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虚拟现实和任务导向训练对小儿手部烧伤后手功能和活动表现的影响:一项随机对照试验。

Effects of Virtual Reality and Task-Oriented Training on Hand Function and Activity Performance in Pediatric Hand Burns: A Randomized Controlled Trial.

机构信息

Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Qassim, Buraidah, Saudi Arabia.

Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Qassim, Buraidah, Saudi Arabia; Department of Physical Therapy, El-Sahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt.

出版信息

Arch Phys Med Rehabil. 2021 Jun;102(6):1059-1066. doi: 10.1016/j.apmr.2021.01.087. Epub 2021 Feb 20.

Abstract

OBJECTIVE

To assess the efficacy of a motion-sensing, hands-free gaming device and task-oriented training (TOT) programs on improving hand function, activity performance, and satisfaction in pediatric hand burns.

DESIGN

A randomized controlled trial.

SETTING

Outpatient rehabilitation center.

PARTICIPANTS

Fifty children with deep partial-thickness or full-thickness hand burns. (N=50; mean age, 10.70±1.64y; range, 7-14y) INTERVENTIONS: Children were randomized into 1 of the following 3 groups: the motion-sensing, hands-free gaming device group that used interactive video games plus traditional rehabilitation (TR); the TOT group that used real materials plus TR; and the control group that only received TR, all groups received the interventions 3 days per week for 8 weeks.

MAIN OUTCOME MEASURES

We assessed the children at the baseline and after 8 weeks of intervention. The primary outcome measures were the Jebsen-Taylor Hand Function Test, Duruoz Hand Index (DHI), and Canadian Occupational Performance Measure (COPM). The secondary outcome measures were range of motion (ROM) of the digits, grip strength, and pinch strengths (tip, palmer, and lateral pinch).

RESULTS

There was a significant increase in all measurements of the motion-sensing, hands-free gaming device and TOT groups compared with that of the control group postintervention (P<.05). There was no significant change in Jebsen-Taylor Hand Function Test, COPM performance, ROM, grip strength, and tip and lateral pinch strengths between the motion-sensing, hands-free gaming device group and TOT group (P>.05), whereas there was a significant increase in DHI, COPM satisfaction, and palmer pinch strength (P<.05) in the motion-sensing, hands-free gaming device group compared with the TOT group postintervention.

CONCLUSIONS

The motion-sensing, hands-free gaming device and TOT programs resulted in significant improvement in hand function, activity performance and satisfaction, ROM of the digits, grip strength, and pinch strengths in pediatric hand burns compared with the traditional hand rehabilitation.

摘要

目的

评估运动感应、免提游戏设备和以任务为导向的训练(TOT)方案在手烧伤患儿手部功能、活动表现和满意度方面的疗效。

设计

随机对照试验。

地点

门诊康复中心。

参与者

50 名手部深度部分厚度或全层烧伤的儿童。(N=50;平均年龄 10.70±1.64 岁;范围 7-14 岁)

干预措施

儿童随机分为以下 3 组之一:使用互动视频游戏加传统康复(TR)的运动感应、免提游戏设备组;使用真实材料加 TR 的 TOT 组;仅接受 TR 的对照组,所有组均在 8 周内每周接受 3 天干预。

主要结局测量

我们在基线和干预 8 周后评估儿童。主要结局测量指标是杰普森-泰勒手功能测试、杜鲁奥手指数(DHI)和加拿大职业表现测量(COPM)。次要结局测量指标是手指活动度(ROM)、握力和捏力(指尖、掌侧和侧捏)。

结果

与对照组相比,运动感应、免提游戏设备和 TOT 组在干预后所有测量指标均显著增加(P<.05)。在杰普森-泰勒手功能测试、COPM 表现、ROM、握力和指尖及侧捏强度方面,运动感应、免提游戏设备组和 TOT 组之间没有显著变化(P>.05),而在 DHI、COPM 满意度和掌侧捏力方面,运动感应、免提游戏设备组显著高于 TOT 组(P<.05)。

结论

与传统手部康复相比,运动感应、免提游戏设备和 TOT 方案在手烧伤患儿手部功能、活动表现和满意度、手指 ROM、握力和捏力方面均显著改善。

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