Comparison of Virtual Reality-Based Rehabilitation and High-Intensity Exercise After Total Knee Arthroplasty: A Randomized Controlled Trial
Keywords:
N\AAbstract
Objective: To determine whether VR-based rehabilitation (VRBR) reduces pain and improve balance, proprioception and joint function following Total knee replacement (TKR).
Methods: The randomized controlled trials (RCTs) were included if they were in English, participants aged ≥ 18 years, underwent a unilateral or bilateral TKR and were treated using VRBR. The outcome was measured Berg balance scale (BBS) and Timed Up and Go Test.
Results: The data was found to be normally distributed. Virtual reality training group shows better effects as compared to conventional balance training group in terms of BBS (p<0.001) and TUG-test (p<0.001).
Conclusion: The range of motion in VR-based rehabilitation produces better results than indifferently supporting the experimental group's pain outcome, but the VRBR showed significant improvement.
Downloads
Metrics
References
Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clinics in Geriatric Medicine. 2010;26(3):355-69.
Wang Y, Chu M, Rong J, Xing B, Zhu L, Zhao Y, et al. No association of the single nucleotide polymorphism rs8044769 in the fat mass and obesity-associated gene with knee osteoarthritis risk and body mass index: A population-based study in China. Bone & Joint Research. 2016;5(5):169-74.
Yadav R, Verma AK, Uppal A, Chahar HS, Patel J, Pal CP. Prevalence of primary knee osteoarthritis in the urban and rural population in India. Indian Journal of Rheumatology. 2022;17(3):239-43.
Thati S. Gender differences in osteoarthritis of knee: An Indian perspective. Journal of Mid-life Health. 2021;12(1):16-20.
Annapareddy A, Mulpur P, Prakash M, Masilamani ABS, Eachempati KK, Reddy AVG. Partial versus total knee arthroplasty for isolated antero-medial
Adamovich SV, Fluet GG, Tunik E, Merians AS. Sensorimotor training in virtual reality: a review. Neuro Rehabilitation 2009;25(1):29-44.
Esculier JF, Vaudrin J, Beriault P, Gagnon K, Tremblay LE. Home-based balance training programme using Wii Fit with balance board for Parkinson's disease: a pilot study. Journal of Rehabilitation Medicine. 2012;44(2):144-50.
Bade MJ, Struessel T, Dayton M, Foran J, Kim RH, Miner T, et al. Early highintensity versus low-intensity rehabilitation after total knee arthroplasty: A randomised controlled trial. Arthritis Care & Research. 2017;69(9):1360-68.
Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine. 2005;30(11):1331-34.
Stratford PW, Kennedy DM, Woodhouse LJ, Spadoni GF. Measurement properties of the WOMAC LK 3.1 pain scale. Osteoarthritis and Cartilage. 2007;15(3):266-72.
Yu J-H, Nekar DM, Kang H-Y, Lee J-W, Oh S-Y. Comparison of Physical Activity Training Using Augmented Reality and Conventional Therapy on Physical Performance following a Total Knee Replacement: A Randomized Controlled Trial. Appl Sci. 2023;13:894.
Eichler S, Salzwedel A, Rabe S, Mueller S, Wochatz FMM, Hadzic M, et al. The effectiveness of telerehabilitation as a supplement to rehabilitation in patients after total knee or hip replacement. JMIR Rehabil Assist Technol. 2019;6(2):e14236.
Yoon S, Son H. Effects of full immersion virtual reality training on balance and knee function in total knee replacement patients: a randomized controlled study. Journal of Mechanics in Medicine and Biology. 2020;20:2040007.
Roig-Casasús S, Blasco JM, López-Bueno L, Blasco-Igual MC. Balance training with a dynamometric platform following total knee replacement: a randomized controlled trial. Journal of geriatric physical therapy. 2018;41:204–9.
Gianola S, Stucovitz E, Castellini G, Mascali M, Vanni F, Tramacere I, et al. Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: a randomized controlled trial. Medicine. 2020; 99.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of [37] the hip or knee. J Rheumatol. 1988;15:1833-40.
Shahrbanian S, Ma X, Aghaei N, Korner-Bitensky N, Moshiri K, Simmonds MJ. Use of virtual reality (immersive vs. non immersive) for pain management in children and adults: A systematic review of evidence from randomised controlled trials. Eur J Exp Biol. 2012;2(5):1408-22.
Nishitha K, Anitha A, Thaheera D. Effectiveness of Virtual Reality-based Rehabilitation and High-intensity Exercise Program for Total Knee Arthroplasty Patients: A Randomised Controlled Trial. Journal of Clinical & Diagnostic Research. 2024 Nov 1;18(11).
Shaheen AA, Algabbani MF, Alshahrani MM, Alshahrani FA, Alsobayel HI, Omar MT, et al. Efficacy of virtual reality-based rehabilitation following total knee replacement: a systematic review and meta-analysis of randomized control trials. Bulletin of Faculty of Physical Therapy. 2025 Mar 5;30(1):15.
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.