National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy.
Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Cerebellum. 2021 Jun;20(3):361-373. doi: 10.1007/s12311-020-01210-x. Epub 2020 Nov 14.
There are no currently available disease-modifying pharmacological treatments for most of the chronic hereditary ataxias; thus, effective rehabilitative strategies are crucial to help improve symptoms and therefore the quality of life. We propose to gather all available evidence on the use of video games, exergames, and apps for tablet and smartphone for the rehabilitation, diagnosis, and assessment of people with ataxias. Relevant literature published up to June 8, 2020, was retrieved searching the databases PubMed, ISI Web of Science, and the Cochrane Database. Data were extracted using a standardized form, and their methodological quality was assessed using RoB and QUADAS-2. Six studies of 434 retrieved articles met the predefined inclusion/exclusion criteria. Two of them were diagnostic, while 4 were experimental studies. Studies included participants ranging from 9 to 28 in trials and 70 to 248 in diagnostic studies. Although we found a small number of trials and of low methodological quality, all of them reported an improvement of motor outcomes and quality of life as measured by specific scales, including the SARA, BBS, DHI, and SF-36 scores. The main reason for such low quality in trials was that most of them were small and uncontrolled, thus non-randomized and unblinded. As video games, exergames, serious games, and apps were proven to be safe, feasible, and at least as effective as traditional rehabilitation, further and more high-quality studies should be carried out on the use of these promising technologies in people with different types of ataxia.
目前大多数慢性遗传性共济失调尚无可用的疾病修正药物治疗方法；因此，有效的康复策略对于改善症状和生活质量至关重要。我们建议收集所有关于视频游戏、运动游戏和平板电脑及智能手机应用程序在共济失调患者康复、诊断和评估中的应用的现有证据。截至 2020 年 6 月 8 日，检索了 PubMed、ISI Web of Science 和 Cochrane 数据库，以获取相关文献。使用标准化表格提取数据，并使用 RoB 和 QUADAS-2 评估其方法学质量。从 434 篇检索文章中筛选出符合预定义纳入/排除标准的 6 项研究。其中两项为诊断性研究，4 项为实验性研究。研究参与者的范围从试验中的 9 人到 28 人，以及诊断研究中的 70 人到 248 人。尽管我们发现试验数量较少且方法学质量较低，但所有试验均报告了运动功能和生活质量的改善，具体指标包括 SARA、BBS、DHI 和 SF-36 评分。试验质量低的主要原因是大多数试验规模较小且未进行对照，因此为非随机和非盲法。由于视频游戏、运动游戏、严肃游戏和应用程序已被证明是安全、可行的，并且至少与传统康复一样有效，因此应该在不同类型的共济失调患者中使用这些有前途的技术开展更多的高质量研究。
