Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland.
ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.
J Neuroeng Rehabil. 2023 Jan 12;20(1):2. doi: 10.1186/s12984-023-01123-w.
Persons with Parkinson's disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL), inter alia due to dysfunctional supplementary motor area (SMA). Combined intermittent theta-burst stimulation (iTBS) over the SMA followed by video game-based training (VBT) may therefore improve dexterity related ADL. The VBT may induce high flow levels related to high performance during the training. The aim of this study is to evaluate the feasibility of a combined iTBS-VBT intervention in persons with PD.
A total of nine persons with PD (mean age 63.3 ± 8.76 years) with self-reported difficulties with dexterity related ADL were included in this pilot iTBS-VBT study. All participants received either iTBS or sham stimulation over the SMA followed by a 45-min VBT, three times a week for a total of three weeks. Feasibility was measured by means of the adherence rate and the system usability (System Usability Scale). Moreover, flow was measured after the last VBT session.
Adherence rate was excellent with 100%. High system usability scores (i.e., mean 80%, range 55-97.5) and a significant Spearman's correlation with the Flow State Scale (r = .762, p = .017) further point to the high feasibility of the VBT. Neither demographic variables nor difficulties in dexterity related ADL affected the usability of the VBT.
This study demonstrates the high feasibility of a combined iTBS-VBT intervention. Moreover, the level of self-reported usability was related to flow experience. Whether this kind of combined iTBS-VBT intervention improves dexterity will be evaluated in a randomized controlled trial. Trial registration clincaltrials.gov NCT04699149, date of registration 1. June 2021.
帕金森病（PD）患者在进行日常生活活动（ADL）时常常表现出动作灵活性困难，这主要是由于辅助运动区（SMA）功能障碍所致。因此，对 SMA 进行联合间歇性经颅磁刺激（iTBS）治疗后再进行基于视频游戏的训练（VBT），可能会改善与动作灵活性相关的 ADL。VBT 可能会在训练过程中产生与高表现相关的高流量水平。本研究的目的是评估联合 iTBS-VBT 干预在 PD 患者中的可行性。
本研究共纳入 9 名 PD 患者（平均年龄 63.3±8.76 岁），自述在与动作灵活性相关的 ADL 方面存在困难。所有参与者均接受 SMA 区的 iTBS 或假刺激治疗，随后进行 45 分钟的 VBT，每周 3 次，共 3 周。通过依从率和系统可用性（系统可用性量表）来衡量可行性。此外，在最后一次 VBT 治疗后测量了流畅度。
依从率为 100%，极佳。高系统可用性评分（即，平均 80%，范围 55-97.5）和与流畅状态量表的显著 Spearman 相关性（r=0.762，p=0.017）进一步表明 VBT 的高可行性。无论是人口统计学变量还是与动作灵活性相关的 ADL 困难，都没有影响 VBT 的可用性。
本研究表明联合 iTBS-VBT 干预具有较高的可行性。此外，自我报告的可用性水平与流畅体验相关。这种联合 iTBS-VBT 干预是否能改善动作灵活性，将在一项随机对照试验中进行评估。临床试验注册 clincaltrials.gov NCT04699149，注册日期 2021 年 6 月 1 日。
