Putrino David
Telemedicine and Virtual Rehabilitation, Burke Medical Research Institute, Department of Physical Medicine and Rehabilitation, Weill Medical College of Cornell University, New York, New York, USA.
Curr Opin Neurol. 2014 Dec;27(6):631-6. doi: 10.1097/WCO.0000000000000152.
Stroke is the leading cause of permanent motor disability in the United States, and the rapidly aging population makes finding large-scale treatment solutions to this problem a national priority. Telerehabilitation is an emerging approach that is being used for the effective treatment of multiple diseases, and is beginning to show promise for stroke. The purpose of this review is to identify and highlight the areas of telerehabilitation that require the most research attention.
Although there are many different forms of telerehabilitation approaches being attempted for stroke, the only approach that is currently showing moderate-strong evidence for efficacy is videogame-driven telerehabilitation (VGDT). However, targeted research is still required to determine the feasibility of VGDT: metrics regarding system usability, cost-effectiveness, and data privacy concerns still require major attention.
VGDT is an emerging approach that shows enormous promise for stroke rehabilitation. Future studies should focus less on developing custom task controllers and therapy games and more on developing innovative, online data acquisition and analytics pipelines, as well as understanding the patient population so that the rehabilitation experience can be better customized.
在美国,中风是导致永久性运动残疾的主要原因,而人口迅速老龄化使得寻找针对这一问题的大规模治疗方案成为国家优先事项。远程康复是一种新兴方法,正被用于多种疾病的有效治疗,并且开始显示出对中风治疗的前景。本综述的目的是确定并突出远程康复中最需要研究关注的领域。
尽管针对中风尝试了许多不同形式的远程康复方法,但目前唯一显示出中度至有力疗效证据的方法是电子游戏驱动的远程康复(VGDT)。然而,仍需要有针对性的研究来确定VGDT的可行性:关于系统可用性、成本效益和数据隐私问题的指标仍需要高度关注。
VGDT是一种新兴方法,对中风康复显示出巨大前景。未来的研究应减少对开发定制任务控制器和治疗游戏的关注,更多地关注开发创新的在线数据采集和分析管道,以及了解患者群体,以便更好地定制康复体验。