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Face Validity and Content Validity of a Game for Distal Radius Fracture Rehabilitation
17 November 2018
09 April 2019
28 May 2019 (online)
Background Patients recovering from a variety of wrist injuries are frequently advised to exercise to regain lost wrist and hand function. Treatment regimens to regain motion in the wrist are highly variable, and adherence to exercise protocols is known to be low. A serious game ReValidate! incorporating standardized exercise regimens was developed to motivate patients. In this study, the game is evaluated regarding its face validity and content validity.
Methods In this cross-sectional study, a mixed group of “users” (n = 53) including patients currently recovering from wrist injury, and a mixed group of “experts” (n = 46) including professionals advising patients on therapy regimen after wrist injury played at least one complete level of the serious game. Players evaluated the game by means of a structured questionnaire regarding its content, clinical applicability, and user experience. Questions were answered on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree).
Results All groups valued the game as being able to support wrist rehabilitation and being of use to patients recovering from a distal radius fracture (users: median 4, P25–P75 3–4 vs. experts: median 4, P25–P75 3.50–5; p = not significant). The types of exercises performed during the game were considered to be both realistic and complete compared with regular physiotherapy exercises (users: median 4, P25–P75 3–4 vs. experts: median 4, P25–P75 3–5, p = not significant).
Conclusions The ReValidate! serious game can be regarded as a valid tool for patients to regain their wrist function after injury.
Level of evidence This is a Level II study.
Keywordsserious gaming - games - rehabilitation - physiotherapy - treatment adherence - distal radius fracture - mobile technology - e-health
This research was performed at the Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
- 1 Rozental TD, Branas CC, Bozentka DJ, Beredjiklian PK. Survival among elderly patients after fractures of the distal radius. J Hand Surg Am 2002; 27 (06) 948-952
- 2 O'Neill TW, Cooper C, Finn JD. , et al; UK Colles' Fracture Study Group. Incidence of distal forearm fracture in British men and women. Osteoporos Int 2001; 12 (07) 555-558
- 3 Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 2001; 26 (05) 908-915
- 4 MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther 2016; 29 (02) 136-145
- 5 Angermann P, Lohmann M. Injuries to the hand and wrist. A study of 50,272 injuries. J Hand Surg Br 1993; 18 (05) 642-644
- 6 de Putter CE, Selles RW, Polinder S, Panneman MJ, Hovius SE, van Beeck EF. Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. J Bone Joint Surg Am 2012; 94 (09) e56
- 7 Larsen CF, Mulder S, Johansen AMT, Stam C. The epidemiology of hand injuries in The Netherlands and Denmark. Eur J Epidemiol 2004; 19 (04) 323-327
- 8 de Putter CE, van Beeck EF, Polinder S. , et al. Healthcare costs and productivity costs of hand and wrist injuries by external cause: a population-based study in working-age adults in the period 2008-2012. Injury 2016; 47 (07) 1478-1482
- 9 Richtlijn Distale Radiusfracturen: diagnostiek en behandeling. Nederlandse Vereniging voor Heelkunde: Utrecht, the Netherlands; 2010
- 10 Sluijs EM, Kok GJ, van der Zee J. Correlates of exercise compliance in physical therapy. Phys Ther 1993; 73 (11) 771-782 , discussion 783–786
- 11 Jack K, McLean SM, Moffett JK, Gardiner E. Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Man Ther 2010; 15 (03) 220-228
- 12 Bonato P. Wearable sensors/systems and their impact on biomedical engineering. IEEE Eng Med Biol Mag 2003; 22 (03) 18-20
- 13 Meijer HA, Graafland M, Goslings JC, Schijven MP. Systematic review on the effects of serious games and wearable technology used in rehabilitation of patients with traumatic bone and soft tissue injuries. Arch Phys Med Rehabil 2018; 99 (09) 1890-1899
- 14 Bergeron BP. . Developing Serious Games. 1st ed. Hingham, MA: Charles River Media; 2006:452
- 15 Baltaci G, Harput G, Haksever B, Ulusoy B, Ozer H. Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction: prospective, randomized, controlled, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc 2013; 21 (04) 880-887
- 16 Burke JW, McNeill MDJ, Charles DK. , et al. Optimising engagement for stroke rehabilitation using serious games. Vis Comput 2009; 25 (12) 1085-1099
- 17 Fan SC, Su FC, Chen SS. , et al. Improved intrinsic motivation and muscle activation patterns in reaching task using virtual reality training for stroke rehabilitation: a pilot randomized control trial. J Med Biol Eng 2014; 34 (04) 399-407
- 18 Laver KE, George S, Thomas S, Deutsch JE, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev 2015; 2 (02) CD008349
- 19 Saposnik G, Levin M. ; Outcome Research Canada (SORCan) Working Group. Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians. Stroke 2011; 42 (05) 1380-1386
- 20 Graafland M, Dankbaar M, Mert A. , et al. How to systematically assess serious games applied to health care. JMIR Serious Games 2014; 2 (02) e11
- 21 Schijven MP, Jakimowicz JJ. Validation of virtual reality simulators: key to the successful integration of a novel teaching technology into minimal access surgery. Minim Invasive Ther Allied Technol 2005; 14 (04) 244-246
- 22 Rohan M. . Serious Game Market worth $5,448.82 Million by 2020. 2014 . Available at: https://www.marketsandmarkets.com/PressReleases/serious-game.asp . Accessed on October 21, 2017
- 23 Brox E, Fernandez-Luque L, Tøllefsen T. Healthy gaming - video game design to promote health. Appl Clin Inform 2011; 2 (02) 128-142
- 24 Gaudet-Blavignac C, Geissbuhler A. Serious games in health care: a survey. Yearb Med Inform 2012; 7: 30-33
- 25 Horne-Moyer HL, Moyer BH, Messer DC, Messer ES. The use of electronic games in therapy: a review with clinical implications. Curr Psychiatry Rep 2014; 16 (12) 520
- 26 Brichetto G, Spallarossa P, de Carvalho ML, Battaglia MA. The effect of Nintendo® Wii® on balance in people with multiple sclerosis: a pilot randomized control study. Mult Scler 2013; 19 (09) 1219-1221
- 27 Butler DP, Willett K. Wii-habilitation: is there a role in trauma?. Injury 2010; 41 (09) 883-885
- 28 Morone G, Tramontano M, Iosa M. , et al. The efficacy of balance training with video game-based therapy in subacute stroke patients: a randomized controlled trial. BioMed Res Int 2014; 2014: 580861
- 29 Elwyn G, Cochran N, Pignone M. Shared decision making—the importance of diagnosing preferences. JAMA Intern Med 2017; 177 (09) 1239-1240
- 30 McCall B. What does the GDPR mean for the medical community?. Lancet 2018; 391 (10127): 1249-1250
- 31 Farner S, Malkani A, Lau E, Day J, Ochoa J, Ong K. Outcomes and cost of care for patients with distal radius fractures. Orthopedics 2014; 37 (10) e866-e878
- 32 Shauver MJ, Yin H, Banerjee M, Chung KC. Current and future national costs to medicare for the treatment of distal radius fracture in the elderly. J Hand Surg Am 2011; 36 (08) 1282-1287
- 33 Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin 2012; 28 (02) 113-125
- 34 Lötters FJ, van den Bergh JP, de Vries F, Rutten-van Mölken MP. Current and future incidence and costs of osteoporosis-related fractures in the Netherlands: combining claims data with BMD measurements. Calcif Tissue Int 2016; 98 (03) 235-243
- 35 Anderson M, Perrin A. . Tech adoption climbs among older adults. 2017 [cited 2017 21 Oct]. Available at: http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/