Adolescents with hemophilic knee arthropathy can improve their gait characteristics, functional ability, and physical activity level through kinect-based virtual reality: A randomized clinical trial

Background Hemophilic arthropathy is caused by recurrent intra-articular bleeding, most commonly in the knee joints. Physically, this arthropathy is disabling and inhibits affected persons' physical activity levels and functionality. Objective This study intended to examine the effect of a physical rehabilitation program incorporating Kinect-based virtual reality (KBVR) on gait characteristics, functional ability, and physical activity level in adolescents diagnosed with hemophilic knee arthropathy (HKA) Materials and methods In a randomized clinical trial, 56 boys, aged 10–14 years, with moderate HKA, were randomly allocated into two groups. The control group (n = 28) received conventional physical therapy (CPT), while the KBVR group (n = 52) received a 30-min KVG-VR-based exercise program in addition to the CPT. Training was conducted three times/week for 12 weeks. Gait characteristics (step length, cadence, velocity, peak knee extension moment during stance, and knee flexion amplitude during swing) were assessed using a three-dimension gait analysis system, functional ability was assessed through the 6-min walk test, and physical activity level were assessed by the Adolescents' Physical Activity Questionnaire pre- and pos-treatment. Results The KBVR group achieved more favorable changes in the gait characteristics [step length (P = 0.015), cadence (P = 0.004), velocity (P = 0.024), peak knee extension moment during stance (P = 0.018), and Knee flexion amplitude during swing (P = 0.032)], functional capacity (P = 0.002), and physical activity levels (P = 0.007) compared to the control group. Conclusion The use of KBVR exercises within a rehabilitation program is a potentially effective therapeutic option for the total care of adolescents with HKA.