Enhancing neuromuscular function and psychological recovery in knee injury patients through an interactive line game: A sex-specific analysis of randomised controlled trials

Background Although game-based exercises for injured patients are expected to reduce post-traumatic stress disorder (PTSD) and anxiety while improving neuromuscular function and enhancing isokinetic moments, there is a lack of research. Furthermore, it is not known whether there are gender differences in these variables. Objective To verify the effects of the interactive line game (ILG) on psychophysical conditions in knee injury patients. This study also aimed to observe changes in these variables based on gender. Methods A total of 54 patients, aged between 20 and 24 years, were included. They were randomly assigned to either control group (CON, n = 28) or game exercise group (GE, n = 26), with an equal gender ratio in both groups. The ILG for the GE was performed 3 days a week for 8 weeks. Results After 8 weeks of ILG, neuromuscular function scores tended to decrease in both genders in the CON, whereas they showed an improvement in both genders in the GE. In contrast to the changes observed in the CON, the peak torque (PT) of GE males showed a significant increase only in the right hamstring ( p < 0.001), while no significant differences were found in other variables. Meanwhile, work per repetition (WR) improved in all regions for the GE male group, whereas in the GE female group, it showed a significant increase only in the right ( p < 0.01) and left ( p < 0.05) hamstrings. Notably, a significant reduction in total PTSD scores was observed in both males and females in the GE. However, for anxiety scores, a significant change was only evident in males ( p < 0.001), although differences between groups were observed for females ( p = 0.009). Conclusions This study indicates that a gamified protocol designed for patients with knee injuries could promote the development of isokinetic moments through the enhancement of neuromuscular function, thereby effectively helping to alleviate PTSD and anxiety. Specifically, it showed more pronounced results in WR compared to PT, with clearer statistical outcomes in males than in females.