Effects of an interactive handgrip game on surgical patients requiring intensive care: An assessor-blinded randomized controlled trial

Objective: To explore the effect of an interactive handgrip game on psychological distress and handgrip strength among critically ill surgical patients. Design: A randomised controlled trial. Setting: A surgical intensive care unit. Intervention: Participants were enrolled in the program within 48 hours of admission to the intensive care unit. Patients in the intervention group played a 20-minute interactive handgrip game twice daily for a maximum of three days in the intensive care unit in addition to routinely passive physical rehabilitation. Patients in the routine care group had a daily target of 20 min of passive physical rehabilitation as needed. Measurement: The primary outcomes included depression, anxiety, and stress measured using the shortened version of the Depression Anxiety Stress Score scale. The secondary outcomes were perceived sleep evaluated using the Richards–Campbell Sleep Questionnaire, delirium assessed using the Intensive Care Delirium Screening Checklist, and handgrip strength measured using handgrip dynamometry within a handgrip device. Results: Two hundred and twenty-seven patients were eligible and 70 patients were recruited in the intervention (n = 35) and routine care groups (n = 35). The patients in the intervention group had lower scores (median = 6.0, 4.0, and 12.0) for depression, anxiety, and stress compared with those in the routine care group (12.0, 12.0, and 20.0; all p < 0.05). The interactive handgrip game did not significantly improve sleep quality and prevent the occurrence of delirium (both p > 0.05). The patients who received the interactive handgrip game intervention exhibited significantly enhanced handgrip strength in both hands over time (both p < 0.001). Conclusion: An interactive handgrip game may benefit the psychological well-being and handgrip strength of critically ill patients. Implications for Clinical Practice: Interactive handgrip games is effective active exercise which should be integrated into routine nursing practice.