PTOTPilotJMIR rehabilitation and assistive technologies2023

Gamified Physical Rehabilitation for Older Adults With Musculoskeletal Issues: Pilot Noninferiority Randomized Clinical Trial.

Mirana Randriambelonoro, Caroline Perrin Franck, François Herrmann and 4 others

PMID 36877563

WHAT IT FOUND

Adding a gamified exercise machine to standard physiotherapy did not change functional outcomes compared to standard care alone.

The study was too small to prove the device is as effective as usual therapy, and no significant differences were found in strength, mobility, or daily living skills.

Key findings

01There was no significant difference in the primary outcome (Short Physical Performance Battery) between the gamified intervention and standard care.

02Secondary outcomes including handgrip strength, functional independence, and step counts showed no significant differences between groups.

03The study was underpowered due to a small sample size and dropouts, making the results inconclusive.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was a pilot with a very small sample size (57 randomized, 41 analysed), which severely limits the statistical power to detect real differences. High dropout rates (16 patients) reduced the analysable sample and may have introduced bias. The noninferiority margin was not met with statistical significance; the confidence intervals were wide, meaning the device could be worse than standard care. The intervention was not blinded, which could influence patient motivation and reported outcomes. Eligibility criteria excluded patients with obesity, cognitive issues, or those too weak to stand, limiting generalizability to more complex geriatric populations.

Declared interests

The authors declared no conflicts of interest related to the funding or design of the study, although one author serves as a Section Editor for the publishing journal.

The easy way to misread this

Do not interpret the lack of significant difference as proof that the gamified device is equivalent to standard care. The study was underpowered and inconclusive, so it fails to demonstrate noninferiority.

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