Prahm Cosima, Vujaklija Ivan, Kayali Fares, Purgathofer Peter, Aszmann Oskar C
Christian Doppler Laboratory for Restoration of Extremity Function, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria.
Clinic for Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, Department of Neurorehabilitation Systems, University Medical Center Göttingen, Göttingen, Germany.
JMIR Serious Games. 2017 Feb 9;5(1):e3. doi: 10.2196/games.6026.
A high number of upper extremity myoelectric prosthesis users abandon their devices due to difficulties in prosthesis control and lack of motivation to train in absence of a physiotherapist. Virtual training systems, in the form of video games, provide patients with an entertaining and intuitive method for improved muscle coordination and improved overall control. Complementary to established rehabilitation protocols, it is highly beneficial for this virtual training process to start even before receiving the final prosthesis, and to be continued at home for as long as needed.
The aim of this study is to evaluate (1) the short-term effects of a commercially available electromyographic (EMG) system on controllability after a simple video game-based rehabilitation protocol, and (2) different input methods, control mechanisms, and games.
Eleven able-bodied participants with no prior experience in EMG control took part in this study. Participants were asked to perform a surface EMG test evaluating their provisional maximum muscle contraction, fine accuracy and isolation of electrode activation, and endurance control over at least 300 seconds. These assessments were carried out (1) in a Pregaming session before interacting with three EMG-controlled computer games, (2) in a Postgaming session after playing the games, and (3) in a Follow-Up session two days after the gaming protocol to evaluate short-term retention rate. After each game, participants were given a user evaluation survey for the assessment of the games and their input mechanisms. Participants also received a questionnaire regarding their intrinsic motivation (Intrinsic Motivation Inventory) at the end of the last game.
Results showed a significant improvement in fine accuracy electrode activation (P<.01), electrode separation (P=.02), and endurance control (P<.01) from Pregaming EMG assessments to the Follow-Up measurement. The deviation around the EMG goal value diminished and the opposing electrode was activated less frequently. Participants had the most fun playing the games when collecting items and facing challenging game play.
Most upper limb amputees use a 2-channel myoelectric prosthesis control. This study demonstrates that this control can be effectively trained by employing a video game-based rehabilitation protocol.
大量上肢肌电假肢使用者因假肢控制困难以及在没有物理治疗师的情况下缺乏训练动力而放弃使用他们的设备。以电子游戏形式存在的虚拟训练系统为患者提供了一种有趣且直观的方法，以改善肌肉协调性并提高整体控制能力。作为既定康复方案的补充，在甚至还未收到最终假肢之前就开始这种虚拟训练过程，并根据需要在家中持续进行，这是非常有益的。
本研究的目的是评估（1）一种市售肌电图（EMG）系统在基于简单电子游戏的康复方案后对可控性的短期影响，以及（2）不同的输入方法、控制机制和游戏。
11名此前无肌电控制经验的身体健全参与者参与了本研究。要求参与者进行一项表面肌电测试，评估他们的临时最大肌肉收缩、电极激活的精细准确性和分离度，以及至少300秒的耐力控制。这些评估在以下阶段进行：（1）在与三款肌电控制电脑游戏交互之前的游戏前阶段；（2）在玩完游戏后的游戏后阶段；（3）在游戏方案后的两天随访阶段，以评估短期保留率。在每款游戏后，给参与者一份用户评估调查问卷，以评估游戏及其输入机制。在最后一款游戏结束时，参与者还收到一份关于他们内在动机（内在动机量表）的问卷。
结果显示，从游戏前的肌电评估到随访测量，电极激活的精细准确性（P<0.01）、电极分离度（P=0.02）和耐力控制（P<0.01）有显著改善。肌电目标值周围的偏差减小，对侧电极的激活频率降低。参与者在收集物品和面对具有挑战性的游戏玩法时玩游戏最开心。
大多数上肢截肢者使用双通道肌电假肢控制。本研究表明，通过采用基于电子游戏的康复方案可以有效训练这种控制。
