title: Xbox Kinect™ based rehabilitation as a feasible adjunct for minor upper limb burns rehabilitation: A pilot RCT.
abstract: BACKGROUND
  Rehabilitation following burns is integral to improving physical and psychological outcomes. Interactive video game consoles are emerging as therapeutic adjuncts due to their ease of use, affordability, and interactive gameplay. The Xbox Kinect™ has advantage over similar consoles, with controller free interaction utilising three dimensional motion capture software. Player movements during gameplay have been shown to be comparable to completing daily tasks and therefore the Xbox Kinect™ has potential for use as a rehabilitation tool.
  
  
  OBJECTIVE
  The objectives of this pilot study were to compare the efficacy of the Xbox Kinect™ with conventional physiotherapy as an adjunctive tool to promote activity and, to explore their efficacy in influencing functionality and pain.
  
  
  METHODS
  A randomised controlled clinical trial design was used. Intervention group participants were asked to complete two daily 30min exercise sessions consisting of 15min of self-directed physiotherapy exercise followed by 15min of Xbox Kinect™ activities, based on location of burn. Control group participants were asked to complete two daily 30min exercise sessions of self-directed physiotherapy exercises involving two 15min sets of exercises, standardised for location of burn. Participants were recruited for a maximum of 7 days. Outcomes assessed included daily activity time, treatment satisfaction, upper limb disability, pain, and self-reported fear of movement (kinesiophobia).
  
  
  RESULTS
  A sample of 30 burn patients admitted to Royal Perth Hospital was randomised into intervention and control groups. The intervention group demonstrated significantly greater total activity time compared to control group (median 49.4 and 26.7min respectively, p<0.0001), irrespective of total burns surface area (TBSA). Significantly greater satisfaction scores were also demonstrated in the intervention group compared to controls (median 8.53 vs 7.8 respectively, p<0.0001). There was no evidence to support differences between group measures for upper limb disability, pain and fear avoidance of movement.
  
  
  CONCLUSIONS
  The Xbox Kinect™ is a useful tool in increasing rehabilitation exercise time and patient satisfaction compared to conventional physiotherapy without indication of concurrent negative effects on patient recovery.
authors.affiliation: University of Western Australia, School of Medicine and Dentistry, Crawley, WA 6009, Australia.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Voon
authors.affiliation: University of Western Australia, School of Medicine and Dentistry, Crawley, WA 6009, Australia.
authors.forename: Ilan
authors.initials: I
authors.lastname: Silberstein
authors.affiliation: University of Western Australia, School of Medicine and Dentistry, Crawley, WA 6009, Australia.
authors.forename: Aditya
authors.initials: A
authors.lastname: Eranki
authors.affiliation: Harry Perkins Institute for Medical Research, University of Western Australia; Royal Perth Hospital, Perth, WA 6000, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Phillips
authors.affiliation: State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, WA 6150, Australia; Burn Injury Research Unit, University of Western Australia, Crawley, WA 6009, Australia; Fiona Wood Foundation, Murdoch, WA 6150, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Wood
authors.affiliation: State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, WA 6150, Australia; Burn Injury Research Unit, University of Western Australia, Crawley, WA 6009, Australia; Fiona Wood Foundation, Murdoch, WA 6150, Australia; Burn Injury Research Node, The University of Notre Dame, Fremantle, WA, Australia. Electronic address: dale.edgar@health.wa.gov.au.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Edgar
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001134:Arm Injuries / Q000534:rehabilitation*; D001830:Body Surface Area; D002056:Burns / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000534:rehabilitation*; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D034941:Upper Extremity; D018910:Video Games
keywords: Acute burn; Minor burn; Physical therapy; Rehabilitation; Video games; Xbox Kinect™