A real time biofeedback using Kinect and Wii to improve gait for post-total knee replacement rehabilitation: a case study report

Disabil Rehabil Assist Technol. 2016;11(3):251-62. doi: 10.3109/17483107.2015.1080767. Epub 2015 Sep 4.


Purpose: This study aimed to develop a low-cost real-time biofeedback system to assist with rehabilitation for patients following total knee replacement (TKR) and to assess its feasibility of use in a post-TKR patient case study design with a comparison group.

Method: The biofeedback system consisted of Microsoft Kinect(TM) and Nintendo Wii balance board with a dedicated software. A six-week inpatient rehabilitation program was augmented by biofeedback and tested in a single patient following TKR. Three patients underwent a six weeks standard rehabilitation with no biofeedback and served as a control group. Gait, function and pain were assessed and compared before and after the rehabilitation.

Results: The biofeedback software incorporated real time visual feedback to correct limb alignment, movement pattern and weight distribution. Improvements in pain, function and quality of life were observed in both groups. The strong improvement in the knee moment pattern demonstrated in the case study indicates feasibility of the biofeedback-augmented intervention.

Conclusion: This novel biofeedback software has used simple commercially accessible equipment that can be feasibly incorporated to augment a post-TKR rehabilitation program. Our preliminary results indicate the potential of this biofeedback-assisted rehabilitation to improve knee function during gait. Research is required to test this hypothesis. Implications for Rehabilitation The real-time biofeedback system developed integrated custom-made software and simple low-cost commercially accessible equipment such as Kinect and Wii board to provide augmented information during rehabilitation following TKR. The software incorporated key rehabilitation principles and visual feedback to correct alignment of the lower legs, pelvic and trunk as well as providing feedback on limbs weight distribution. The case study patient demonstrated greater improvement in their knee function where a more normal biphasic knee moment was achieved following the six-week biofeedback intervention.

Keywords: Biofeedback; exercises; knee replacement; rehabilitation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Biofeedback, Psychology / instrumentation*
  • Exercise Therapy / methods*
  • Female
  • Gait*
  • Humans
  • Male
  • Middle Aged
  • Pain / rehabilitation
  • Postural Balance
  • Quality of Life
  • Video Games*