Tao Gordon, Miller William C, Eng Janice J, Lindstrom Heather, Imam Bita, Payne Michael
The University of British Columbia, Vancouver, BC, Canada.
University of Alberta, Edmonton, AB, Canada.
Prosthet Orthot Int. 2020 Apr;44(2):52-59. doi: 10.1177/0309364620906272. Epub 2020 Mar 1.
While home-based exergames help overcome accessibility barriers to rehabilitation, it is unclear what constitutes effective intervention design in using exergames to support self-efficacy and engagement.
Examine usage of an in-home exergame, compared to control, unsupervised after supervised training by older persons with lower-limb amputation.
Secondary analysis of a multi-site parallel evaluator-masked randomized control trial.
WiiNWalk uses the WiiFit and teleconferencing for in-home group-based exergame therapy with clinical supervision. Participants engaged in a 4-week supervised training phase followed by a 4-week unsupervised phase in experimental (WiiNWalk) and attention control groups. Usage between phases and between groups was compared using unsupervised/supervised ratio of session count (over 4 weeks) and session time (mean min/session over 4 weeks) for each phase.
Participants: n=36 experimental, n=28 control, unilateral lower-limb amputation, age > 50 years, prosthesis usage ≥ 2 hours/day. Session count ratio unsupervised/supervised, median and interquartile range (IQR), was less than parity (<0.01) for experimental (0.25, IQR 0.00 -0.68) and control (0.18, IQR 0.00 -0.67) groups, with no different between groups (=0.92). Experimental session time unsupervised/supervised showed consistency (1.12, IQR 0.80 -1.41) between phases (=0.24); control showed lower (0.76, IQR 0.57 -1.08) ratios compared to experimental (=0.027).
Unsupervised exercise duration remained consistent with supervised, but frequency was reduced. Social and clinical guidance features may remain necessary for sustained lower-limb amputation exergame engagement at home.
This study provides context regarding when prosthesis users are more likely to use exergames such as Wii Fit for exercise therapy. Clinicians may consider our results when applying exergames in their practice or when developing new exergame intervention strategies.
虽然居家运动游戏有助于克服康复过程中的可达性障碍，但目前尚不清楚在利用运动游戏支持自我效能感和参与度方面，什么构成有效的干预设计。
研究与对照组相比，下肢截肢老年人在接受监督训练后进行无监督的居家运动游戏的使用情况。
对一项多中心平行评估者盲法随机对照试验进行二次分析。
WiiNWalk利用WiiFit和电话会议进行基于家庭小组的运动游戏治疗，并接受临床监督。参与者在实验（WiiNWalk）组和注意力控制组中进行为期4周的监督训练阶段，随后是为期4周的无监督阶段。使用每个阶段无监督/监督的会话次数（4周内）和会话时间（4周内平均分钟/会话）的比率来比较各阶段之间以及各小组之间的使用情况。
参与者：实验组n = 36，对照组n = 28，单侧下肢截肢，年龄> 50岁，假体使用时间≥ 2小时/天。实验组（0.25，四分位间距IQR 0.00 - 0.68）和对照组（0.18，IQR 0.00 - 0.67）无监督/监督的会话次数比率，中位数和四分位间距均小于1（<0.01），两组之间无差异（P = 0.92）。实验组无监督/监督的会话时间在各阶段之间显示出一致性（1.12，IQR 0.80 - 1.41）（P = 0.24）；与实验组相比，对照组显示出较低的比率（0.76，IQR 0.57 - 1.08）（P = 0.027）。
无监督运动的持续时间与有监督的一致，但频率降低。社交和临床指导功能对于在家中持续进行下肢截肢运动游戏可能仍然是必要的。
本研究提供了有关假肢使用者何时更有可能使用诸如Wii Fit之类的运动游戏进行运动治疗的背景信息。临床医生在将运动游戏应用于实践或制定新的运动游戏干预策略时可考虑我们的结果。
