Abstract
BackgroundThere is sparse research on the effectiveness of therapeutic exercise for the treatment of neck pain in older adult populations. Moreover, there is a lack of research on the use of serious games or virtual reality for the treatment of neck pain in this population.ObjectiveThe primary aim of this study was to develop and assess the suitability of a serious game for performing task-oriented cervical exercises in patients with neck pain.MethodsA serious game was designed based on the key features identified by previous studies that designed serious video games for physical and cognitive rehabilitation or exercise. The game in this study was designed to provide an interactive scenario, with the main functionality of the software solution to control a virtual airplane to reach targets using head motions. At the end of the exercise, the application stores the targets reached and missed and the airplane’s trajectory. A crossover pilot study was carried out for preliminary evaluation of the suitability of the technology in the older adult population. Men and women over 65 years of age with chronic neck pain were included. Subjects were randomly assigned to two study arms; each arm consisted of a sequence of two 4-week treatments with an intermediate washout period of 4 weeks. The total study duration was 16 weeks due to a final follow-up measure 4 weeks after the end of all treatments. Treatment A consisted of the use of the serious game developed in this study, and treatment B consisted of conventional exercises. Subjects allocated to the A-B study arm received treatment A first, followed by treatment B, and vice versa in the B-A arm. The following variables were assessed: Suitability Evaluation Questionnaire (SEQ) scores, Visual Analog Scale scores, and the number of targets reached in the serious game.ResultsA total of 18 subjects were assessed for eligibility. A total of 13 subjects, aged between 71 and 92 years (mean 81.85, SD 6.82), were finally included and completed the study protocol. The global mean SEQ score was 50.38 (SD 5.35) out of 65 points, showing good suitability of the serious game. Most patients considered the experience very enjoyable and “real” in terms of the virtual environment and found the information provided to be clear. Also, they believed that the game could be very helpful for their rehabilitation. None of the patients felt any neck pain or discomfort when playing the game, and only 2 patients out of 13 (15%) reported some degree of dizziness, eye discomfort, or disorientation, which did not limit their capacity to finish the session.ConclusionsThe serious game developed in this study showed good suitability for use in adults over 70 years of age with chronic neck pain. The game was a safe method for performing task-oriented cervical exercises, and patients reported very high levels of satisfaction and acceptance after the use of this technology.
Highlights
Neck pain is a highly prevalent musculoskeletal disorder among populations of developed societies that leads to considerable pain, disability, and economic burden [1]
The serious game developed in this study showed good suitability for use in adults over 70 years of age with chronic neck pain
Results from the Spanish National Health Survey showed that the age group of individuals older than 75 years had a higher prevalence of chronic neck pain (17.32% of males and 34.60% of females) compared to other age groups [5]
Summary
Neck pain is a highly prevalent musculoskeletal disorder among populations of developed societies that leads to considerable pain, disability, and economic burden [1]. The 1-year prevalence of neck pain in the general population has been shown to be 25.8% (range 4.8%-79.5%) on average, with a point prevalence of 14.4% (range 0.4%-41.5%) [2]. It has been ranked as the 4th-greatest contributor to overall global disability and 21st in terms of overall burden [3]. Neck pain has been shown to be higher in females and to increase with age, up to 70 to 74 years, to decrease with older age [1]. There is a lack of research on the use of serious games or virtual reality for the treatment of neck pain in this population
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