Wüest Seline, Borghese Nunzio Alberto, Pirovano Michele, Mainetti Renato, van de Langenberg Rolf, de Bruin Eling D
Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport , ETH Zurich, Zurich, Switzerland .
Department of Computer Science, University of Milan , Milan, Italy .
Games Health J. 2014 Apr 1;3(2):106-114. doi: 10.1089/g4h.2013.0093.
Post-stroke recovery benefits from structured, intense, challenging, and repetitive therapy. Exergames have emerged as promising to achieve sustained therapy practice and patient motivation. This study assessed the usability and effects of exergames on balance and gait. Sixteen elderly participants were provided with the study intervention based on five newly developed exergames. The participants were required to attend 36 training sessions; lasting for 20 minutes each. Adherence, attrition and acceptance were assessed together with (1) Berg Balance Scale, (2) 7-m Timed Up and Go, (3) Short Physical Performance Battery, (4) force platform stance tests, and (5) gait analysis. Thirteen participants completed the study (18.8 percent attrition), without missing a single training session (100 percent adherence). Participants showed high acceptance of the intervention. Only minor adaptations in the program were needed based on the users' feedback. No changes in center of pressure area during quiet stance on both stable and unstable surfaces and no changes of walking parameters were detected. Scores for the Berg Balance Scale (=0.007; =0.51), the 7-m Timed Up and Go (=0.002; =0.56), and the Short Physical Performance Battery (=0.013; =0.48) increased significantly with moderate to large effect sizes. Participants evaluated the usability of the virtual reality training intervention positively. Results indicate that the intervention improves gait- and balance-related physical performance measures in untrained elderly. The present results warrant a clinical explorative study investigating the usability and effectiveness of the exergame-based program in stroke patients.
中风后的恢复得益于结构化、高强度、具有挑战性和重复性的治疗。运动游戏已成为有望实现持续治疗实践和患者积极性的方式。本研究评估了运动游戏对平衡和步态的可用性及效果。16名老年参与者接受了基于5种新开发的运动游戏的研究干预。参与者被要求参加36次训练课程，每次持续20分钟。评估了依从性、损耗率和接受度，同时还进行了（1）伯格平衡量表、（2）7米定时起立行走测试、（3）简短体能测试电池、（4）测力平台站立测试和（5）步态分析。13名参与者完成了研究（损耗率为18.8%），没有错过一次训练课程（依从率为100%）。参与者对干预表现出高度接受度。根据用户反馈，只需对程序进行微小调整。在稳定和不稳定表面上安静站立时，压力中心区域没有变化，行走参数也没有变化。伯格平衡量表（=0.007；=0.51）、7米定时起立行走测试（=0.002；=0.56）和简短体能测试电池（=0.013；=0.48）的得分显著提高，效应量为中等至大。参与者对虚拟现实训练干预的可用性给予了积极评价。结果表明，该干预可改善未经训练的老年人与步态和平衡相关的身体性能指标。目前的结果值得进行一项临床探索性研究，以调查基于运动游戏的方案在中风患者中的可用性和有效性。
