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Exergames for physiotherapy goals in shoulder rehabilitation

By E Ani; W Marley; J Wilson; A Barratt; R Davies; B Roy, Trafford General Hospital, Central Manchester University Hospitals, Manchester

Winner of the Paul Calvert Endeavour prize for of the best paper from either a small institution or one with no established shoulder fellow, awarded by BESS in 2017, we present below the abstract of the paper focused on the use of exergames for should rehabilitation.



Our study was designed to assess whether the movement and exercise objectives of physiotherapy can be achieved using a computer-based Exergame rehabilitation programme in patients with shoulder pathology.



A Delphi process was utilised with an expert focus group composed of the multidisciplinary team in identifying the key objectives of physiotherapy. Significant themes identified included patient education, pain relief, improved range of movement and exercise. The movement and exercise category was further divided into 5 key domains including range of movement, control, speed, activation of the kinetic chain and improvement in strength. The software in this study was developed by MIRA Rehab Ltd. (Medical Interactive Recovery Assistant (MIRA)). Combined with a Microsoft Kinect TM device it allows patients to play different games as part of their rehabilitation. To assess the technology, specialist shoulder physiotherapists played ten different Exergames and were asked to grade them in their relative weighting in their ability to deliver each of the five key domains. Each assessor was blinded from the other therapists. Analysis was conducted using Krippendorff’s Alpha method to calculate the intraclass correlation coefficient (ICC) using 95% CIs used to evaluate inter-rater agreement.



150 data points were available for assessment. The ICC was calculated as 0.28 (95% CI 0.08-0.47). The pooled data shows significant correlation between the therapists.






Goal based rehabilitation can be used in a computer-based exergame rehabilitation programme. The targeting of specific physiotherapy goals is possible which may in turn encourage patient activation and motivation through enjoyment of the gaming process as well as being provided with instantaneous feedback.

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