1 RREACH (Robotics for Rehabilitation Exercise and Assessment in Collaborative Healthcare) Lab, Department of Mechanical Engineering, The University of British Columbia , Vancouver, Canada .
2 Sunny Hill Health Centre for Children , Therapy Department, Vancouver, Canada .
Games Health J. 2018 Jun;7(3):197-207. doi: 10.1089/g4h.2017.0137. Epub 2018 Mar 22.
To identify the factors that influence the use of an at-home virtual rehabilitation gaming system from the perspective of therapists, engineers, and adults and adolescents with hemiparesis secondary to stroke, brain injury, and cerebral palsy.
This study reports on qualitative findings from a study, involving seven adults (two female; mean age: 65 ± 8 years) and three adolescents (one female; mean age: 15 ± 2 years) with hemiparesis, evaluating the feasibility and clinical effectiveness of a home-based custom-designed virtual rehabilitation system over 2 months. Thematic analysis was used to analyze qualitative data from therapists' weekly telephone interview notes, research team documentation regarding issues raised during technical support interactions, and the transcript of a poststudy debriefing session involving research team members and collaborators.
Qualitative themes that emerged suggested that system use was associated with three key factors as follows: (1) the technology itself (e.g., characteristics of the games and their clinical implications, system accessibility, and hardware and software design); (2) communication processes (e.g., preferences and effectiveness of methods used during the study); and (3) knowledge and training of participants and therapists on the technology's use (e.g., familiarity with Facebook, time required to gain competence with the system, and need for clinical observations during remote therapy). Strategies to address these factors are proposed.
Lessons learned from this study can inform future clinical and implementation research using commercial videogames and social media platforms. The capacity to track compensatory movements, clinical considerations in game selection, the provision of kinematic and treatment progress reports to participants, and effective communication and training for therapists and participants may enhance research success, system usability, and adoption.
从治疗师、工程师以及脑卒中、脑损伤和脑瘫后偏瘫的成人和青少年的角度，确定影响家庭虚拟康复游戏系统使用的因素。
本研究报告了一项研究的定性结果，该研究纳入了 7 名偏瘫成人（2 名女性；平均年龄：65±8 岁）和 3 名偏瘫青少年（1 名女性；平均年龄：15±2 岁），评估了 2 个月内家庭使用定制的基于虚拟现实的康复系统的可行性和临床效果。采用主题分析法对治疗师每周电话访谈记录、研究团队关于技术支持互动中提出问题的文件以及包括研究团队成员和合作者在内的研究后汇报会议记录中的定性数据进行分析。
出现的定性主题表明，系统的使用与以下三个关键因素有关：（1）技术本身（例如，游戏的特征及其临床意义、系统的可访问性以及硬件和软件设计）；（2）沟通流程（例如，研究过程中使用的方法的偏好和效果）；（3）参与者和治疗师对技术使用的知识和培训（例如，对 Facebook 的熟悉程度、掌握系统所需的时间以及远程治疗期间进行临床观察的需求）。提出了针对这些因素的策略。
本研究中的经验教训可为未来使用商业视频游戏和社交媒体平台的临床和实施研究提供信息。跟踪代偿性运动的能力、游戏选择的临床考虑、向参与者提供运动学和治疗进展报告的能力以及治疗师和参与者的有效沟通和培训，可能会提高研究成功率、系统可用性和采用率。
