School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.
Clin Exp Optom. 2021 Sep;104(7):773-779. doi: 10.1080/08164622.2021.1878834. Epub 2021 Mar 1.
: Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness.: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia ('lazy eye'), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752).: Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for a total of 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyse adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries.: One hundred and five of the 115 randomised participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p < 0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time.: Adherence to home-based videogame treatment was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation.
家庭为基础的视频游戏治疗方法在弱视治疗中越来越受欢迎。然而，家庭治疗往往时间较短，经常中断，这可能会降低双眼视觉刺激的效果。在考虑剂量反应关系和治疗效果时，需要考虑这些治疗依从性模式。
家庭为基础的视频游戏治疗方法越来越多地用于各种感觉条件，包括弱视（“懒眼”），但治疗依从性仍然限制了其成功率。为了研究与家庭为基础的视频游戏治疗相关的详细行为模式，我们详细分析了双眼弱视视频游戏治疗（BRAVO）临床试验（ACTRN12613001004752）的视频游戏依从性数据。
患有单侧弱视的儿童（7-12 岁）、青少年（13-17 岁）和成年人（≥18 岁）被借给带有主动治疗或安慰剂视频游戏的 iPod Touch 设备，并被指示在家中每天总共玩 1-2 小时，为期六周。使用设备软件客观记录的依从性数据来分析依从性模式，例如会话长度、每日游戏分布、使用暂停功能以及年龄组之间的差异。还将客观记录的依从性与基于纸质的日记中主观报告的依从性进行了比较。
在 115 名随机参与者中，有 105 名完成了六周的视频游戏训练。平均依从率为规定最低时间的 65%（SD 37%）。游戏训练通常在较短的会话中进行（平均 21.5，SD 11.2 分钟），主要在晚上，频繁暂停（中位数每 4.1 分钟，IQR 6.1）。儿童的会话时间明显更短，暂停频率也高于其他年龄组（p<0.0001）。与客观记录的游戏时间相比，参与者在主观日记中往往会高估自己的依从性。
家庭为基础的视频游戏治疗的依从性特点是短时间的会话穿插频繁的暂停，表明经常脱离治疗。这使得剂量反应计算变得复杂，并可能干扰像双眼治疗弱视这样的治疗效果，因为双眼治疗需要持续的视觉刺激。
