Date of Award

August 2014

Degree Type

Thesis

Degree Name

Master of Science

Department

Kinesiology

First Advisor

Jennifer Earl-Boehm

Committee Members

Monna Arvinen-Barrow, Kyle Ebersole

Keywords

Active Video Games, Ankle Sprains, Chronic Ankle Instability, Exergaming, Injury Psychology, Rehabilitation

Abstract

INTRODUCTION: Research into the treatment of acute lateral ankle sprains with individuals currently suffering from an acute injury, rather than a history of injury, is sparse. These acute injuries have psychological effects (e.g. confidence in one's readiness to return to play, changes to one's mood, adherence to the rehabilitation) to the individual that must be recognized as they have the potential to affect the rehabilitation process as much as the physical effects. In spite of previous research into the treatment of acute lateral ankle sprains the rate of recurrent injury remains high. With these recurrent ankle sprains comes the development of chronic ankle instability. Chronic ankle instability has mechanical and perceived components which factor into the extent of the condition. Individuals with long term chronic ankle instability may suffer from continued pain as well as decreased participation in physical activity and are at risk to develop early onset ankle osteoarthritis. The implementation of active video gaming within the rehabilitation environment has become popular in spite of the lack of empirical studies evaluating its effectiveness. Few studies have evaluated the use of active video gaming in a musculoskeletal context, with even fewer evaluating both the physical and psychological effects of such a modality. PURPOSE: The primary purpose of this study was to describe the functional, select psychosocial and patient-oriented outcomes of a rehabilitation program including active video gaming and a traditional rehabilitation protocol in the treatment of patients with acute lateral ankle sprains. The secondary purpose of this study was to compare and describe the functional, psychosocial, and patient-oriented outcomes of a rehabilitation program including active video gaming and a traditional rehabilitation protocol in the treatment of patients with chronic ankle instability. METHODS: Two collegiate student-athletes with acute lateral ankle sprains and 20 individuals with chronic ankle instability were recruited for the current study. Participants were randomly assigned to a traditional treatment protocol or a treatment protocol using active video games with the Xbox KinectTM during the balance training portion of their rehabilitation. Participants' static and dynamic stability, confidence in their readiness to return to play, mood states, adherence to the rehabilitation, and self-reported ankle function were recorded at multiple points during the rehabilitation. RESULTS: The acute active video gaming participant showed consistently better mood states during the balance training protocol than did the traditional participant while both showed similar improvements in balance. In the chronic condition similar improvements were seen in balance ability, confidence in their readiness to return to play, adherence to the rehabilitation, and self-reported ankle function. CONCLUSIONS: The use of active video gaming in the rehabilitation of acute lateral ankle sprains appears to have a positive effect on mood while having similar effects on balance compared to the traditional protocol. This positive effect on mood has potential benefits for one's performance in the rehabilitation but also in their confidence to return to participation in physical activity and decrease the chance for re-injury. In the rehabilitation of chronic ankle instability the comparable improvements in balance, confidence in their readiness to return to play, and self-reported ankle function provide evidence that implementing active video gaming into a rehabilitation protocol does not have any adverse effects. The improvements seen by both groups in their confidence to return to play may have potential to be a key component to a successful rehabilitation outcome in the treatment of chronic ankle instability in which perception may play a large role.

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