knee osteoarthritis. Design: Controlled before and after design. Methods: Nineteen patients with knee osteoarthritis took part in this laboratory-based study. Exercise sessions took place on 2 separate days. During session 1, participants used a conventional electromyography biofeedback system while performing 3 sets of lower body exercises with emphasis on maximal muscle activation, endurance, and precision. During session 2, participants used the KneeBright game to match the exercise sets in the first session. For both sessions, knee extension torque during the isometric muscle activation exercises and time to voluntary additional exercise were recorded. Patient engagement was assessed using the technology acceptance model and System Usability Score questionnaires. Results: The peak knee extension torque produced during the control exercise session and the KneeBright exercise session were positively correlated. Knee extension torque generated during KneeBright game exercise sessions was increased by an average of 25% compared to the control sessions (2.14 vs 1.77 N·m/kg, P = .02). The mean technology acceptance model score for the KneeBright system was 3.4/5 and the mean System Usability Score was 79, both indicating positive patient engagement. Conclusions: Patients using the KneeBright game produced greater knee torque than patients using the conventional system, had positive levels of engagement, and exercised longer with the KneeBright game.

Hart (joe_hart@med.unc.edu) is corresponding author.

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