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Trial registered on ANZCTR
Registration number
ACTRN12618001698268
Ethics application status
Approved
Date submitted
3/10/2018
Date registered
15/10/2018
Date last updated
15/10/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating the effectiveness of a game-based application (SuperGramps) in
rehabilitation for total knee arthroplasty patients in a tertiary hospital in Singapore
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Scientific title
Evaluating the effectiveness of a game-based application (SuperGramps) in
rehabilitation for total knee arthroplasty patients in a tertiary hospital in Singapore
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Secondary ID [1]
296248
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None
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Universal Trial Number (UTN)
U1111-1221-6222
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Total knee arthroplasty
309908
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Condition category
Condition code
Physical Medicine / Rehabilitation
308690
308690
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0
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Physiotherapy
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Musculoskeletal
308724
308724
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In the intervention group, patients will receive the standard physiotherapy intervention by attending physiotherapist and be taught how to play the game on post op day 1. The exercises taught via the game (straight leg raise and heel slides), will not be taught in the traditional manner. Apart from the 2 exercises, all standard physiotherapy interventions will be carried out.
From day 2 onwards, patients will play the supergramps game for knee ranging and muscle strengthening exercises without standard physiotherapy intervention. These patients will continue to be seen once daily by the physiotherapist to be assessed and ambulated with an appropriate walking aid during their inpatient stay. They would be advised to play the game 3x a day.
Patients in the intervention group will be provided with an inertial measurement unit (IMU) which is a triangular device which they are to put on. The device will be taped onto silicon belts, which the participants are required to place around their thigh and calf. The device will be able to communicate with the game on a tablet provided in order to facilitate participation of the patient. The game will require the patient to control the character either by bending their knees or lifting their legs, similar to the exercises done post-total knee arthroplasty surgeries.
Patients will be encouraged to do these exercises 3x/day, as per usual protocol. The game should take about 10-15 minutes to complete.
The participants are required to play the game for 3 days post surgery, after which the inertial measurement units and tablets will be collected back. We will monitor adherence to the game by checking their game results on a separate portal.
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Intervention code [1]
312577
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Rehabilitation
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Comparator / control treatment
In the control group, patients will receive the standard physiotherapy
intervention daily as per knee arthroplasty protocol for knee ranging and muscle strengthening exercises during their acute inpatient hospital stay. Exercises taught include heel slides, static quadriceps contraction, inner range quadriceps activation, straight leg raises. They will be seen once a day by the physiotherapist and encouraged to do the exercises twice in their own time.
The usual orthopaedic team members will be carrying out the control treatment.
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Control group
Active
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Outcomes
Primary outcome [1]
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Knee range, as measured by a goniometer by a blinded assessor
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Assessment method [1]
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Timepoint [1]
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End of day 1, 2, and 3 post surgery
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Primary outcome [2]
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Ability to perform straight leg raise as assessed by a blinded assessor, with a goniometer to measure knee angle during straight leg raise
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Assessment method [2]
307703
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Timepoint [2]
307703
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End of day 1, 2, and 3 post surgery
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Primary outcome [3]
307704
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Patient satisfaction after using the game (for intervention group) using a 4 question questionairre
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Assessment method [3]
307704
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Timepoint [3]
307704
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Once at the end of day 3 post surgery
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Secondary outcome [1]
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Pain score at rest - using a verbal numerical scale or simple pain description scale.
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Assessment method [1]
352509
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Timepoint [1]
352509
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Post operative day 1, 2 and 3
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Secondary outcome [2]
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Level of assistance and gait aid required during therapy sessions post surgery. This assessment will be based on clinical judgement by the treating physiotherapist and documented in the patients charts.
This information will be pulled from patients medical records.
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Assessment method [2]
352587
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Timepoint [2]
352587
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Post operative day 1, 2, 3
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Eligibility
Key inclusion criteria
The inclusion criteria for research participants are:
1. Age between 50-85 years
2. Had undergone primary unilateral TKA for knee osteoarthritis
3. Premorbid ambulant
4. Able to follow game instructions
5. Able to use an electronic device (e.g. iPad) other than making a phone call
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Minimum age
50
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
The exclusion criteria for research participants are:
1. Had revision TKA
2. Had a history of lower limb fracture
3. Had a history of stroke or other neurological disorders (e.g. Parkinson's disease, dementia)
4. Had developed intra- or post-operative medical or surgical complications
5. Required knee brace post-operation
6. Had visual or auditory impairment
7. Colour blind
8. Sensitive to silicone
9. With Multidrug-Resistant Organisms (MDRO)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation was done by study team member who is not involved in recruitment of subjects/participants
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation done by computer generated sequence
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
16/10/2018
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Actual
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Date of last participant enrolment
Anticipated
4/03/2019
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
20896
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Singapore
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State/province [1]
20896
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singapore
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Funding & Sponsors
Funding source category [1]
300845
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Hospital
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Name [1]
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Singapore General Hospital
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Address [1]
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Outram Rd, Singapore 169608
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Country [1]
300845
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Singapore
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Primary sponsor type
Individual
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Name
Samantha Koh
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Address
Singapore General Hospital
Department of Physiotherapy
Outram Rd, Singapore 169608
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Country
Singapore
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Secondary sponsor category [1]
300393
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None
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Name [1]
300393
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-
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Address [1]
300393
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-
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Country [1]
300393
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Other collaborator category [1]
280378
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Individual
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Name [1]
280378
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Eleanor Chew
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Address [1]
280378
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Singapore General Hospital
Department of Physiotherapy
Outram Rd, Singapore 169608
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Country [1]
280378
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Singapore
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301613
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Centralised Institutional Review Board - SingHealth Research
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Ethics committee address [1]
301613
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Outram Road, Singapore 169608
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Ethics committee country [1]
301613
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Singapore
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Date submitted for ethics approval [1]
301613
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21/02/2018
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Approval date [1]
301613
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27/02/2018
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Ethics approval number [1]
301613
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2017/2965
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Summary
Brief summary
All patients who undergo total knee arthroplasty (TKA) in Singapore General Hospital (SGH) are managed using a coordinated clinical pathway to ensure standardised medical, pharmacologic and rehabilitation care. Most TKA patients receive standard physiotherapy intervention daily as per protocol from postoperative day 1 (POD 1) onwards, which include knee range-of-motion (ROM) and muscle strengthening exercises. Considering the replicated protocol-based nature of standard physiotherapy care delivered by physiotherapists, the study team will introduce a game-based application, SuperGramps, to deliver equivalent exercises for TKA patients. SuperGramps was developed in the 2017 SIngHealth Hackathon to aid in the rehabilitation of patients in the hospital. It is expected that TKA patients will improve their knee ROM and strength by playing the game. The study will evaluate the effectiveness of the game play versus standard physiotherapy intervention for TKA patients in terms of clinical outcomes as well as patient satisfaction. If the game-based application is feasible to provide non-inferior rehabilitation for TKA patients, physiotherapists will therefore be freed up to attend more complex cases. This will address the increasing manpower needs for therapists and demand for healthcare services in Singapore.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Ms Samantha Koh
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Address
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Singapore General Hospital
Department of Physiotherapy
Outram Rd, Singapore 169608
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Country
87558
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Singapore
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Phone
87558
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+65 81821542
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Fax
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Email
87558
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[email protected]
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Contact person for public queries
Name
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Samantha Koh
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Address
87559
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Singapore General Hospital
Department of Physiotherapy
Outram Rd, Singapore 169608
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Country
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Singapore
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Phone
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+65 81821542
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Fax
87559
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Email
87559
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[email protected]
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Contact person for scientific queries
Name
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Samantha Koh
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Address
87560
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Singapore General Hospital
Department of Physiotherapy
Outram Rd, Singapore 169608
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Country
87560
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Singapore
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Phone
87560
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+65 81821542
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Fax
87560
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Email
87560
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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