Bohan Zhang , Ka Po Wong , Mingyue Liu , Vivian Hui , Cai Guo , Zihan Liu , Yue Liu , Qian Xiao , Jing Qin
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All participants received training for 30 min per session per day, five times per week for 4 weeks. The primary outcome was change in swallowing function from baseline (T0) to post-intervention (T1) and 1 month follow-up (T2). Secondary outcomes included changes in laryngeal function, oral intake function, nutritional status, and swallowing-related quality of life. The adherence, satisfaction, and acceptance of the two groups were evaluated. Changes in outcomes over time were compared using generalized estimating equation modeling.</div></div><div><h3>Results</h3><div>A total of 84 participants (AI-VG group = 42, age = 65.00 ± 9.70 years, 57.10 % male; usual care group = 42, age = 66.40 ± 13.10 years, 69.00 % male) were included in this study. Compared with the usual care group, the AI-VG group showed significantly improved swallowing function, with a mean group difference of 4.02 (95 % CI = from −6.16 to −1.89, <em>P</em> < 0.001) at T1 and 4.14 (95 % CI = from −6.16 to 2.12, <em>P</em> < 0.001) at T2. Oral intake function, nutritional status, and swallowing-related quality of life improved significantly (<em>P</em> < 0.001 for overall group × time interaction). Adherence was significantly higher in the intervention group than in the control group (median [IQR], 18.00 [17.00–20.00] vs. 16.00 [15.00–17.00], <em>P</em> < 0.001). The intervention group had higher levels of acceptance and satisfaction of AI-VG (103.00 [100.50–104.00] and 73.00 [72.00–74.00], respectively). No significant difference was observed in laryngeal function (<em>P</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>The AI-VG intervention is an effective method for enhancing swallowing function in patients with post-stroke dysphagia. Future validation through multicenter, large-sample RCTs are warranted to confirm the findings and explore broader clinical applications.</div></div><div><h3>Clinical trial registration</h3><div>ClinicalTrials. Gov Identifier: NCT05978700, <span><span>https://clinicaltrials.gov/study/NCT05978700</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 81-90"},"PeriodicalIF":7.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of artificial intelligence-based video-game system on dysphagia in patients with stroke: A randomized controlled trial\",\"authors\":\"Bohan Zhang , Ka Po Wong , Mingyue Liu , Vivian Hui , Cai Guo , Zihan Liu , Yue Liu , Qian Xiao , Jing Qin\",\"doi\":\"10.1016/j.clnu.2024.12.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and aims</h3><div>Post-stroke dysphagia is highly prevalent and causes complication. While video games have demonstrated potential to increase patient engagement in rehabilitation, their efficacy in stroke patients with dysphagia remains unclear. This aim of this study was to explore the effectiveness of the artificial intelligence-based video-game (AI-VG) intervention in improving swallowing function among stroke patients with dysphagia.</div></div><div><h3>Methods</h3><div>A prospective, single blinded, randomized controlled trial (RCT) was conducted in a rehabilitation hospital from October 2023 to July 2024. Participants were randomly assigned to either the AI-VG system group or the usual care group. All participants received training for 30 min per session per day, five times per week for 4 weeks. The primary outcome was change in swallowing function from baseline (T0) to post-intervention (T1) and 1 month follow-up (T2). Secondary outcomes included changes in laryngeal function, oral intake function, nutritional status, and swallowing-related quality of life. The adherence, satisfaction, and acceptance of the two groups were evaluated. Changes in outcomes over time were compared using generalized estimating equation modeling.</div></div><div><h3>Results</h3><div>A total of 84 participants (AI-VG group = 42, age = 65.00 ± 9.70 years, 57.10 % male; usual care group = 42, age = 66.40 ± 13.10 years, 69.00 % male) were included in this study. Compared with the usual care group, the AI-VG group showed significantly improved swallowing function, with a mean group difference of 4.02 (95 % CI = from −6.16 to −1.89, <em>P</em> < 0.001) at T1 and 4.14 (95 % CI = from −6.16 to 2.12, <em>P</em> < 0.001) at T2. Oral intake function, nutritional status, and swallowing-related quality of life improved significantly (<em>P</em> < 0.001 for overall group × time interaction). Adherence was significantly higher in the intervention group than in the control group (median [IQR], 18.00 [17.00–20.00] vs. 16.00 [15.00–17.00], <em>P</em> < 0.001). 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引用次数: 0
摘要
背景与目的脑卒中后吞咽困难非常普遍并可引起并发症。虽然视频游戏已被证明有可能增加患者对康复的参与，但它们对患有吞咽困难的中风患者的疗效尚不清楚。本研究的目的是探讨基于人工智能的视频游戏（AI-VG）干预在改善脑卒中吞咽困难患者吞咽功能方面的有效性。方法于2023年10月至2024年7月在某康复医院进行前瞻性、单盲、随机对照试验（RCT）。参与者被随机分配到AI-VG系统组或常规护理组。所有参与者每天接受30分钟的训练，每周5次，持续4周。主要结局是吞咽功能从基线（T0）到干预后（T1）和1个月随访（T2）的变化。次要结局包括喉功能、口腔摄取功能、营养状况和吞咽相关生活质量的改变。评估两组患者的依从性、满意度和接受度。使用广义估计方程模型比较结果随时间的变化。结果共84例受试者(AI-VG组= 42例，年龄= 65.00±9.70岁，男性占57.10%；常规护理组= 42例，年龄= 66.40±13.10岁，69.00%为男性。与常规护理组相比，AI-VG组吞咽功能明显改善，组间平均差异为4.02 (95% CI = - 6.16 ~ - 1.89, P <；0.001) T1和4.14 (95% CI =−6.16到2.12,P & lt;0.001)。口服摄入功能、营养状况及吞咽相关生活质量显著改善(P <；总组×时间相互作用0.001)。干预组依从性显著高于对照组(中位数[IQR]， 18.00[17.00-20.00]比16.00 [15.00-17.00],P <；0.001)。干预组对AI-VG的接受度和满意度分别为103.00[100.50-104.00]和73.00[72.00-74.00]。两组患者喉部功能差异无统计学意义(P >；0.05)。结论AI-VG干预是改善脑卒中后吞咽困难患者吞咽功能的有效方法。未来需要通过多中心、大样本随机对照试验来证实这些发现，并探索更广泛的临床应用。临床试验注册临床试验。Gov标识符：NCT05978700， https://clinicaltrials.gov/study/NCT05978700。
Effect of artificial intelligence-based video-game system on dysphagia in patients with stroke: A randomized controlled trial
Background and aims
Post-stroke dysphagia is highly prevalent and causes complication. While video games have demonstrated potential to increase patient engagement in rehabilitation, their efficacy in stroke patients with dysphagia remains unclear. This aim of this study was to explore the effectiveness of the artificial intelligence-based video-game (AI-VG) intervention in improving swallowing function among stroke patients with dysphagia.
Methods
A prospective, single blinded, randomized controlled trial (RCT) was conducted in a rehabilitation hospital from October 2023 to July 2024. Participants were randomly assigned to either the AI-VG system group or the usual care group. All participants received training for 30 min per session per day, five times per week for 4 weeks. The primary outcome was change in swallowing function from baseline (T0) to post-intervention (T1) and 1 month follow-up (T2). Secondary outcomes included changes in laryngeal function, oral intake function, nutritional status, and swallowing-related quality of life. The adherence, satisfaction, and acceptance of the two groups were evaluated. Changes in outcomes over time were compared using generalized estimating equation modeling.
Results
A total of 84 participants (AI-VG group = 42, age = 65.00 ± 9.70 years, 57.10 % male; usual care group = 42, age = 66.40 ± 13.10 years, 69.00 % male) were included in this study. Compared with the usual care group, the AI-VG group showed significantly improved swallowing function, with a mean group difference of 4.02 (95 % CI = from −6.16 to −1.89, P < 0.001) at T1 and 4.14 (95 % CI = from −6.16 to 2.12, P < 0.001) at T2. Oral intake function, nutritional status, and swallowing-related quality of life improved significantly (P < 0.001 for overall group × time interaction). Adherence was significantly higher in the intervention group than in the control group (median [IQR], 18.00 [17.00–20.00] vs. 16.00 [15.00–17.00], P < 0.001). The intervention group had higher levels of acceptance and satisfaction of AI-VG (103.00 [100.50–104.00] and 73.00 [72.00–74.00], respectively). No significant difference was observed in laryngeal function (P > 0.05).
Conclusions
The AI-VG intervention is an effective method for enhancing swallowing function in patients with post-stroke dysphagia. Future validation through multicenter, large-sample RCTs are warranted to confirm the findings and explore broader clinical applications.
期刊介绍：
Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.
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