Background Physical exercises and physiotherapy are of high importance for maintenance of joint function in patients with rheumatoid arthritis (RA). However, many RA patients complain about problems to receive prescriptions for or lack of access to physical therapy.
Recent reports have shown positive effects of the Wii™ game console (Nintendo®) on physical and psychosocial conditions of patients with other underlying diseases. In fact, a home-based animated physical exercise program could be cost-effective, freely available and adjustable to the individual situation.
Objectives To investigate practicability and effects of an animated home-based exercise program for RA patients treated with biologic DMARDs.
Methods This study was conducted as an investigator initiated, not manufacturer supported, single-center, cross-over trial with two treatment arms over 24 weeks. Eligibility criteria included patients with RA with low disease activity according to DAS28 under biological DMARD therapy. After detailed instruction, 10 patients started with a conventional home-based physical exercise program and 10 patients with the animated exercise program by using the Wii™ game console for 12 weeks. Afterwards, patients were crossed over to the other treatment arm for another period of 12 weeks.
A multi-methodical approach was used for this study: A qualitative analysis of the interview-data was performed by interpretation and inter-individual comparison of given answers. Measurements for muscle strength (isometric measurement) and 6-minute walk test (6-MWT) were compared from Baseline to week 12 and week 24. Statistical computing was performed with SPSS using the 'Analysis of Covariance' (ANCOVA), adjusted for baseline status.
Results We evaluated data from 20 patients (17 females) with a mean age of 55,5 (±9) years. More than 14 hours of interview data were transcribed and analyzed. By using a special software for coding patients response, categories were identified indicating practicability and easy accessibility. Of note, mainly fore foot disabilities were described as limiting factors for performing some exercises of the program. Many patients stated a positive influence by the game console on their perseverance to doing exercises.
Over the observation period, both groups showed a clear benefit from the exercise programs and the analysis of test results showed no significant differences between both treatment arms after 12 weeks: Muscle strength improved by mean of 11 N (increase of 13% from baseline) with a non-significant difference of 3 N between both groups (p=0,64). The mean 6-MWT distance was increased by 50 meters (increase of 9% from baseline) without a relevant difference between both groups (p=0,73).
Results from week 24 suggested that beginning with the home based physical exercise program followed by a subsequent Wii™ game console program was the most effective program.
Conclusions This study showed that an animated home-based exercise program by using a Wii™ game console was beneficial for RA-Patients. Compared to standard physical home exercises, similar effects in both treatment groups were observed indicating that such an animated and well received program might be an alternative or additional option for RA-patients depending on their own preferences.
Disclosure of Interest None declared
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