Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada.
Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Attending Physician Stroke Rehabilitation Unit, Riverview Health Centre, Winnipeg, Canada.
PM R. 2021 Jan;13(1):45-54. doi: 10.1002/pmrj.12354. Epub 2020 Apr 13.
There is a need for innovation to improve compliance and accessibility of rehabilitation programs for individuals with acquired brain injuries. A computer game-assisted tele-rehabilitation platform (GTP) has been developed to address this need. With the novel application of a miniature inertial computer mouse and taking advantage of the wide variety of computer games, the GTP can provide engaging exercises for rehabilitation of upper extremity motor skills.
To determine the feasibility and acceptability of the game-assisted home exercise program for upper extremity rehabilitation for people with stroke. The treatment effect was also measured after 16 weeks of intervention.
A feasibility study.
College of Rehabilitation Science, University of Manitoba.
Ten stroke clients.
Participants received three to four initial clinically supervised therapy sessions for training with the game assisted therapy program. Once trained, participants continued the program at the home for 16 weeks, four times per week.
Feasibility was evaluated based on retention rate and compliance. Semistructured interviews after the completion of the program were done to assess acceptability of the program. Quantitative analysis included (1) the Wolf Motor Function Test A and B and (2) a computerized performance-based assessment of specific object manipulation tasks that required a combination of finger, wrist, elbow and shoulder motion.
Findings demonstrated the feasibility and acceptability of the home tele-rehab program. Eight of the 10 participants fully complied with the 16-week exercise program. Two participants had difficulty with computer operations and did not complete the program. For the eight participants who completed the program, there was a substantial improvement from pre- to postintervention.
Although some difficulties with the technology were reported, the findings demonstrate feasible trial procedures, acceptable game-assisted task-oriented home training with a high compliance rate and positive outcomes. These findings and the theoretical evidence direct the next phase of a full-scale randomized controlled trial.
需要创新以提高后天性脑损伤患者康复计划的依从性和可及性。已经开发出一种计算机游戏辅助远程康复平台 (GTP) 来满足这一需求。利用微型惯性计算机鼠标的新颖应用，并利用各种计算机游戏的优势，GTP 可以为上肢运动技能康复提供引人入胜的练习。
确定游戏辅助上肢康复家庭锻炼计划对中风患者的可行性和可接受性。还测量了 16 周干预后的治疗效果。
可行性研究。
马尼托巴大学康复科学学院。
10 名中风患者。
参与者接受了三到四次初始的临床监督治疗课程，以接受游戏辅助治疗计划的培训。一旦接受培训，参与者在家中继续进行 16 周的每周 4 次的治疗计划。
基于保留率和依从性评估可行性。在完成计划后进行半结构化访谈，以评估计划的可接受性。定量分析包括（1）沃尔夫运动功能测试 A 和 B，以及（2）需要手指、手腕、肘部和肩部运动组合的特定物体操纵任务的基于计算机的性能评估。
研究结果表明家庭远程康复计划具有可行性和可接受性。10 名参与者中有 8 名完全遵守了 16 周的锻炼计划。有 2 名参与者由于计算机操作困难而没有完成该计划。对于完成计划的 8 名参与者，干预前后有显著改善。
尽管报告了一些与技术相关的困难，但研究结果表明可行的试验程序、可接受的游戏辅助任务导向的家庭训练，具有高依从率和积极的结果。这些发现和理论依据指导下一阶段的全面随机对照试验。
