EFFECT OF VIRTUAL REALITY GAME-BASED EXERCISES ON STRENGTH AND BALANCE IN PATIENTS WITH ANTERIOR CRUCIATE LIGAMENT (ACL) INJURY: A RANDOMIZED CONTROLLED STUDY

Abstract

Objective of the Study: To investigate and compare the effects of virtual reality (VR) game-based exercise versus conventional physiotherapy on strength and balance in patients with anterior cruciate ligament (ACL) injury. Aim of the Study: To determine whether a 3-week VR-based exercise intervention is more effective than traditional isometric and stretching exercises in improving functional outcomes such as balance, strength, and pain levels in ACL-injured individuals. Methodology: This randomized controlled trial was conducted at the Health & Wellness Physio Rehab Center over a period of 3 months. A total of 40 patients aged 20 years and above with diagnosed ACL injuries were enrolled and randomly allocated into two equal groups. Group A (Experimental) received VR game-based training focused on strength and balance, 5 sessions per week for 3 weeks. Group B (Control) received conventional physiotherapy, including isometric and stretching exercises for the knee, 5 sessions per week over 3 months. Assessment tools included ACL Functional Strength Test, Balance Error Scoring System (BESS), Numeric Pain Rating Scale (NPRS), and a demographic questionnaire. Data were analyzed using SPSS version 26, including descriptive statistics, paired and independent t-tests. Results: Both groups showed statistically significant improvements in strength and balance. However, Group A demonstrated greater improvement in functional strength (mean gain: +16.8) and balance scores (mean gain: +14.2) compared to Group B (mean strength gain: +8.1; balance gain: +6.4). Pain levels decreased more significantly in Group A (mean reduction: -3.1) than in Group B (-1.7), with p-values < 0.001 across most outcomes. The VR-based intervention achieved these results within a shorter duration of therapy. Conclusion: VR game-based rehabilitation significantly enhances strength and balance in patients with ACL injury and can be a more efficient alternative or adjunct to conventional physiotherapy. The interactive and immersive nature of VR may increase patient motivation and accelerate recovery by stimulating neuromuscular coordination and sensorimotor learning. Integration of VR into ACL rehabilitation protocols is recommended to improve clinical outcomes in a shorter time frame.