The efficacy of virtual reality tools for total knee replacement rehabilitation: A systematic review

Purpose. To assess the effects of training with virtual reality tools (VRT) during rehabilitation of patients after total knee replacement (TKR). Methods. Systematic review. Six databases were queried. Search criteria included studies in which participants underwent TKR, took part in a rehabilitation protocol with VRT, and clinical outcomes of rehabilitation were considered. Available demographic, interventional and outcome data, along with functional, balance, and pain outcome measures were extracted. Patient satisfaction was also summarized. Results. Six trials were included. Available information shows that multi-modal intervention with VRT is used primarily to augment conventional rehabilitation. The Wii Balance Board is the most frequently used device. Conclusions. Findings suggest that an augmented VRT physical therapy intervention that is specifically-oriented to enhance balance could be more effective for overcoming balance limitations than standard physical therapy. However, rehabilitation with VRT has no advantage over conventional training for enhancing function, resolving pain, or increasing patient satisfaction after TKR. Future studies are needed to confirm the findings, particularly regarding the feasibility of preoperative and continued in-home intervention. Registration: CRD42017057087.