Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
IF – 2.1 (5-Year IF – 2.0), JCI (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker – 4.3)
Q1 in SJR 2024, SJR score – 0.598
IC – 171.00; MNiSW – 70 pts
Initial editorial assessment and first decision within 24 h

ISSN 1899–5276 (print), ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 5, September-October, p. 931–936

doi: 10.17219/acem/32590

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial

Ali Yavuz Karahan1,A,B,C,D,E,F, Fatih Tok2,C,D,E,F, Pelin Yildirim3,C,D,E,F, Banu Ordahan1,B,C,D, Gozde Turkoglu1,B,C,D, Nilay Sahin4,C,D,E,F

1 Department of Physical Medicine and Rehabilitation, Beyhekim State Hospital, Konya, Turkey

2 Department of Physical Medicine and Rehabilitation, Iskenderun Marine Regiment Medical Center, Iskenderun, Hatay, Turkey

3 Department of Physical Medicine and Rehabilitation, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey

4 Department of Physical Medicine and Rehabilitation, Balikesir University, Balikesir, Turkey

Abstract

Background. Exergames are a well-known type of game based on a virtual avatar’s body movements. This hightech approach promotes an active lifestyle.
Objectives. The aim of this randomized controlled trial was to evaluate the effects of exergames on pain, disease activity, functional capacity and quality of life in patients with ankylosing spondylitis (AS).
Material and Methods. The study involved 60 patients, who were randomized into either the exergame group (EG) or the control group (CG). The EG patients engaged in exergaming, and CG patients did not engage in any exercises. The exergaming sessions were performed five times a week for eight weeks (40 sessions in total). The patients were assessed before and after the eight-week program on a visual analog scale (VAS), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire.
Results. A statistically significant improvement was observed in VAS, BASFI, BASDAI and ASQoL scores in the EG group after completion of the exercise program (p < 0.05).
Conclusion. This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle. The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could, therefore, be feasible and safe.

Key words

ankylosing spondylitis, exergame, exercise, quality of life

References (43)

  1. Bostan EE, Borman P, Bodur H, Barca N: Functional disability and quality of life in patients with ankylosing spondylitis. Rheumatol Int 2003, 23, 121–126.
  2. Baysal O, Durmus B, Ersoy Y: Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis. Rheumatol Int 2010, 31, 795–800.
  3. Ovayolu N, Ovayolu O, Karadag G: Health-related quality of life in ankylosing spondylitis, fibromyalgia syndrome, and rheumatoid arthritis: A comparison with a selected sample of healthy individuals. Clin Rheumatol 2010, 30, 655–664.
  4. Bodur H, Sivas F, Yilmaz O, Ozgocmen, S, Gunaydin R, Kaya T: Turkish league against rheumatism national recommendations for the management of ankylosing spondylitis. Turk J Rheumatol 2011, 26, 173–186.
  5. Brophy S, Cooksey R, Davies H, Dennis MS, Zhou SM, Siebert S: The effect of physical activity and motivation on function in ankylosing spondylitis: A cohort study. Semin Arthritis Rheum 2013, 42, 619–626.
  6. Karapolat H, Akkoc Y, Sari I, Eyigor S, Akar S, Kirazli Y, Akkoc N: Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: Effects on bath ankylosing spondylitis indices, quality of life and depression. Clin Rheumatol 2008, 27, 695–700.
  7. Durmus D, Alayli G, Uzun O, Tander B, Canturk F, Bek Y, Erkan L: Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Joint Bone Spine 2009, 76, 150–155.
  8. Ortancil O, Sarikaya S, Sapmaz P, Basaran A, Ozdolap S: The effect(s) of a six-week home-based exercise program on the respiratory muscle and functional status in ankylosing spondylitis. J Clin Rheumatol 2009, 15, 68–70.
  9. Tekeoglu I, Hiz O, Ozbay B, Toprak M, Avcu S: Pulmonary involvement in rheumatic diseases: HRCT findings. J Clin Anal Med 2011, 2, 36–39.
  10. Yigit S, Sahin Z, Demir SE, Aytac DH: Home-based exercise therapy in ankylosing spondylitis: Short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors. Rheumatol Int 2013, 33, 71–77.
  11. Aytekin E, Caglar ES, Ozgonenel L, Tutun S, Demiryontar DY, Demir SE: Home-based exercise therapy in patients with ankylosing spondylitis: Effects on pain, mobility, disease activity, quality of life, and respiratory functions. Clin Rheumatol 2012, 31, 91–97.
  12. Durmus D, Alayli G, Cil E, Canturk F: Effects of a home-based exercise program on quality of life, fatigue, and depression in patients with ankylosing spondylitis. Rheumatol Int 2009, 29, 673–677.
  13. Analay Y, Ozcan E, Karan A, Diracoglu D, Aydin R: The effectiveness of intensive group exercise on patients with ankylosing spondylitis. Clin Rehabil 2003, 17, 631–636.
  14. Wang CY, Chiang PY, Lee HS, Wei JC: The effectiveness of exercise therapy for ankylosing spondylitis: A review. Int J Rheum Dis 2009, 12, 207–210.
  15. Staiano AE, Calvert SL: The promise of exergames as tools to measure physical health. Entertain Comput 2011, 2, 17–21.
  16. Staiano AE, Calvert SL: Exergames for physical education courses: Physical, social, and cognitive benefits. Child Dev Perspect 2011, 5, 93–98.
  17. Verheijden Klompstra L, Jaarsma T, Strömberg A: Exergaming in older adults: A scoping review and implementation potential for patients with heart failure. Eur J Cardiovasc Nurs 2014, 5, 388–398.
  18. Agmon M, Perry CK, Phelan E Demiris G, Nguyen HQ: A pilot study of Wii Fit exergames to improve balance in older adults. J Geriatr Phys Ther 2011, 34, 161–167.
  19. Fogel VA, Miltenberger RG, Graves R, Koehler S: The effects of exergaming on physical activity among inactive children in a physical education classroom. J Appl Behav Anal 2010, 43, 591–600.
  20. Franco JR, Jacobs K, Inzerillo C Kluzik J: The effect of the Nintendo Wii Fit and exercise in improving balance and quality of life in community-dwelling elders. Technol Health Care 2012, 20, 95–115.
  21. Zochling J: Measures of symptoms and disease status in ankylosing spondylitis: Ankylosing Spondylitis Disease Activity Score (ASDAS), Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score (BAS-G), Bath Ankylosing Spondylitis Metrology Index (BASMI), Dougados Functional Index (DFI), and Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S). Arthritis Care Res (Hoboken) 2011, 63, Suppl 11, 47–58.
  22. Calin A, Garrett S, Whitelock H: A new approach to defining functional ability in ankylosing spondylitis: The development of the bath ankylosing spondylitis functional index. J Rheumatol 1994, 21, 2281–2285.
  23. Yazicioglu K, Goktepe AS, Yilmaz B, Gunduz S: BATH indexes in the evaluation of patients with ankylosing spondylitis. Turk J Rheumatol 2003, 2, 70–76.
  24. Karatepe AG, Akkoc Y, Akar S, Kirazli Y, Akkoc N: The Turkish versions of the bath ankylosing spondylitis and dougados functional indices: Reliability and validity. Rheumatol Int 2005, 25, 612–618.
  25. Ozer HT, Sarpel T, Gulek B, Alparslan ZN, Erken E: The Turkish version of the bath ankylosing spondylitis functional index: Reliability and validity. Clin Rheumatol 2005, 24, 123–128.
  26. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A: A new approach to defining disease status in ankylosing spondylitis: The bath ankylosing spondylitis disease activity index. J Rheumatol 1994, 21, 2286–2291.
  27. Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N: A Turkish version of the bath ankylosing spondylitis disease activity index: Reliability and validity. Rheumatol Int 2005, 25, 280–284.
  28. Ay S, Kutlay S, Kurtais Y, Yanik B: Adaptation and validation of the Turkish version of bath ankylosing spondylitis disease activity index (BASDAI). Turk J Rheumatol 2004, 3, 139–146.
  29. Doward LC, Spoorenberg A, Cook SA: Development of the ASQoL: A quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 2003, 62, 20–26. DOI:10.1136/ard.62.1.20.
  30. Van Tubergen A, Landewe R, van der Heijde D: Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: A randomized controlled trial. Arthritis Care Res 2001, 45, 430–438.
  31. Atlan L, Bingol U, Aslan M, Yurtkuran M: The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 2006, 35, 283–289.
  32. Lee EN, Kim YH, Chung WT, Lee MS: Tai chi for disease activity and flexibility in patients with ankylosing spondylitis – a controlled clinical trial. Evid Based Complement Alternat Med 2008, 5, 457–462.
  33. Karapolat H, Eyigor S, Zoghi M, Akkoc Y, Kirazli Y, Keser G: Are swimming or aerobic exercise better than a conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Eur J Phys Rehabil Med 2010, 45, 449–457.
  34. Falkenbach A: Disability motivates patients with ankylosing spondylitis for more frequent physical exercise. Arch Phys Med Rehabil 2003, 84, 382–383.
  35. Bodur H, Ataman S, Rezvani A: Quality of life and related variables in patients with ankylosing spondylitis. Qual Life Res 2011, 20, 543–549.
  36. Sundstrom B, Ekergard H, Sundelin G: Exercise habits among patients with ankylosing spondylitis. A questionnaire based survey in the County of Vasterbotten, Sweden. Scand J Rheumatol 2002, 31, 163–167.
  37. Passalent LA, Soever LJ, O’Shea FD, Inman RD: Exercise in ankylosing spondylitis: discrepancies between recommendations and reality. J Rheumatol 2010, 37, 835-841.
  38. Bateni H: Changes in balance in older adults based on use of physical therapy vs. the Wii Fit gaming system: A preliminary study. Physiotherapy 2012, 98, 211–216.
  39. Duclos C, Mieville C, Gagnon D, Leclerc C: Dynamic stability requirements during gait and standing exergames on the Wii fit system in the elderly. J Neuroeng Rehabil 2012, 9, 28.
  40. Szturm T, Betker AL, Moussavi Z Desai A, Goodman V: Effects of an interactive computer game exercise regimen on balance impairment in frail community-dwelling older adults: A randomized controlled trial. Phys Ther 2011, 91, 1449–1462.
  41. Karahan AY, Tok F, Taşkın H, Kuçuksaraç S, Başaran A, Yıldırım P: Effects of exergames on balance, functional mobility, and quality of life of geriatrics versus home exercise programme: Randomized controlled study. Cent Eur J Public Health 2015, 23, Suppl S, 14–18.
  42. Staiano AE, Abraham AA, Calvert SL: Adolescent exergame play for weight loss and psychosocial improvement: A controlled physical activity intervention. Obesity (Silver Spring) 2013, 21, 598–601. DOI: 10.1002/oby.20282.
  43. Kramer A, Dettmers C, Gruber M: Exergaming with additional postural demands improves balance and gait in patients with multiple sclerosis as much as conventional balance training and leads to high adherence to homebased balance training. Arch Phys Med Rehabil 2014, May, 10. pii: S0003-9993(14)00340-2. DOI: 10.1016/j. apmr.2014.04.020.
© Wroclaw Medical University