Abstract

BackgroundPhysical exercises and physiotherapy are of great importance for maintenance of joint function in patients with rheumatoid arthritis (RA). However, many RA patients complain about problems to receive prescriptions or have a lack of access to physiotherapy. Recent reports have shown positive effects of the Wii game console on physical and psychosocial conditions of patients with other underlying diseases. The primary objectives of this prospective controlled pilot study were to investigate feasibility and patients’ assessment using an animated home-based exercise program.MethodThis pilot study was conducted as a single-center, cross-over trial with two treatment arms over 24 weeks. Eligibility criteria included patients with RA reaching low disease activity under therapy with a biological disease modifying anti-rheumatic drug (bDMARD). After detailed instruction, 15 patients started with a conventional home-based physical exercise program and 15 patients began with a predefined 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.Multi-methodical assessments were performed by qualitative analysis of the interview-data as well as statistical analysis of functional tests and patient reported outcomes (PRO’s).ResultsEvaluation of the interviews indicated feasibility and usefulness of the chosen animated home-based exercise program. Forefoot disabilities were identified as a main limiting factor for performing some of the animated exercises. After 12 weeks, both treatment arms showed improvement of functional tests without significant differences between groups: Overall muscle strength improved for a mean value of 10 Newton (+12 %) and the mean 6-min walk test (6-MWT) distance increased for 28 meters (+5 %).ConclusionThis study showed that an animated home-based exercise program by using a Wii game console was feasible and beneficial for RA patients. Compared to standard physical home exercises, similar effects were observed indicating that such an animated program might be an alternative supportive option for RA patients.Trial registrationClinicalTrials.gov ID: NCT02658370 (19-Jan-2016).Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1208-3) contains supplementary material, which is available to authorized users.

Highlights

  • Physical exercises and physiotherapy are of great importance for maintenance of joint function in patients with rheumatoid arthritis (RA)

  • After 12 weeks, both treatment arms showed improvement of functional tests without significant differences between groups: Overall muscle strength improved for a mean value of 10 Newton (+12 %) and the mean 6-min walk test (6-MWT) distance increased for 28 meters (+5 %)

  • This study showed that an animated home-based exercise program by using a Wii game console was feasible and beneficial for RA patients

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Summary

Introduction

Physical exercises and physiotherapy are of great importance for maintenance of joint function in patients with rheumatoid arthritis (RA). Physical exercises and physiotherapy are of high importance for maintenance of joint function in patients with rheumatoid arthritis. International guidelines for long-term treatment of RA recommend non-pharmacological interventions as adjunctive therapy to pharmacologic treatment [9, 10] In this context, many publications underline that physical therapy plays an important role regarding preventative, curative and rehabilitative aims in the treatment of RA patients. Patients with progressive and aggressive arthritis benefit from physiotherapy and physical exercises. These RA patients can delay or even avoid an early invalidity as well as improve their fitness [11,12,13,14,15,16]

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