Active video games (AVGs) have become popular and have been investigated for their therapeutic purposes. However, the effect of AVGs on patients with knee osteoarthritis (OA) remains uncertain.

We aimed to compare the effects of AVGs with those of traditional therapeutic exercise on patients with knee OA.

This was a prospective single-blind, randomized controlled trial. Participants (n=80) with knee OA were allocated to the AVGs group (n=40) or therapeutic exercise group (n=40). Both groups received treatment 3 times a week for 4 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and secondary outcome measures were the World Health Organization Quality of Life-Brief Vision, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, physical functional performance (including time for 10-m walking and for ascending and descending stairs), Biodex Stability System, Chronic Pain Grade Questionnaire, and Work Ability Index. The patients were evaluated at baseline, 2 and 4 weeks after treatment, and 1 and 3 months after treatment completion.

Both groups showed significant time effect in the pain subcategory of the WOMAC (P=0.047). However, we found no significant group×time interaction effect between the groups at any follow-up assessments for pain (P=0.066), stiffness (P=0.284), or physical function (P=0.179) for the WOMAC. Among the secondary outcomes, we found significant group×time effects favoring the AVG group in dynamic balance (P=0.020), and physical functional performance including 10-m walking time (P=0.002) and stair ascent time (P=0.005), and the physical domain of health (P=0.032).

Therapeutic exercises and playing AVGs similarly improved the pain of patients with knee OA; however, playing AVGs improved dynamic balance, physical functional performance, and physical health more than therapeutic exercises did.