TY - JOUR AU - Wiskerke, Evelyne AU - Kool, Jan AU - Hilfiker, Roger AU - Sattelmayer, Karl Martin AU - Verheyden, Geert PY - 2022 DA - 2022/3/22 TI -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JO - JMIR严肃游戏SP - e30366 VL - 10 IS - 1kw -数字治疗KW -虚拟现实KW -运动游戏KW -平衡KW -中风KW -多发性硬硬症KW -神经康复KW - Rasch分析AB -背景:虚拟现实(VR)运动游戏作为增加训练强度的附加疗法，在神经障碍患者的康复中得到了普及。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。然而，由于锻炼难度往往与患者的能力不匹配，患者的挑战往往不足。Rasch分析可以建立exergame项目的层次结构，以协助以患者为中心的治疗。目的:本研究的目的是应用Rasch模型来创建现有VR平衡锻炼游戏的等级顺序，并将这些锻炼游戏与神经障碍患者的能力联系起来，以提供挑战和变化。方法:共纳入30例脑卒中患者和51例多发性硬化症(MS)患者。所有参与者都进行了一项训练计划，MS患者持续3周，中风患者持续4周，其中他们使用基于运动识别的系统(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 SN - 2291-9279 UR - https://games.www.mybigtv.com/2022/1/e30366 UR - https://doi.org/10.2196/30366 UR - http://www.ncbi.nlm.nih.gov/pubmed/35315785 DO - 10.2196/30366 ID - info:doi/10.2196/30366 ER -