Xu Yangfan, Tong Meiqinzi, Ming Wai-Kit, Lin Yangyang, Mai Wangxiang, Huang Weixin, Chen Zhuoming
The First Affiliated Hospital of Jinan University, Guangzhou, China.
The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
JMIR Serious Games. 2021 Mar 24;9(1):e20916. doi: 10.2196/20916.
The use of virtual reality is popular in clinical rehabilitation, but the effects of using commercial virtual reality games in patients with stroke have been mixed.
We developed a depth camera-based, task-specific virtual reality game, Stomp Joy, for poststroke rehabilitation of the lower extremities. This study aims to assess its feasibility and clinical efficacy.
We carried out a feasibility test for Stomp Joy within representative user groups. Then, a clinical efficacy experiment was performed with a randomized controlled trial, in which 22 patients with stroke received 10 sessions (2 weeks) of conventional physical therapy only (control group) or conventional physical therapy plus 30 minutes of the Stomp Joy intervention (experimental group) in the clinic. The Fugl-Meyer Assessment for Lower Extremity (FMA-LE), Modified Barthel Index (MBI), Berg Balance Scale (BBS) score, single-leg stance (SLS) time, dropout rate, and adverse effects were recorded.
This feasibility test showed that Stomp Joy improved interest, pressure, perceived competence, value, and effort using the Intrinsic Motivation Inventory. The clinical efficacy trial showed a significant time-group interaction effect for the FMA-LE (P=.006), MBI (P=.001), BBS (P=.004), and SLS time (P=.001). A significant time effect was found for the FMA-LE (P=.001), MBI (P<.001), BBS (P<.001), and SLS time (P=.03). These indicated an improvement in lower extremity motor ability, basic activities of daily living, balance ability, and single-leg stance time in both groups after 2 weeks of the intervention. However, no significant group effects were found for the FMA-LE (P=.06), MBI (P=.76), and BBS (P=.38), while a significant group interaction was detected for SLS time (P<.001). These results indicated that the experimental group significantly improved more in SLS time than did the control group. During the study, 2 dropouts, including 1 participant who fell, were reported.
Stomp Joy is an effective depth camera-based virtual reality game for replacing part of conventional physiotherapy, achieving equally effective improvement in lower extremity function among stroke survivors. High-powered randomized controlled studies are now needed before recommending the routine use of Stomp Joy in order to confirm these findings by recruiting a large sample size.
虚拟现实技术在临床康复中应用广泛，但使用商业虚拟现实游戏对中风患者的疗效不一。
我们开发了一款基于深度摄像头的、针对特定任务的虚拟现实游戏“踩欢乐”，用于中风后下肢康复。本研究旨在评估其可行性和临床疗效。
我们在具有代表性的用户群体中对“踩欢乐”进行了可行性测试。然后，进行了一项随机对照试验的临床疗效实验，22名中风患者在诊所接受仅10节（2周）常规物理治疗（对照组）或常规物理治疗加30分钟“踩欢乐”干预（实验组）。记录下肢Fugl-Meyer评估（FMA-LE）、改良Barthel指数（MBI）、Berg平衡量表（BBS）评分、单腿站立（SLS）时间、退出率和不良反应。
该可行性测试表明，使用内在动机量表，“踩欢乐”提高了兴趣、压力、自我效能感、价值感和努力程度。临床疗效试验显示，FMA-LE（P = 0.006）、MBI（P = 0.001）、BBS（P = 0.004）和SLS时间（P = 0.001）存在显著的时间-组交互效应。FMA-LE（P = 0.001）、MBI（P < 0.001）、BBS（P < 0.001）和SLS时间（P = 0.03）存在显著的时间效应。这些表明干预2周后两组下肢运动能力、日常生活基本活动能力、平衡能力和单腿站立时间均有所改善。然而，FMA-LE（P = 0.06）、MBI（P = 0.76）和BBS（P = 0.38）未发现显著的组间效应，而SLS时间存在显著的组间交互作用（P < 0.001）。这些结果表明，实验组在SLS时间上的改善明显优于对照组。研究期间，报告了2例退出者（包括1例跌倒参与者）。
“踩欢乐”是一款基于深度摄像头的有效虚拟现实游戏，可替代部分传统物理治疗方法，在中风幸存者下肢功能改善方面取得同样有效的效果。在推荐“踩欢乐”常规使用之前，现在需要进行大样本量的高功率随机对照研究以证实这些发现。
