Prahm Cosima, Kayali Fares, Sturma Agnes, Aszmann Oskar
Medical University of Vienna, CD Laboratory for Restoration of Extremity Function, Spitalgasse 23, 1090 Vienna, Austria(∗).
Vienna University of Technology, HCI Group, Vienna, Austria(†).
PM R. 2018 Nov;10(11):1252-1260. doi: 10.1016/j.pmrj.2018.09.027.
Prosthetic motor rehabilitation usually relies on the highly repetitive training of movements. Patients might drop out of training because the rehabilitation process is long and often discouraging. Game-based interventions provide a potentially useful alternative to standard myoelectric (electromyographic [EMG]) training and can increase engagement with training.
To assess the short-term impact of a game-based rehabilitation protocol on parameters for EMG control, evaluate how game-based interventions affect patient motivation, performance, and effort, and compare the game-based intervention with a standard tool in rehabilitation (MyoBoy).
This randomized controlled trial included 2 patient groups and 1 control group. After establishing a baseline, the 2 patient groups received different interventions that were compared with each other and with the able-bodied control group.
University hospital-based study.
Fourteen patients with traumatic transradial or transhumeral upper extremity amputation and 10 able-bodied participants.
For the game-based intervention, EMG proficiency was assessed before and after playing the games and 2 days later as follow-up to measure retention rate. EMG proficiency was measured using maximum voluntary contraction, proportional precision control, signal separation, and muscle endurance. Questionnaires for rating the game-based intervention and intrinsic motivation were provided after the intervention.
Outcome measures for EMG proficiency were provisional maximum voluntary muscle contraction, precise proportional control, electrode separation, and muscle endurance. Quantitative outcome measures for participant experience were intrinsic motivation, enjoyment, pressure, exerted effort, and usefulness of the intervention. The qualitative outcome measure was the surveyed attitude toward the game-based intervention.
Results showed an overall improvement in EMG control, fine muscle activation, and electrode separation. Patients stated that racing games provided slightly more fun, but rhythm-based games were considered to provide better challenges for EMG control.
Game-based interventions provide a useful addition to standard EMG training and can achieve better results in clinical outcome measures. The racing and music game genres provide solid starting points for interventions. Further studies can look at a wider range of genres and identify more specific game mechanics suitable for training.
I.
假肢运动康复通常依赖于高度重复的动作训练。由于康复过程漫长且常常令人沮丧，患者可能会退出训练。基于游戏的干预为标准肌电（肌电图[EMG]）训练提供了一种潜在有用的替代方法，并且可以提高训练的参与度。
评估基于游戏的康复方案对肌电控制参数的短期影响，评估基于游戏的干预如何影响患者的动机、表现和努力程度，并将基于游戏的干预与康复中的标准工具（MyoBoy）进行比较。
这项随机对照试验包括2个患者组和1个对照组。在确定基线后，2个患者组接受不同的干预，并相互比较以及与健全对照组进行比较。
基于大学医院的研究。
14名创伤性经桡或经肱骨截肢的患者和10名健全参与者。
对于基于游戏的干预，在玩游戏前后以及2天后进行随访，评估肌电熟练程度以测量保留率。使用最大自主收缩、比例精度控制、信号分离和肌肉耐力来测量肌电熟练程度。干预后提供用于评估基于游戏的干预和内在动机的问卷。
肌电熟练程度的结果测量指标为临时最大自主肌肉收缩、精确比例控制、电极分离和肌肉耐力。参与者体验的定量结果测量指标为内在动机、享受程度、压力、付出的努力和干预的有用性。定性结果测量指标是对基于游戏的干预的调查态度。
结果显示肌电控制、精细肌肉激活和电极分离总体上有所改善。患者表示赛车游戏提供的乐趣略多，但基于节奏的游戏被认为对肌电控制提供了更好的挑战。
基于游戏的干预是标准肌电训练的有益补充，并且在临床结果测量中可以取得更好的效果。赛车和音乐游戏类型为干预提供了坚实的起点。进一步的研究可以着眼于更广泛的游戏类型，并确定更适合训练的具体游戏机制。
I级
