Does the use of active videogame and computer-based technologies influence physiotherapy practice in mobility rehabilitation?

Author: Heather Weber

Weber, Heather, 2021 Does the use of active videogame and computer-based technologies influence physiotherapy practice in mobility rehabilitation?, Flinders University, College of Nursing and Health Sciences

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Physiotherapy rehabilitation for mobility limitations has shown to be effective, particularly intensive programs based on motor learning principles. Virtual reality technologies, especially non-immersive active videogame and computer technologies are increasingly being studied and employed in mobility rehabilitation. The overall aim of this thesis was to explore if and how the use of active videogame and computer-based technologies influence the practice of physiotherapy in rehabilitation for mobility limitations.

Chapter 1 provided an introduction to the thesis and summarised the rationale that has led to the research objectives.

Chapter 2 reviewed key concepts in the existing literature pertaining to mobility limitations and physiotherapy rehabilitation, and provided context on the use of virtual reality for the rehabilitation of people with mobility limitations.

A systematic review presented in Chapter 3 investigated how virtual reality (VR) interventions are delivered in studies for mobility limitation rehabilitation, and specifically considered the described role of the therapist. This study identified that reporting of VR interventions in existing research studies generally lacks detail, and that the therapist role is poorly defined.

In Chapter 4, the validity of the Notch commercial sensor 3D motion capture system was studied by simultaneously recording gait with the Notch sensor and Vicon optical motion capture systems. This study demonstrated that the accuracy of the Notch sensor system is not sufficiently accurate to capture kinematic data for clinical or research use.

Chapter 5 provides the detailed protocol for the major study of this thesis, a large observational study in which patient and physiotherapist dyads undertook matched mobility rehabilitation exercises without and with active videogame and computer-based (AVC) technology. During these sessions physiotherapist focus of visual attention and provision of instruction and feedback were recorded and later analysed. This chapter included a detailed description of the different AVC technologies and the games used in this study.

Chapter 6 describes the examination and comparison of physiotherapists’ focus of visual attention in mobility rehabilitation without and with AVC technologies. This study found that physiotherapists’ primary focus of attention in rehabilitation without AVC technologies was the patient body, but that this shifted to the technology screen during rehabilitation with AVC technologies. While the reasons for this visual attention shift cannot be determined from this study, it is suggested that this may be unintentional, or therapists may be using the screen display to inform clinical practice.

In Chapter 7 the similarities and differences in physiotherapist instruction and feedback, in the same rehabilitation sessions without and with AVC technologies from Chapter 6, were investigated. The results of this study indicated that although AVC technologies provided continuous feedback and frequent instruction, overall amount of physiotherapist instruction and feedback during AVC rehabilitation with AVC technologies remained largely unchanged when compared to rehabilitation without AVC technologies. However, significant differences were observed in instruction and feedback types, with less frequent provision of performance instruction, knowledge of results (task or game) and internally focused statements within an AVC-based rehabilitation session.

Chapter 8 presents an overall discussion of the thesis, including the strengths and limitations of the thesis, and highlights future research plans in this field.

Keywords: rehabilitation, physiotherapy, virtual reality, exergaming, active videogaming, feedback, mobility limitation, visual attention, physiotherapist

Subject: Rehabilitation thesis

Thesis type: Doctor of Philosophy
Completed: 2021
School: College of Nursing and Health Sciences
Supervisor: Associate Professor Maayken van den Berg