DSilva Linda J, Skop Karen M, Pickle Nathan T, Marschner Katherine, Zehnbauer Timothy P, Rossi Michael, Roos Paulien E
Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States.
Physical Medicine and Rehabilitation Services, Department of Physical Therapy, James A. Haley Veterans' Hospital, Morsani College of Medicine, University of South Florida, School of Physical Therapy, Tampa, FL, United States.
Front Neurol. 2022 Feb 24;13:836571. doi: 10.3389/fneur.2022.836571. eCollection 2022.
Close to half people over 60 years of age experience vestibular dysfunction. Although vestibular rehabilitation has been proven effective in reducing dizziness and falls in older adults, adherence to exercise programs is a major issue and reported to be below 50%. Therefore, this research aimed to develop an app with gaming elements to improve adherence to exercises that are part of vestibular rehabilitation, and to provide feedback to increase the accuracy during exercise performance. A clinician-informed design was used where five physical therapists were asked identical questions about the exercises they would like to see in the app, including their duration and frequency. Games were developed to train the vestibulo-ocular (VOR) reflex using VOR and gaze shifting exercises; and to train the vestibulo-spinal system using weight shifting and balance exercises. The games were designed to progress from simple to more complex visuals. The games were controlled by an Inertial Measurement Unit placed on the head or anterior waist. The app was tested on ten healthy females (69.1 ± 5.1 years) with no prior history of vestibular dysfunction or complaints of dizziness. Participants completed gaze stabilization and balance exercises using the app and provided feedback on the user interface, ease of use, usefulness and enjoyment using standardized questionnaires and changes they would like to see in the form of open-ended questions. In general, participants reported that they found the app easy to use, the user interface was friendly, and they enjoyed playing the games due to the graphics and colors. They reported that the feedback provided during the exercise session helped them recognize their mistakes and motivated them to do better. However, some elements of the app were frustrating due to incomplete instructions and inability to distinguish game objects due to insufficient contrast. Feedback received will be implemented in a revised version which will be trialed in older adults with dizziness due to vestibular hypofunction. We have demonstrated that the "Vestibular App" created for rehabilitation with gaming elements was found to be enjoyable, useful, and easy to use by healthy older adults. In the long term, the app may increase adherence to vestibular rehabilitation.
近半数60岁以上的人会经历前庭功能障碍。尽管前庭康复已被证明能有效减少老年人的头晕和跌倒，但坚持锻炼计划是一个主要问题，据报道坚持率低于50%。因此，本研究旨在开发一款带有游戏元素的应用程序，以提高对前庭康复锻炼的依从性，并提供反馈以提高锻炼过程中的准确性。采用了临床医生指导的设计，向五名物理治疗师询问了他们希望在应用程序中看到的锻炼内容，包括锻炼的时长和频率。开发了游戏来通过前庭眼（VOR）反射和注视转移练习训练前庭眼反射；并通过重心转移和平衡练习训练前庭脊髓系统。游戏设计为从简单到更复杂的视觉效果逐步推进。游戏由放置在头部或前腰部的惯性测量单元控制。该应用程序在十名没有前庭功能障碍病史或头晕症状的健康女性（69.1±5.1岁）身上进行了测试。参与者使用该应用程序完成了注视稳定和平衡练习，并通过标准化问卷以及以开放式问题形式提出的他们希望看到的变化，对用户界面、易用性、实用性和趣味性提供了反馈。总体而言，参与者报告说他们觉得该应用程序易于使用，用户界面友好，并且由于图形和颜色，他们喜欢玩游戏。他们报告说锻炼过程中提供的反馈帮助他们认识到自己的错误，并激励他们做得更好。然而，由于说明不完整以及对比度不足导致无法区分游戏对象，应用程序的某些元素令人沮丧。收到的反馈将在修订版中实施，修订版将在前庭功能减退导致头晕的老年人中进行试验。我们已经证明，为康复而创建的带有游戏元素的“前庭应用程序”被健康的老年人认为是有趣、有用且易于使用的。从长远来看，该应用程序可能会提高对前庭康复的依从性。
