Skip to main content

Advertisement

SpringerLink
Log in

Is Xbox 360 Kinect-based virtual reality training as effective as standard physiotherapy in patients undergoing breast cancer surgery?

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Breast cancer surgery may be associated with pain and physical symptoms in the upper limbs. Functional impairment and pain-related avoidance of movement may further increase disability level. This study aimed to investigate the potential effects of early postoperative virtual reality (VR) therapy on pain, range of motion (ROM), muscle strength, functionality, and fear of movement.

Methods

Forty women with breast cancer who had undergone unilateral mastectomy with axillary lymph node dissection and who were receiving adjuvant therapy were included in the study and randomly assigned to two groups: the Kinect-based rehabilitation group (KBRG) and the standardized physical therapy group (SPTG). The KBRG (n = 20) received VR therapy using Xbox Kinect-based games and the SPTG (n = 20) received standard physiotherapy. Study subjects were assessed at baseline and after the 6-week treatment. Outcome measures were pain (visual analogue scale), grip strength (dynamometer), functionality (disabilities of the arm shoulder and hand questionnaire), muscle strength (handheld dynamometer), ROM (digital goniometer), and fear of movement (Tampa kinesiophobia scale (TKS)).

Results

Both groups detected significant changes in pain, ROM, muscle strength, grip strength, functionality, and TKS scores after the treatment (p < 0.01). Fear of movement was significantly improved in the KBRG and the SPTG displayed more improvement in functionality (p < 0.05). There were no differences in ROM, muscle strength, grip strength, and pain between the groups after the treatment (p > 0.05).

Conclusion

Kinect-based VR therapy resulted in significant outcomes that were comparable to those obtained under standard physiotherapy in the early postoperative phase in patients who had undergone breast cancer surgery.

Trial registration

This study is registered at ClinicalTrials.gov (ClinicalTrials.gov identifier: NCT03618433).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Zhang X, Li Y, Liu D (2019) Effects of exercise on the quality of life in breast cancer patients: a systematic review of randomized controlled trials. Support Care Cancer 27(1):9–21

    PubMed  Google Scholar 

  2. Loh SY, Musa AN (2015) Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews. Breast Cancer: Targets and Therapy 7:81

    Google Scholar 

  3. Zaidi S, Hussain S, Verma S et al (2018) Efficacy of complementary therapies in the quality of life of breast cancer survivors. Front Oncol 7:32

    Google Scholar 

  4. Mijwel S, Backman M, Bolam KA, Olofsson E, Norrbom J, Bergh J, Sundberg CJ, Wengström Y, Rundqvist H (2018) Highly favorable physiological responses to concurrent resistance and high-intensity interval training during chemotherapy: the OptiTrain breast cancer trial. Breast Cancer Res Treat 169(1):93–103

    PubMed  PubMed Central  Google Scholar 

  5. Stubblefield MD, Keole N (2014) Upper body pain and functional disorders in patients with breast cancer. PM&R 6(2):170–118

    Google Scholar 

  6. Tantawy SA, Kamel DM (2016) The effect of kinesio taping with exercise compared with exercise alone on pain, range of motion, and disability of the shoulder in postmastectomy females: a randomized control trial. J Phys Ther Sci 28(12):3300–3305

    PubMed  PubMed Central  Google Scholar 

  7. De Groef A, Van Kampen M, Vervloesem N et al (2017) Myofascial techniques have no additional beneficial effects to a standard physical therapy programme for upper limb pain after breast cancer surgery: a randomized controlled trial. Clin Rehabil 31(12):1625–1635

    PubMed  Google Scholar 

  8. Rafn BS, Hung S, Hoens AM, McNeely M, Singh CA, Kwan W, Dingee C, McKevitt E, Kuusk U, Pao J, van Laeken N, Goldsmith CH, Campbell KL (2018) Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial. Clin Rehabil 32(6):811–826

    PubMed  Google Scholar 

  9. Arman N, Tarakci E, Tarakci D, Kasapcopur O (2019) Effects of video games–based task-oriented activity training (Xbox 360 Kinect) on activity performance and participation in patients with juvenile idiopathic arthritis: a randomized clinical trial. Am J Phys Med Rehabil 98(3):174–181

    PubMed  Google Scholar 

  10. Yang Z, Rafiei MH, Hall A, Thomas C, Midtlien HA, Hasselbach A, Adeli H, Gauthier LV (2018) A novel methodology for extracting and evaluating therapeutic movements in game-based motion capture rehabilitation systems. J Med Syst 42(12):255

    PubMed  PubMed Central  Google Scholar 

  11. Da Gama A, Fallavollita P, Teichrieb V, Navab N (2015) Motor rehabilitation using Kinect: a systematic review. Games for Health Journal 4(2):123–135

    PubMed  Google Scholar 

  12. Fager SK, Burnfield JM (2014) Patients’ experiences with technology during inpatient rehabilitation: opportunities to support independence and therapeutic engagement. Disab Rehab: Assistive Technology 9(2):121–127

    Google Scholar 

  13. Parry I, Carbullido C, Kawada J, Bagley A, Sen S, Greenhalgh D, Palmieri T (2014) Keeping up with video game technology: objective analysis of Xbox Kinect™ and PlayStation 3 Move™ for use in burn rehabilitation. Burns 40(5):852–859

  14. Ding ZQ, Luo ZQ, Causo A, Chen IM, Yue KX, Yeo SH, Ling KV (2013) Inertia sensor-based guidance system for upperlimb posture correction. Med Eng Phys 35(2):269–276

    CAS  PubMed  Google Scholar 

  15. Celletti C, Fara MA, Filippi GM et al (2017) Focal muscle vibration and physical exercise in postmastectomy recovery: an explorative study. BioMed Research International 2017

  16. Zengin Alpozgen A, Razak Ozdincler A, Karanlik H, Yaman Agaoglu F, Narin AN (2017) Effectiveness of Pilates-based exercises on upper extremity disorders related with breast cancer treatment. Eur J Cancer Care 26(6):e12532

    Google Scholar 

  17. Liu L, Petrich S, McLaren B, Kelly L, Baxter GD (2018) An integrative Tai Chi program for patients with breast cancer undergoing cancer therapy: study protocol for a randomized controlled feasibility study. J Integr Med 16(2):99–105

    PubMed  Google Scholar 

  18. Wilson DJ (2017) Exercise for the patient after breast cancer surgery. Semin Oncol Nurs 33(1):98–105

    PubMed  Google Scholar 

  19. Harris SR, Schmitz KH, Campbell KL, McNeely ML (2012) Clinical practice guidelines for breast cancer rehabilitation: syntheses of guideline recommendations and qualitative appraisals. Cancer 118(S8):2312–2324

    PubMed  Google Scholar 

  20. Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8(12):1153–1157

    CAS  PubMed  Google Scholar 

  21. Wang L, Guyatt GH, Kennedy SA, Romerosa B, Kwon HY, Kaushal A, Chang Y, Craigie S, de Almeida CPB, Couban RJ, Parascandalo SR, Izhar Z, Reid S, Khan JS, McGillion M, Busse JW (2016) Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies. Can Med Assoc J 188(14):E352–E361

    Google Scholar 

  22. Smoot B, Paul SM, Aouizerat BE et al (2016) Predictors of altered upper extremity function during the first year after breast cancer treatment. Am J Phys Med Rehab/Assoc Acad Physiatrists 95(9):639

    Google Scholar 

  23. Serra-Añó P, Inglés M, Bou-Catalá C, Iraola-Lliso A, Espí-López GV (2019) Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial. Supportive Care in Cancer 1-9

  24. Donatelli R, Ellenbecker TS, Ekedahl SR, Wilkes JS, Kocher K, Adam J (2000) Assessment of shoulder strength in professional baseball pitchers. J Orthop Sports Phys Ther 30(9):544–551

    CAS  PubMed  Google Scholar 

  25. Belmonte R, Messaggi-Sartor M, Ferrer M, Pont A, Escalada F (2018) Prospective study of shoulder strength, shoulder range of motion, and lymphedema in breast cancer patients from pre-surgery to 5 years after ALND or SLNB. Support Care Cancer 26(9):3277–3287

    PubMed  Google Scholar 

  26. Smith TM, Broomhall CN (2016) Physical and psychological effects of a 12-session cancer rehabilitation exercise program. Clin J Oncol Nurs 20(6):653

    PubMed  Google Scholar 

  27. Harrington S, Michener LA, Kendig T, Miale S, George SZ (2014) Patient-reported upper extremity outcome measures used in breast cancer survivors: a systematic review. Arch Phys Med Rehabil 95(1):153–162

    PubMed  Google Scholar 

  28. Lundberg M, Styf J, Jansson B (2009) On what patients does the Tampa Scale for Kinesiophobia fit? Physiother Theor Pract 25(7):495–506

    Google Scholar 

  29. Beurskens CH, van Uden CJ, Strobbe LJ, Oostendorp RA, Wobbes T (2007) The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study. BMC Cancer 7(1):166

    PubMed  PubMed Central  Google Scholar 

  30. Zeng Y, Zhang JE, Cheng AS, Cheng H, Wefel JS (2019) Meta-analysis of the efficacy of virtual reality–based interventions in cancer-related symptom management. Integrative Cancer Ther 18:1534735419871108

    Google Scholar 

  31. Uhm KE, Lee S, Kurillo G, Han JJ, Yang JH, Yoo YB, Lee J (2019) Usefulness of Kinect sensor–based reachable workspace system for assessing upper extremity dysfunction in breast cancer patients. Supportive Care in Cancer 1-8

  32. Hidding JT, Beurskens CH, van der Wees PJ, van Laarhoven HW, Nijhuis-van der Sanden MW (2014) Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One 9(5):e96748

    PubMed  PubMed Central  Google Scholar 

  33. Harrington S, Gilchrist L, Sander A (2014) Breast cancer EDGE task force outcomes: clinical measures of pain. Rehab Oncol 32(1):13

    Google Scholar 

  34. Lee JS, Hobden E, Stiell IG, Wells GA (2003) Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med 10(10):1128–1130

    PubMed  Google Scholar 

  35. Aguilar-Lazcano CA, Rechy-Ramirez EJ, Hu H, Rios-Figueroa HV, Marin-Hernandez A (2019) Interaction modalities used on serious games for upper limb rehabilitation: a systematic review. Games Health J 8(5):313–325

    PubMed  Google Scholar 

  36. Sin H, Lee G (2013) Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia. Am J Phys Med Rehabil 92(10):871–880

    PubMed  Google Scholar 

  37. McNeely ML, Campbell K, Ospina M et al (2010) Exercise interventions for upper-limb dysfunction due to breast cancer treatment. Cochrane Database Syst Rev 6:CD005211

    Google Scholar 

  38. Muir SW, Corea CL, Beaupre L (2010) Evaluating change in clinical status: reliability and measures of agreement for the assessment of glenohumeral range of motion. North Am J Sports Phys Ther: NAJSPT 5(3):98–110

    Google Scholar 

  39. Galantino ML, Stout NL (2013) Exercise interventions for upper limb dysfunction due to breast cancer treatment. Phys Ther 93(10):1291–1297

    PubMed  Google Scholar 

  40. Htut TZC, Hiengkaew V, Jalayondeja C, Vongsirinavarat M (2018) Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial. Eur Rev Aging Phys Act 15(1):10

    PubMed  PubMed Central  Google Scholar 

  41. Nesvold IL, Reinertsen KV, Fosså SD, Dahl AA (2011) The relation between arm/shoulder problems and quality of life in breast cancer survivors: a cross-sectional and longitudinal study. J Cancer Surviv 5(1):62–72

    PubMed  Google Scholar 

  42. Campbell KL, Pusic AL, Zucker DS, McNeely ML, Binkley JM, Cheville AL, Harwood KJ (2012) A prospective model of care for breast cancer rehabilitation: function. Cancer 118(S8):2300–2311

    PubMed  Google Scholar 

  43. Karadibak D, Yavuzsen T, Saydam S (2008) Prospective trial of intensive decongestive physiotherapy for upper extremity lymphedema. J Surg Oncol 97(7):572–577

    PubMed  Google Scholar 

  44. Yelvar GDY, Çırak Y, Dalkılınç M, Demir YP, Guner Z, Boydak A (2017) Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. Eur Spine J 26(2):538–545

    Google Scholar 

  45. Kim SS, Min WK, Kim JH, Lee BH (2014) The effects of VR-based Wii fit yoga on physical function in middle-aged female LBP patients. J Phys Ther Sci 26(4):549–552

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

We are grateful to our patients for taking part in this study. Part of this study was presented at the 11th Congress of the European Pain Federation.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey

    Özlem Feyzioğlu

  2. Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey

    Özlem Feyzioğlu

  3. Department of Radiation Oncology, Ministry of Health Okmeydanı Research and Training Hospital, Istanbul, Turkey

    Selvi Dinçer

  4. Department of Breast and Endocrine Surgery, Ministry of Health Okmeydanı Research and Training Hospital, Istanbul, Turkey

    Arzu Akan

  5. Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey

    Zeliha Candan Algun

Authors
  1. Özlem Feyzioğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Selvi Dinçer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arzu Akan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zeliha Candan Algun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Özlem Feyzioğlu.

Ethics declarations

All study procedures were conducted in line with the rules and principles of the Declaration of Helsinki of the World Medical Association. The study was approved by the Ethics Committee of Acibadem Mehmet Ali Aydinlar University (Protocol ID:ATADEK-2018/9). Written informed consent was obtained from every eligible patient before the initiation of the study procedures.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Feyzioğlu, Ö., Dinçer, S., Akan, A. et al. Is Xbox 360 Kinect-based virtual reality training as effective as standard physiotherapy in patients undergoing breast cancer surgery?. Support Care Cancer 28, 4295–4303 (2020). https://doi.org/10.1007/s00520-019-05287-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-019-05287-x

Keywords

Search

Navigation