Mult Scler. 2016 Oct;22(12):NP9-NP11. doi: 10.1177/1352458515585718. Epub 2015 Jun 3.
In the article The use of gaming technology for rehabilitation in people with multiple sclerosis, DOI: 10.1177/1352458514563593, published in Multiple Sclerosis Volume 21 Issue 4, Table 1 was printed incorrectly. The corrected Table 1 is below:spmsj;22/12/NP9/TABLE11352458515585718T1table1-1352458515585718Table 1.Exergaming studies.Ref.PlatformParticipants and interventionOutcomesPlow and FinlaysonWiiPre-test vs. post-test repeated measures home-based Wii training.
N=30, age 43.2 ± 9.3 years, 9 ± 6.8 years since diagnosis.
3 x per week programme consisting of yoga, balance, strength, and aerobic training in each session. Wii playing minutes ranged from 10-30 minutes based on participants' RPE when playing the "Basic Run" game. No therapist monitored training in the home. Participants were telephoned every other week (a total of four times) for the first seven weeks after receiving Wii-Fit to monitor adverse events and to encourage increases in the duration or frequency of using Wii-Fit. By the end of the seven weeks, all participants were encouraged to play Wii-Fit three to five times a week for 20 to 30 mins.TUG/TUG dual task; Maximum number of push-ups; timed number of sit-ups in 60s; Maximum number of steps in three mins onto a six-inch platform; Single/double leg balance with eyes open/closed on a soft/firm surface; Physical Activity and Disability Survey; SF-36; MFIS; The barrier self-efficacy scale.Improvements pre- vs. post-test: Number of steps and push-ups; Eyes/open closed, single leg balance on firm surface.Post-test vs. follow-up (14 weeks): measures returned to baseline.Kalron et al.WiiPilot intervention. No control group.
N=32, age 43.6 ± 1.9 years, 6.9 ± 0.8 years since diagnosis, EDSS 3.1 ± 0.2.
Wii Tennis played for one session of 30 mins (3x10 mins).FRT and FSST taken pre- and post-intervention. FRT and FSST both significantly improved by 9.1% and 17.5% respectively.Prosperini et al.WiiRandomized Crossover Trial - Home-Based.
N=36, age 36.2 ± 8.6 years, 10.7 ± 5.8 years since diagnosis, and median EDSS of 3.5 (1.5-5.0). Wii group - 12-week duration, daily sessions (with the exception of the weekend) of home-based training with the Wii Balance Board, each lasting 30 mins. No intervention group - 12 weeks of no intervention. They then swapped to the Wii group after 12 weeks and the Wii group had no intervention for 12 weeks. Contact with physiotherapists every four weeks and phone contact once per week.CoP path, Four Square Step, 25-FWT, MSIS-29. Significant improvements for time × treatment interaction for all measures.Plow and FinlaysonWiiA repeated measures longitudinal design with a baseline control period.
See Plow and Finlayson Intervention: All participants were prescribed a three-times-a-week exercise programme - see Plow and Finalyson.Semi-structured interviews conducted over the phone before and after the 14-week Wii-Fit programme. Examined the usability of Nintendo Wii-Fit and identified reasons for using or not using Wii-Fit on; a regular basis.Nilsagard et al.WiiA multicentre RCT with random (1:1) allocation to exercise group or non-exercise group. Wii group: participants N=42, age 50.0 ± 11.5 years, 12.5 ± 8.0 years since. Individual physiotherapist-supervised sessions of 30 mins of balance exercise using Wii-Fit Plus twice a week for six to seven weeks, a total of 12 sessions. Non-exercise group: participants N=42, age 49.4 ± 11.1 years, 12.2 ± 9.2 years since diagnosis. This group was invited to start exercising using Wii-Fit Plus after the second data collection.TUG; TUG dual task; Four Square Step; Timed Chair Stands; 25-FWT; Dynamic Gait Index; ABC; MSWS-12. Improvements in Wii Group pre- vs. post-test: TUG dual task, Four Square Step, Timed Chair Stands, Dynamic Gait Index.Improvements in Non-exercise group pre- vs. post-test: Dynamic Gait Index.Wii vs. non-exercise at follow-up: No significant difference.Guidi et al.WiiSingle-blind, RCT.
Aged between 25-65 years, at least three years since diagnosis, EDSS score 0-3.5. Wii group (N=9) played Physiofun Balance Training - Physio Mode. Sessions 10x45-mins, twice a week for five weeks. Non-exercise group (N=8) received advice about strategies for behaviour and environment aimed at reducing falls.BBS significantly improved for Wii Group vs. Non-exercise group.Brichetto et al.WiiRCT: Wii vs. traditional rehabilitation strategies. Twelve sessions (three 60-minute sessions/week) of intervention. Wii group: participants N=18, age 40.7 ± 11.5 years, years since diagnosis 11.2 ± 6.4 years, mean EDSS 3.9 ± 1.6. One hour of supervised Wii Balance Board sessions.
participants N=18, age 43.2 ± 10.6 years, years since diagnosis 12.3 ± 7.2 years, mean EDSS 4.3 ± 1.6. Exercises consisted of static and dynamic exercises in both single leg and double leg stance, with or without an equilibrium board and half-kneeling exercises of increasing difficulty.BBS and MFIS. Postural assessment was quantified with a stabilometric platform (quiet standing, barefoot with open/closed eyes). No significant differences between the groups at baseline. Significant improvements in outcomes for both modes at post-test. A significant group × time interaction, revealing a more marked improvement for BBS score, open/closed-eye stabilometry in the Wii group compared to the control group.Ortiz-Gutiérrez, et al.KinectXbox-group: participants N=24, age 39.7 ± 8.1 years, years since diagnosis 9.7 ± 6.8. 40 sessions - four sessions per week (20 mins per session) for 10 weeks. Individual Tele-Rehabilitation treatments using commercial games. Sessions were monitored via videoconference.
participants N=23, age 42.8 ± 7.4 years, years since diagnosis 10.9 ± 5.4. Physiotherapy treatment twice a week (40 mins per session) at a clinic for 10 weeks. Low-load strength exercises, proprioception exercises on unstable surfaces, gait facilitation exercises, and muscle-tendon stretching.Computerized dynamic posturography and SOT. Improvement of general balance in both groups. Visual preference and the contribution of vestibular information, via SOT, yielded significant differences in the exercise group.Kramer et al.WiiMatched controlled trial (3 groups). Three weeks, nine supervised training sessions lasting 30 mins each.
N=23, age 42.8 ± 7.4 years, years since diagnosis 10.9 ± 5.4. Conventional balance training (control) group: Consisted of various exercises on the floor. Exergame training (playing exergames on an unstable platform) group: Wii Sports/Sports Resort/Fit games that require arm movements (tennis, table tennis, boxing, archery, and sword fight) or displacements of the whole body to control the game avatar (ski slalom, balance bubble, penguin picnic, soccer heading, tilt city, and perfect ten). Table tennis, tennis, and tilt city were the preferred games. Single task (ST) exercises on the unstable platform group.Pre- and post-testing. Combination of single and dual tasks. Six static balance tests: four balance tests on an unstable surface, and two gait analyses (normal and dual task). All groups significantly improved balance and gait measures. The exergame training group showed significantly higher improvements in the gait dual task condition compared to the single task condition. Adherence to home-based balance training was highest in the exergame group.Goble et al.WiiCase study. N=1, 28 year old Male. Relapsing-remitting MS since age 11. EDSS 5.0.
Six-week balance training, 3x30 mins per week. Wii-Fit games (yoga, table-tilt, penguin slide, ski jump and bubble balance).20s double leg standing. CoP path length (body sway). Participant relapsed after five weeks training. Follow-up measure taken post-relapse (two months). Over first two weeks 12% decrease in body sway from baseline. 22% increase in body sway over the next two weeks despite training. Relapse occurred week five. Balance impairment remained upon remittance (follow-up) when compared to week two.Forsberg et al.WiiParticipants: N=15, median age 55 years, median time since diagnosis 13 years.
See Nilsagard et al.Qualitative research approach. Interviewed (15-45 mins) within two weeks after the end of the intervention period. Interview covered reflections on using Wii-Fit for exercising. Patients considered Wii-Fit exercises to be fun, challenging, and self-motivating.*Thomas et al.WiiPublished trial methodology multicentre definitive RCT to assess the clinical and cost-effectiveness of a home-based physiotherapist-supported Wii intervention. Immediate arm (N=15): Wii training for 12 months. Delayed arm (N=15): Wii training after six months. Comparison between first six months of immediate arm vs. six months of no training in delayed group, and then 12 months of Wii training in immediate group vs. six months Wii training in delayed group.Balance, gait and mobility: Two-minute walk test, Step test, Steady stance test, Instrumented TUG, Gait stride-time rhythmicity, Static posturography.Physical activity: GLTEQ, ActivPAL.Hand dexterity/coordination: Nine-hole peg test.Self-efficacy: SCI-ESES, MSSE.Psychological well-being and QoL: HADS, EQ-5D-5L, MSIS-29, FSI, SF-36v2. Adherence to training.*published trial methodology25-FWT: 25 Foot Walk Time; ABC: Activities-specific Balance Confidence; AI: Ambulation Index; BBS: Berg Balance Score; CoP: Centre of Pressure; EDSS: Expanded Disability Status Scale; EQ-5D-5L: EuroQual 5 Dimensions-5 Levels; FRT: Functional Reach Test; FSI: Fatigue Symptom Inventory; FSST: Four Square Step Test; GLTEQ: Godin Leisure-Time Exercise Questionnaire; HADS: Hospital Anxiety and Depression Scale; MFIS: Modified Fatigue Impact Scale; MMSE: Mini-Mental State Examination; MS: Multiple Sclerosis; MSIS-29: Multiple Sclerosis Impact Scale; MSSE: Multiple Sclerosis Self-Efficacy Scale; MSWS-12: MS Walking Scale; QoL: Quality of Life; RCT: Randomized Control Trial; RPE: Ratings of Perceived Exertion; SCI-ESES: Spinal Cord Injury Exercise Self-Efficacy Scale; SF-36: Short-Form Health Survey; SOT: Sensory Organization Test; TUG: Timed-Up-and-Go.
在发表于《多发性硬化症》第21卷第4期、DOI为10.1177/1352458514563593的文章《利用游戏技术对多发性硬化症患者进行康复治疗》中,表1印刷有误。更正后的表1如下:
spmsj;22/12/NP9/TABLE11352458515585718T1table1-1352458515585718
表1. 运动游戏研究
参考文献
平台
参与者及干预措施
结果
普洛和芬利森
Wii
前测与后测重复测量的家庭式Wii训练。
N = 30,年龄43.2±9.3岁,确诊后9±6.8年。
每周3次的训练计划,每次训练包括瑜伽、平衡、力量和有氧运动。根据参与者玩“基础跑步”游戏时的主观用力程度,Wii游戏时间为10 - 30分钟。家中训练无治疗师监督。在收到Wii Fit后的前七周,每隔一周(共4次)给参与者打电话,监测不良事件并鼓励增加使用Wii Fit的时长或频率。到七周结束时,鼓励所有参与者每周玩Wii Fit三到五次,每次20到30分钟。
定时起立行走测试/定时起立行走双重任务测试;最大俯卧撑次数;60秒内定时仰卧起坐次数;三分钟内在6英寸平台上的最大步数;在柔软/坚硬表面睁眼/闭眼单腿/双腿平衡测试;身体活动与残疾调查;简明健康状况调查量表(SF - 36);改良疲劳影响量表(MFIS);障碍自我效能感量表。
步数和俯卧撑次数;睁眼/闭眼单腿在坚硬表面的平衡测试。
后测与随访(14周):各项指标恢复至基线水平。
卡尔龙等人
Wii
试点干预。无对照组。
N = 32,年龄43.6±1.9岁,确诊后6.9±0.8年,扩展残疾状态量表(EDSS)评分为3.1±0.2。
进行一次30分钟的Wii网球训练(3×10分钟)。
干预前后进行功能性前伸测试(FRT)和四方步测试(FSST)。FRT和FSST分别显著改善了9.1%和17.5%。
普罗斯佩里尼等人
Wii
随机交叉试验 - 家庭式。
N = 36,年龄36.2±8.6岁,确诊后10.7±5.8年,EDSS中位数为3.5(1.5 - 5.0)。Wii组 - 为期12周,除周末外每天在家使用Wii平衡板进行训练,每次30分钟。无干预组 - 12周不进行干预。12周后两组互换,Wii组12周不进行干预。每四周与物理治疗师联系一次,每周电话联系一次。
压力中心路径(CoP path)、四方步测试、25步步行时间测试(25 - FWT)、多发性硬化症影响量表(MSIS - 29)。所有指标在时间×治疗交互作用方面均有显著改善。
普洛和芬利森
Wii
具有基线对照期的重复测量纵向设计。
见普洛和芬利森
所有参与者均被规定每周进行三次锻炼计划 - 见普洛和芬利森。
在为期14周的Wii Fit计划前后通过电话进行半结构化访谈。考察任天堂Wii Fit的可用性,并确定定期使用或不使用Wii Fit的原因。
尼尔萨加德等人
Wii
多中心随机对照试验(RCT),随机(1:1)分配至运动组或非运动组。Wii组:参与者N = 42,年龄50.0±11.5岁,确诊后12.5±8.0年。由个体物理治疗师监督,每周两次,每次30分钟,使用Wii Fit Plus进行平衡训练,共六至七周,总计12次训练。非运动组:参与者N = 42,年龄49.4±11.1岁,确诊后12.2±9.2年。该组在第二次数据收集后被邀请开始使用Wii Fit Plus进行锻炼。
定时起立行走测试(TUG);定时起立行走双重任务测试;四方步测试;定时椅上站立测试;25步步行时间测试(25 - FWT);动态步态指数;ABC平衡信心量表;MS步行量表(MSWS - 12)。
Wii组前测与后测的改善情况:定时起立行走双重任务测试、四方步测试、定时椅上站立测试、动态步态指数。
动态步态指数。
随访时Wii组与非运动组比较:无显著差异。
圭迪等人
Wii
单盲随机对照试验。
年龄在25 - 65岁之间,确诊至少三年,EDSS评分0 - 3.5。Wii组(N = 9)进行物理功能平衡训练 - 物理模式。共10次,每次45分钟,每周两次,持续五周。非运动组(N = 8)接受关于行为和环境策略的建议,旨在减少跌倒。
Berg平衡量表(BBS)评分:Wii组与非运动组相比有显著改善。
布里切托等人
Wii
Wii与传统康复策略对比。进行12次干预(每周三次,每次60分钟)。Wii组:参与者N = 18,年龄40.7±11.5岁,确诊11.2±6.4年,平均EDSS为3.9±1.6。进行一小时的Wii平衡板监督训练。
参与者N = 18,年龄43.2±10.6岁,确诊12.3±7.2年,平均EDSS为4.3±1.6。训练包括单腿和双腿站立的静态和动态练习,有或没有平衡板,以及难度逐渐增加的半跪练习。
BBS和MFIS。使用稳定测量平台(安静站立,赤脚,睁眼/闭眼)对姿势评估进行量化。两组在基线时无显著差异。后测时两种模式的结果均有显著改善。存在显著的组×时间交互作用,表明与对照组相比,Wii组BBS评分、睁眼/闭眼稳定测量的改善更为明显。
奥尔蒂斯 - 古铁雷斯等人
Kinect
Xbox组:参与者N = 24,年龄39.7±8.1岁,确诊9.7±6.8年。共40次训练 - 每周四次(每次20分钟),持续10周。使用商业游戏进行个体远程康复治疗。训练通过视频会议进行监测。
参与者N =