Designing an Exergame and Clinical Evaluation of its Effect on Pain Sensation and Muscle Strength in People with Cervical Osteoarthritis: A Randomized Clinical Trial

Introduction: Cervical osteoarthritis is a disease resulting from degeneration of facet joints in cervical vertebra which may be associated with paresthesia, muscle weakness in limbs, severe pain in neck, shoulder, and back, spinal cord dysfunction, and myelopathy. Cervical osteoarthritis is more prevalent among the elderly. The present study aims to design an exergame and clinically evaluate its effect on pain sensation and muscle strength in people with cervical osteoarthritis. Materials and Methods: This was a randomized clinical trial study conducted on 23 patients referred to the Physiotherapy Clinic of Shariati Hospital in Isfahan, Iran, who were referred by an orthopedic specialist. The subjects were randomly allocated to two groups of exercise with game (n = 12) and routine exercise (n = 11). The exercise with game group received routine physiotherapy treatment along with performing isometric neck exercises with the exergame and the routine exercise group received routine physiotherapy treatment with isometric exercises without the game. Both groups were treated for 4 weeks as 3 sessions per week. The Neck Disability Index (NDI), visual analogue scale (VAS), and hand-held dynamometer (HHD) were respectively used to measure the neck functional disability, pain severity, and isometric strength of the neck muscles in three steps (baseline, post-treatment assessment, and follow-up at 1 month). Results: The results of this study showed that in both routine treatment and treatment with exergame groups, mean neck muscle strength increased, followed by a decrease in the mean pain intensity and mean level of functional disability. In the treatment with exergame group, the pain intensity was significantly lower than the routine treatment group (P ≤ 0.048). Conclusion: One of the main challenges in designing an exergame is to perform isometric neck exercises with specific repetition, intensity, duration, and the standard training protocol. Playing a game seems to gradually improve neck pain and neck functional level in patients with cervical osteoarthritis.