@文章{info:doi/10.2196/31305，作者=“Allegue, Dorra raakia and Sweet, Shane Norman and Higgins, Johanne and Archambault, Philippe S and Michaud, Francois and Miller, William C and Tousignant, Michel and Kairy, Dahlia”，标题=“从临床医生和中风幸存者那里吸取的关于使用远程康复与Exergames结合的经验教训:多个案例研究”，期刊=“JMIR Rehabil辅助技术”，年=“2022”，月=“Sep”，日=“15”，卷=“9”，数=“3”，页=“e31305”，关键词=“中风;康复;虚拟现实;视频游戏;telerehabilitation;上肢;背景:在加拿大，由于缺乏资源，中风幸存者难以获得基于社区的康复服务。VirTele是一个结合了虚拟现实锻炼游戏和远程康复的个性化远程康复项目，它为中风幸存者提供了一个机会，在接受临床医生持续随访的同时，在家中恢复他们的慢性上肢(UE)缺陷。目的:我们旨在确定临床医生在VirTele干预过程中使用的行为和激励技术，探索中风幸存者赋权的指标，并调查中风幸存者和临床医生使用VirTele的决定因素。方法:这项多案例研究涉及3名患有慢性UE缺损的中风幸存者和他们各自的临床医生(物理治疗师)，他们参与了VirTele干预，这是一个2个月的远程康复干预，使用非沉浸式虚拟现实锻炼游戏和远程康复，旨在改善中风幸存者的UE缺损。 Study participants had autonomous access to Jintronix exergames and were asked to use them for 30 minutes, 5 times a week. The VirTele intervention included 1-hour videoconference sessions with a clinician 1 to 3 times a week, during which the clinician engaged in motivational interviewing, supervised the stroke survivors' use of the exergames, and monitored their use of the affected UE through activities of daily living. Semidirected interviews were conducted with the clinicians and stroke survivors 4 to 5 weeks after the end of the VirTele intervention. All interviews were audiorecorded and transcribed verbatim. An abductive thematic analysis was conducted to generate new ideas through a dynamic interaction between data and theory. Results: Three stroke survivors (n=2, 67{\%}, women and n=1, 33{\%}, man), with a mean age of 58.8 (SD 19.4) years, and 2 physiotherapists participated in the study. Five major determinants of VirTele use emerged from the qualitative analyses, namely technology performance (usefulness and perception of exergames), effort (ease of use), family support (encouragement), facilitators (considerations of the stroke survivors' safety as well as trust and understanding of instructions), and challenges (miscommunication and exergame limits). During the VirTele intervention, both clinicians used motivational and behavioral techniques to support autonomy, competence, and connectivity. All these attributes were reflected as empowerment indicators in the stroke survivors. Lessons learned from using telerehabilitation combined with exergames are provided, which will be relevant to other researchers and contexts. Conclusions: This multiple case study provides a first glimpse into the impact that motivational interviewing can have on adherence to exergames and changes in behavior in the use of the affected UE in stroke survivors. Lessons learned regarding the supportive role caregivers play and the new responsibilities clinicians have when using the VirTele intervention may inform the use of exergames via telerehabilitation. These lessons will also serve as a model to guide the implementation of similar interventions. International Registered Report Identifier (IRRID): RR2-10.2196/14629 ", issn="2369-2529", doi="10.2196/31305", url="https://rehab.www.mybigtv.com/2022/3/e31305", url="https://doi.org/10.2196/31305", url="http://www.ncbi.nlm.nih.gov/pubmed/36107484" }