Abdulsatar Farah, Walker Rachel G, Timmons Brian W, Choong Karen
Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON, Canada.
Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON, Canada Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
J Pediatr Rehabil Med. 2013 Jan 1;6(4):193-204. doi: 10.3233/PRM-130260.
To evaluate the safety and feasibility of virtual reality (VR) exercise as a novel acute rehabilitation intervention in a Pediatric Critical Care Unit (PCCU) setting.
Children aged 3-18 years with an anticipated PCCU stay > 48 hours, and baseline normal to moderate cognitive and functional disability were eligible. Exclusion criteria included: anticipated death, physical inability, or a contraindication to mobilization. Nintendo Wii™ Boxing was prescribed for a minimum of 10 minutes twice a day for 2 days. Primary outcomes were feasibility and safety.
Of 21 eligible patients, 12 (57.1%) were enrolled and 8 completed the study. 41.7% (5/12) were males, and the median age was 11 (3,16) years. Four of the 8 participants who received the intervention were mechanically ventilated during Wii™ play. Participants used the Wii™ a median of 2 times (1,5) over the 2-day intervention period, for a median total duration of 54.5 (15, 224) minutes. There were no adverse events attributable to the intervention. Upper limb activity during Wii™ was significantly greater than the average daily activity (p=0.049). Grip strength did not change significantly from baseline (p=0.20).
While the results of this pilot trial suggest that VR exercise may be safely applied in a subset of critically ill children, we observed several threats to its feasibility in this population.
评估虚拟现实(VR)运动作为儿科重症监护病房(PCCU)一种新型急性康复干预措施的安全性和可行性。
年龄在3 - 18岁、预计在PCCU住院时间超过48小时且基线认知和功能残疾为正常至中度的儿童符合条件。排除标准包括:预计死亡、身体无法活动或有活动禁忌证。规定使用任天堂Wii™拳击游戏,每天两次,每次至少10分钟,共进行2天。主要结局为可行性和安全性。
在21名符合条件的患者中,12名(57.1%)被纳入研究,8名完成了研究。41.7%(5/12)为男性,中位年龄为11(3,16)岁。8名接受干预的参与者中有4名在玩Wii™游戏时接受机械通气。在为期2天的干预期内,参与者使用Wii™的中位次数为2次(1,5),总时长中位值为54.5(15, 224)分钟。没有可归因于该干预措施的不良事件。玩Wii™游戏期间上肢活动明显大于平均日常活动(p = 0.049)。握力与基线相比无显著变化(p = 0.20)。
虽然这项试点试验的结果表明VR运动可能可安全应用于一部分危重症儿童,但我们在这一人群中观察到了对其可行性的若干威胁。