Early Virtual-Reality-Based Home Rehabilitation after Total Hip Arthroplasty: A Randomized Controlled Trial

The benefits of early virtual-reality-based home rehabilitation following total hip arthroplasty (THA) have not yet been assessed. The aim of this randomized controlled study was to compare the efficacy of early rehabilitation via the Virtual Reality Rehabilitation System (VRRS) versus traditional rehabilitation in improving functional outcomes after THA. Subjects were randomized either to an experimental (VRRS; n = 21) or a control group (control; n = 22). All participants were invited to perform a daily home exercise program for rehabilitation after THA with different administration methods—namely, an illustrated booklet for the control group and a tablet with wearable sensors for the VRRS group. The primary outcome was the hip disability (HOOS JR). Secondary outcomes were the level of independence and the degree of global perceived effect of the rehabilitation program (GPE). Outcomes were measured before surgery (T0) and at the 4th (T1), 7th (T2), and 15th (T3) day after surgery. Mixed-model ANOVA showed no significant group effect but a significant effect of time for all variables (<em>p </em>&lt; 0.001); no differences were observed in HOOS JR between VRRS and the control at T0, T1, T2, or T3. Further, no differences in the level of independence were found between VRRS and the control, whereas the GPE was higher at T3 in VRSS compared to the control (4.76 ± 0.43 vs. 3.96 ± 0.65; <em>p </em>&lt; 0.001). Virtual-reality-based home rehabilitation resulted in similar improvements in functional outcomes with a better GPE compared to the traditional rehabilitation program following THA. The application of new technologies could offer novel possibilities for service delivery in rehabilitation.

全髋关节置换术（Total Hip Arthroplasty, THA）后早期虚拟现实居家康复的临床获益尚未得到评估。本随机对照研究旨在对比基于虚拟现实康复系统（Virtual Reality Rehabilitation System, VRRS）的早期康复方案与传统康复方案，在改善全髋关节置换术后患者功能结局方面的疗效。受试者被随机分为试验组（VRRS组，n=21）与对照组（n=22）。所有受试者均需每日完成全髋关节置换术后居家康复训练计划，两组采用不同的实施方式：对照组使用图文指导手册，VRRS组则使用搭载可穿戴传感器的平板电脑。本研究的主要结局指标为髋关节残疾评分（HOOS JR），次要结局指标包括自理能力水平以及康复方案整体感知效应评分（GPE）。分别于术前（T0）、术后第4天（T1）、术后第7天（T2）及术后第15天（T3）对所有结局指标进行评估。混合效应方差分析结果显示，组间效应无统计学意义，但所有变量的时间效应均具有显著统计学差异（p<0.001）；在T0、T1、T2及T3各时间点，VRRS组与对照组的HOOS JR评分均无显著差异。此外，两组的自理能力水平亦无显著差异；而在T3时间点，VRRS组的GPE评分显著高于对照组（4.76±0.43 vs. 3.96±0.65；p<0.001）。相较于传统康复方案，全髋关节置换术后基于虚拟现实的居家康复在功能结局改善方面效果相当，但整体感知效应评分更优。新技术的应用可为康复服务的供给提供全新的可能性。