TY - JOUR AU - Allegue, Dorra Rakia AU - Kairy, Dahlia AU - Higgins, Johanne AU - Archambault, Philippe S AU - Michaud, Francois AU - Miller, William C AU - Sweet, Shane N AU - Tousignant, Michel PY - 2021 DA - 201/8/31 TI -在慢性中风幸存者中使用Exergames与远程康复应用程序相结合的个性化家庭康复计划:混合方法案例研究JO - JMIR严肃游戏SP - e26153 VL - 9 IS - 3 KW -中风KW -康复KW -虚拟现实KW -视频游戏KW -远程康复KW -上肢KW -动机AB -背景:在加拿大，只有11%的中风幸存者从住院康复出院后可以获得门诊和社区康复。因此，创新的社区战略需要提供足够的康复后服务。VirTele项目结合了虚拟现实运动游戏和远程康复应用程序，为中风患者提供了参与个性化家庭康复项目的机会。目的:本研究旨在确定VirTele用于慢性脑卒中幸存者远程上肢康复的可行性;探讨VirTele对上肢运动功能、上肢使用量和质量的初步疗效，以及对生活质量和动力的影响;并探索行为意图和使用VirTele行为的决定因素以及授权指标。方法:一名63岁男性中风幸存者(3岁)伴有中度上肢损伤，参加了为期2个月的VirTele干预。他被要求每周5次，进行30分钟的运动(上肢运动5次)，并与临床医生进行至少每周一次的视频会议。动机性访谈被纳入VirTele，以使参与者能够继续锻炼，并在日常活动中使用他的上肢。 Upper extremity motor function (Fugl-Meyer Assessment–upper extremity), amount and quality of upper extremity use (Motor Activity Log-30), and impact on quality of life (Stroke Impact Scale-16) and motivation (Treatment Self-Regulation Questionnaire-15) were measured before (T1), after (T2) VirTele intervention, and during a 1- (T3) and 2-month (T4) follow-up period. Qualitative data were collected through logs and semistructured interviews. Feasibility data (eg, number and duration of videoconference sessions and adherence) were documented at the end of each week. Results: The participant completed 48 exergame sessions (33 hours) and 8 videoconference sessions. Results suggest that the VirTele intervention and the study protocol could be feasible for stroke survivors. The participant exhibited clinically meaningful improvements at T2 on the Fugl-Meyer and Stroke Impact Scale-16 and maintained these gains at T3 and T4. During the follow-up periods, the amount and quality of upper extremity use showed meaningful changes, suggesting more involvement of the affected upper extremity in daily activities. The participant demonstrated a high level of autonomous motivation, which may explain his adherence. Performance, effort, and social influence have meaningful weights in the behavioral intention of using VirTele. However, the lack of control of technical and organizational infrastructures may influence the long-term use of technology. At the end of the intervention, the participant demonstrated considerable empowerment at both the behavioral and capacity levels. Conclusions: VirTele was shown to be feasible for use in chronic stroke survivors for remote upper extremity rehabilitation. Meaningful determinants of behavioral intention and use behavior of VirTele were identified, and preliminary efficacy results are promising. International Registered Report Identifier (IRRID): RR2-10.2196/14629 SN - 2291-9279 UR - https://games.www.mybigtv.com/2021/3/e26153 UR - https://doi.org/10.2196/26153 UR - http://www.ncbi.nlm.nih.gov/pubmed/34132649 DO - 10.2196/26153 ID - info:doi/10.2196/26153 ER -