了解针对偏瘫儿童的电子游戏家庭干预：一项混合方法多案例研究。
Understanding a videogame home intervention for children with hemiplegia: a mixed methods multi-case study.
作者信息
Chan-Víquez Daniela, Khan Ajmal, Munce Sarah, Fehlings Darcy, Wright F Virginia, Biddiss Elaine
机构信息
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
出版信息
Front Med Technol. 2023 Jul 12;5:1217797. doi: 10.3389/fmedt.2023.1217797. eCollection 2023.
INTRODUCTION
Access to rehabilitation therapies is a salient and growing issue for children with cerebral palsy (CP) and their families, motivating interest in home-based interventions. Bootle Blast is a low-cost, movement-tracking videogame that can be used at home to encourage upper limb (UL) functional exercise tailored to each child's abilities and therapy goals. The study objectives were to: 1) Establish the extent to which children achieve their self-directed play-time goal over a 12-week intervention, 2) Measure changes in UL motor outcomes, and 3) Explore participants' experiences of using Bootle Blast at home.
METHODS
Mixed methods case series study of four children with hemiplegic cerebral palsy (HCP), each with a participating parent. Participants played Bootle Blast at home for 12 weeks. Study assessments occurred at baseline, post-intervention and four week follow up. A post-intervention interview explored participants' experiences. Game-logs provided play time and progress data.
RESULTS
Three of four participants (8-13 yrs., Manual Ability Classification Level I-II) completed the intervention. One dropped out at week 6. Play-time goals were achieved in most weeks, with two of four children surpassing their overall intervention goals. Outcomes varied across the three participants, however consistent improvements were observed on the Canadian Occupational Performance Measure and the Box and Blocks Test. Inductive analysis generated four main themes: 1) Intrinsic motivators fostered play engagement, 2) Virtual play for real-world gains, 3) Therapy on demand (at home), and 4) Shifting the onus from the parent to the game. Integration of qualitative and quantitative data was important for interpreting play patterns/usage and clinical outcomes.
DISCUSSION
This mixed methods study describes a novel videogaming intervention designed for home-rehabilitation for children with HCP and provides preliminary evidence to guide future study design and research.
CLINICAL TRIAL REGISTRATION
[https://clinicaltrials.gov/ct2/show/NCT04009031?recrs=h&cond=Cerebral+Palsy&cntry=CA&city=Toronto&draw=2&rank=1], identifier [NCT04009031].
引言
对于脑瘫（CP）儿童及其家庭而言，获得康复治疗是一个突出且日益严重的问题，这激发了人们对家庭干预的兴趣。Bootle Blast是一款低成本的运动追踪电子游戏，可在家中使用，以鼓励根据每个孩子的能力和治疗目标进行上肢（UL）功能锻炼。本研究的目标是：1）确定儿童在为期12周的干预中在多大程度上实现了自我设定的游戏时间目标；2）测量上肢运动结果的变化；3）探索参与者在家中使用Bootle Blast的体验。
方法
对四名偏瘫型脑瘫（HCP）儿童及其参与的家长进行混合方法病例系列研究。参与者在家中玩Bootle Blast游戏12周。研究评估在基线、干预后和四周随访时进行。干预后的访谈探讨了参与者的体验。游戏日志提供了游戏时间和进展数据。
结果
四名参与者中有三名（8 - 13岁，手动能力分类水平I - II）完成了干预。一名在第6周退出。大多数周都实现了游戏时间目标，四名儿童中有两名超过了他们总体的干预目标。三名参与者的结果各不相同，然而在加拿大职业表现测量和方块积木测试中观察到了持续的改善。归纳分析产生了四个主要主题：1）内在动机促进了游戏参与；2）虚拟游戏带来现实收获；3）按需治疗（在家中）；4）将责任从家长转移到游戏。定性和定量数据的整合对于解释游戏模式/使用情况和临床结果很重要。
讨论
这项混合方法研究描述了一种为HCP儿童家庭康复设计的新型电子游戏干预，并提供了初步证据以指导未来的研究设计和研究。
临床试验注册
[https://clinicaltrials.gov/ct2/show/NCT04009031?recrs=h&cond=Cerebral+Palsy&cntry=CA&city=Toronto&draw=2&rank=1]，标识符 [NCT04009031]。
Zotero 插件