@文章{信息:doi/10.2196/26153,作者=“Allegue, Dorra Rakia和Kairy, Dahlia和Higgins, Johanne和Archambault, Philippe S和Michaud, Francois和Miller, William C和Sweet, Shane N和Tousignant, Michel”,标题=“在慢性中风患者中使用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”,期刊=“JMIR Serious Games”,年=“2021”,月=“8”,日=“31”,卷=“9”,数=“3”,页=“e26153”,关键词=“笔画;康复;虚拟现实;视频游戏;telerehabilitation;上肢;背景:在加拿大,只有11%的中风幸存者在住院康复出院后能够获得门诊和社区康复服务。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。 Objective: This study aims to determine the feasibility of VirTele for remote upper extremity rehabilitation in a chronic stroke survivor; explore the preliminary efficacy of VirTele on upper extremity motor function, the amount and quality of upper extremity use, and impact on quality of life and motivation; and explore the determinants of behavioral intention and use behavior of VirTele along with indicators of empowerment. Methods: A 63-year-old male stroke survivor (3 years) with moderate upper extremity impairment participated in a 2-month VirTele intervention. He was instructed to use exergames (5 games for upper extremity) for 30 minutes, 5 times per week, and conduct videoconference sessions with a clinician at least once per week. Motivational interviewing was incorporated into VirTele to empower the participant to continue exercising and use his upper extremities in everyday activities. 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 ", issn="2291-9279", doi="10.2196/26153", url="https://games.www.mybigtv.com/2021/3/e26153", url="https://doi.org/10.2196/26153", url="http://www.ncbi.nlm.nih.gov/pubmed/34132649" }
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