用于上肢治疗的关节特定游戏控制器：腕部损伤儿童的可行性研究
Joint-Specific Play Controller for Upper Extremity Therapy: Feasibility Study in Children With Wrist Impairment.
作者信息
Wilcox Bethany J, Wilkins Megan M, Basseches Benjamin, Schwartz Joel B, Kerman Karen, Trask Christine, Brideau Holly, Crisco Joseph J
机构信息
B.J. Wilcox, PhD, Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin St, CORO West, Ste 404, Providence, RI 02903 (USA).
M.M. Wilkins, PT, DPT, Meeting Street, Providence, Rhode Island.
出版信息
Phys Ther. 2016 Nov;96(11):1773-1781. doi: 10.2522/ptj.20150493. Epub 2016 May 19.
BACKGROUND
Challenges with any therapeutic program for children include the level of the child's engagement or adherence. Capitalizing on one of the primary learning avenues of children, play, the approach described in this article is to develop therapeutic toy and game controllers that require specific and repetitive joint movements to trigger toy/game activation.
OBJECTIVE
The goal of this study was to evaluate a specially designed wrist flexion and extension play controller in a cohort of children with upper extremity motor impairments (UEMIs). The aim was to understand the relationship among controller play activity, measures of wrist and forearm range of motion (ROM) and spasticity, and ratings of fun and difficulty.
DESIGN
This was a cross-sectional study of 21 children (12 male, 9 female; 4-12 years of age) with UEMIs.
METHODS
All children participated in a structured in-clinic play session during which measurements of spasticity and ROM were collected. The children were fitted with the controller and played with 2 toys and 2 computer games for 5 minutes each. Wrist flexion and extension motion during play was recorded and analyzed. In addition, children rated the fun and difficulty of play.
RESULTS
Flexion and extension goal movements were repeatedly achieved by children during the play session at an average frequency of 0.27 Hz. At this frequency, 15 minutes of play per day would result in approximately 1,700 targeted joint motions per week. Play activity was associated with ROM measures, specifically supination, but toy perception ratings of enjoyment and difficulty were not correlated with clinical measures.
LIMITATIONS
The reported results may not be representative of children with more severe UEMIs.
CONCLUSIONS
These outcomes indicate that the therapeutic controllers elicited repetitive goal movements and were adaptable, enjoyable, and challenging for children of varying ages and UEMIs.
背景
任何针对儿童的治疗方案都面临挑战，其中包括儿童的参与度或依从性。利用儿童主要的学习途径之一——玩耍，本文所描述的方法是开发治疗性玩具和游戏控制器，这些控制器需要特定且重复的关节运动来触发玩具/游戏激活。
目的
本研究的目的是在一组上肢运动障碍（UEMI）儿童中评估一种专门设计的手腕屈伸游戏控制器。目的是了解控制器游戏活动、手腕和前臂活动范围（ROM）及痉挛测量值之间的关系，以及趣味性和难度评分。
设计
这是一项对21名患有UEMI的儿童（12名男性，9名女性；4至12岁）进行的横断面研究。
方法
所有儿童都参加了一次结构化的门诊游戏环节，在此期间收集痉挛和ROM测量值。给儿童佩戴上控制器，让他们分别玩2个玩具和2款电脑游戏，每次玩5分钟。记录并分析游戏过程中的手腕屈伸运动。此外，儿童对游戏的趣味性和难度进行评分。
结果
在游戏环节中，儿童反复实现屈伸目标动作，平均频率为0.27赫兹。以这个频率，每天玩15分钟每周将产生约1700次目标关节运动。游戏活动与ROM测量值相关，特别是旋后，但玩具的趣味性和难度感知评分与临床测量值无关。
局限性
报告的结果可能不代表患有更严重UEMI的儿童。
结论
这些结果表明，治疗性控制器引发了重复性目标动作，对不同年龄和患有UEMI的儿童具有适应性、趣味性和挑战性。
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