Video-Game-Based Exercises for Older People With Chronic Low Back Pain: A Randomized Controlledtable Trial (GAMEBACK)

Phys Ther. 2019 Jan 1;99(1):14-27. doi: 10.1093/ptj/pzy112.

Abstract

Background: Video game technology increases adherence to home exercise and could support self-management for older people with chronic low back pain (LBP).

Objective: The objective was to investigate the effects of home-based video game exercises on pain self-efficacy and care-seeking in older people with chronic LBP.

Design: The study was a randomized controlled trial.

Setting: The setting was a community and waiting list.

Participants: Sixty participants, aged > 55 years with chronic LBP, were randomized (1:1) to Wii Fit U exercises or to continue their usual activities for 8 weeks.

Intervention: The intervention was home-based Wii Fit U flexibility, strengthening, and aerobic exercises for 60 minutes, 3 times per week, with fortnightly calls from a physical therapist.

Measurements: Measurements included pain self-efficacy and care-seeking (primary outcomes), and physical activity, pain, function, disability, fear of movement/reinjury, falls efficacy, recruitment and response rates, adherence, experience with the intervention, and adverse events (secondary outcomes).

Results: The mean age of participants was 67.8 (standard deviation = 6.0) years. Adherence to the total recommended exercise time was 70.8%, and no adverse events were reported. Participants completing Wii Fit U exercises had significantly higher pain self-efficacy at 6 months, but not immediately postintervention or at 3 months; there were no between-group differences in care-seeking. Compared with the control group, participants completing Wii Fit U exercises demonstrated significantly greater improvements in pain and function at 8 weeks and were more likely to engage in flexibility exercises at 6 months. There were no significant between-group differences for the remaining outcomes.

Limitations: Participants and therapists were not blinded.

Conclusions: Wii Fit U exercises improved pain self-efficacy at 6 months, and pain and function immediately postintervention in older people with chronic LBP, but the clinical importance of these changes is questionable. Wii Fit U exercises had no effect on care-seeking, physical activity, disability, fear of movement/reinjury, or falls efficacy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Exercise
  • Exercise Therapy / methods*
  • Female
  • Health Services Needs and Demand / statistics & numerical data
  • Health Services for the Aged / statistics & numerical data
  • Humans
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Compliance / statistics & numerical data
  • Range of Motion, Articular
  • Resistance Training / methods
  • Sample Size
  • Self Efficacy
  • Single-Blind Method
  • Video Games*