@文章{信息:doi/10.2196/30366，作者=“Wiskerke, Evelyne和Kool, Jan和Hilfiker, Roger和Sattelmayer, Karl Martin和Verheyden, Geert”，标题=“使用Rasch分析确定神经障碍患者平衡治疗的最佳虚拟现实Exergame方法:纵向观察研究”，期刊=“JMIR严肃游戏”，年=“2022”，月=“Mar”，日=“22”，卷=“10”，数字=“1”，页=“e30366”，关键词=“数字疗法;虚拟现实;exergaming;平衡;中风;多发性硬化;neurorehabilitation;背景:虚拟现实(VR) exergames作为一种增加训练强度的附加疗法，在神经障碍患者的康复中受到了广泛的欢迎。强度很大程度上取决于病人的动机。动机可以通过在训练和有挑战性的练习中提供变化来增加。 However, patients are often underchallenged, as exergame difficulty often does not match the patient's ability. A Rasch analysis can establish hierarchy of exergame items in order to assist the delivery of patient-centered therapy. Objective: The aim of this study was to apply the Rasch model to create a hierarchical order of existing VR balance exergames and to relate these exergames to the abilities of persons with neurological disorders, in order to deliver challenge and variation. Methods: A total of 30 persons with stroke and 51 persons with multiple sclerosis (MS) were included in the study. All participants performed a training program, lasting 3 weeks for persons with MS and 4 weeks for persons with stroke, in which they performed VR balance exergames with a movement recognition--based system (MindMotion GO; MindMaze SA). VR exercise scores, Berg Balance Scale scores, and clinical descriptive data were collected. Berg Balance Scale and device scores were analyzed with the Rasch model using a repeated-measures approach to examine whether the distribution of exercise scores fitted the Rasch model. Secondly, a person-item map was created to show the hierarchy of exercise difficulty and person ability. Results: Participants completed a selection of 56 balance exercises (ie, items), which consisted of a combination of various balance tasks and levels (ie, exercises). Using repeated measures, this resulted in a count of 785 observations. Analysis showed strong evidence for unidimensionality of the data. A total of 47 exercises (ie, items) had a sufficiently good fit to the Rasch model. Six items showed underfit, with outfit mean square values above 1.5. One item showed underfit but was kept in the analysis. Three items had negative point-biserial correlations. The final model consisted of 47 exercises, which were provided for persons with low to moderate balance ability. Conclusions: The VR exercises sufficiently fitted the Rasch model and resulted in a hierarchical order of VR balance exercises for persons with stroke and MS with low to moderate balance ability. In combination with the Berg Balance Scale, the results can guide clinical decision-making in the selection of patient-focused VR balance exercises. Trial Registration: ClinicalTrials.gov NCT03993275; https://clinicaltrials.gov/ct2/show/NCT03993275 ", issn="2291-9279", doi="10.2196/30366", url="https://games.www.mybigtv.com/2022/1/e30366", url="https://doi.org/10.2196/30366", url="http://www.ncbi.nlm.nih.gov/pubmed/35315785" }