PNF and Movement 2023; 21(3): 345-356
Effects of Physical Therapy Combined with Virtual Reality Games on Pain, Function, Quality of Life, And Engagement in Post-Knee-Surgery Patients
Hong-Gil Kim, P.T., M.S.1⋅Ju-Hyeon Jung, P.T., Ph.D.2†
1Department of Physical Therapy, Seomyeon the Zone Oriental Medicine Hospital
2Department of Physical Therapy, College of Nursing Healthcare Sciences and Human Ecology, Dong-Eui University
Correspondence to: Ju-Hyeon Jung (
Received: November 9, 2022; Revised: December 2, 2022; Accepted: December 5, 2022; Published online: December 31, 2023.
© Korea Proprioceptive Neuromuscular Facilitation Association. All rights reserved.

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Purpose: The aim of this study was to investigate the effects of physical therapy combined with a virtual reality (VR) game on pain, quality of life (QOL), engagement, and knee function in post-knee-surgery patients.
Methods: Twenty-four patients who had undergone knee surgery four weeks or more before the study were recruited. Two withdrew from the study during the four-week experimental period, and a total of 22 patients were included in the final analysis. Routine physical therapy consisting of electrostimulation (10 min.) and therapeutic massage (10 min.) was the base intervention for all groups. The experimental group (n = 10) was additionally exposed to a VR game intervention, while the control group (n = 12) underwent an intervention involving similar motions as the experimental intervention but with no VR. The intervention for the experimental group used the game Rig Fit Adventure on Nintendo switch. Both groups underwent their respective interventions 3 times a week (35 min. per session) for 4 weeks. Pain was assessed using the numeric rating scale (NRS), and QOL was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L). Engagement was assessed using the Korea flow state scale (K-FSS). Finally, knee movement and function were assessed based on knee flexion and extension, range of motion (ROM), and Western Ontario and McMaster Universities Arthritis Index (WOMAC).
Results: After the four-week physical therapy, both groups showed significant reductions in pain (on the NRS), increased knee ROM (flexion), better WOMAC scores, and increased EQ-5D-5L scores (p < 0.05), with the experimental group showing significantly better improvements in EQ-5D-5L and K-FSS scores (p < 0.05).
Conclusion: The results of this study confirm that a VR-game-integrated intervention is effective for improving pain, QOL, engagement, and knee function in post-knee surgery patients and that VR-game-integrated interventions could be therapeutic alternatives for patients bedridden for prolonged periods with little motivation for rehabilitation.
Keywords: Post knee surgery patients, Virtual reality game, Physical therapy

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