52FEEDBACK INTEGRATED REHABILITATION FOR SIT-TO-STAND TRAINING (FIRST): A PILOT RANDOMISED CONTROLLED TRIAL

Abstract

Introduction: The ability to stand up from a sitting position declines in old age (Manini, 2013). Since manual rehabilitation services are being challenged by the ageing population and budget constraints, patients have sub-optimal access to professional therapists. Technology may offer solutions. A virtual reality based system, aimed at training the sit-to-stand (STS) movements in geriatric population, with visual (3D avatar) and audio feedback on performance (i.e. weight-symmetry loading, muscle strength and upper trunk posture) was developed. The aim of this study was to test the feasibility and clinical effectiveness of this system in a geriatric population undergoing rehabilitation. Methods: A phase two pilot randomised controlled trial (RCT) was conducted at a geriatric rehabilitation unit. All participants underwent two functional assessments (Tinetti Assessment Tools (TAT) and Elderly Mobility Score (EMS)) 48 hours before the study began and at the end of the trial. The experimental group received augmented STS training for four weeks, three sessions a week, while the control group received standard physiotherapy. Results: Sixteen participants (n = 16) completed the trial, eight in each group. No adverse event was recorded during the study period, while the retention rate was 100%. The increase in TAT score (t-value = 2.48) and EMS (t-value = 4.32) in the experimental group were statistically significant (p < 0.05) better than the control. Regarding the system acceptability, participants found it motivating, intuitive and enjoyable. Conclusion: To our knowledge, this is the first RCT evaluating a virtual-reality system that provides automated visual and audio feedback during STS training. The system is feasible and safe in a clinical environment. The computerised biofeedback was found to be superior to standard physiotherapy in recovering the STS movements. Virtual reality systems have the potential to benefit future geriatric rehabilitation.