新冠肺炎期间,戴虚拟现实眼镜的男孩与Duchenne和Becker进行为期5周的远程康复计划的有效性:一项临床试验。

IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES JMIR Serious Games Pub Date : 2023-09-30 DOI:10.2196/48022
Rosa Baeza Barragan, Maria Teresa Labajos Manzanares, Mercedes Cristina Amaya Álvarez, Fabian Morales Vega, Judith Rodriguez Ruiz, Rocío Martín Valero
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引用次数: 0

摘要

背景:Duchenne和Becker肌营养不良(分别为“DMD”和“BMD”)是儿童发病最严重的神经肌肉疾病。它影响肌营养不良蛋白的产生,降低患者的行动能力和生活质量。新技术已成为DMD和BMD物理治疗的一部分。在新冠肺炎大流行期间,通过虚拟现实游戏进行远程康复可以帮助这些儿童保持他们的能力。目的:本研究的目的是了解在多模式干预计划中使用虚拟平台是否会改变受DMD和BMD影响的儿童在6分钟步行测试中获得的结果。评估DMD和BMD患者在10次常规和远程康复治疗之间的活动能力差异,通过6分钟步行测试(6MWT)测量。作为次要目标,建议测量其他特定的运动量表,以查看在接受10次确定的训练后这些量表是否发生了变化。方法:描述性、开放性、准实验性研究,采用前瞻性A-B(对照干预)设计。12名符合对照标准的参与者的样本量对该项目进行了为期5周的跟踪,最多10次远程康复。在课程中,参与者使用虚拟现实眼镜为治疗目标进行训练。所有会议都是亲自进行的,参与者在干预前后都接受了评估。根据每个测试的不同功能评估,使用R(R核心团队(2022)进行分析。结果:参与者的6MWT量表增加了19.55米。根据用于评估的其他量表,运动功能也保持稳定。North Start结果在两种治疗中都保持稳定(P值=.199)。此外,在远程康复时间中,Time up and go测试在0.1秒内更短,所有3个维度的运动功能测量均无显着差异,P值=.084。最后,婴儿努力(EPInfant)显示,在训练过程中,疲劳在中间增加,在训练结束时减少,但在整个训练过程中的感知力较低,尽管运动强度增加了。结论:传统治疗和远程康复治疗没有区别,因此远程康复工具可以在不伤害这类儿童、促进他们获得治疗和刺激学习以保持他们的功能能力的情况下使用。远程康复可能有助于维持DMD和BMD儿童的运动功能。学习效果有助于减少孩子在项目期间的疲劳感。临床试验:该试验已获得Andalucía伦理委员会的批准,PEIBA代码为0107-N-20。研究人员将在同行评审期刊上公布研究结果。试验注册号:NCT03879304。
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Effectiveness of a 5 weeks telerehabilitation programme with virtual reality glasses in boys with Duchenne and Becker during the COVID-19: A clinical trial.

Background: Duchenne and Becker muscular dystrophy (from now "DMD" and "BMD" respectively) are the neuromuscular diseases with the most significant involvement in children. It affects dystrophin production, reducing the patient's mobility and quality of life. New technologies have become part of physical therapy in DMD and BMD. During the COVID-19 pandemic, telerehabilitation through virtual reality-based games could help these children to keep their abilities.

Objective: The purpose of this study is to know if the use of the virtual platform in a multimodal intervention program achieves changes in the results obtained in the six-minute walk test in children affected by DMD and BMD. To estimate the difference in mobility in patients with DMD and BMD, as measured with the six-minute walking test (6MWT), between 10 conventional and telerehabilitation treatment sessions. As secondary objectives, measuring other specific motor scales was proposed to see whether these had changed after receiving the 10 defined sessions.

Methods: Descriptive, open, quasi-experimental study with prospective A-B (control-intervention) design. Sample size of twelve participants who fulfilled the control criteria followed the program for five weeks, up to 10 telerehabilitation sessions. During the sessions, the participants used virtual reality glasses to train for the treatment goals. All sessions were in person, and participants were assessed before and after the intervention. Analysis was performed using R (R Core Team (2022) according to the different functional assessments performed for each test.

Results: The participants showed a 19.55 m increase in the 6MWT scale. The motor function was also kept stable according to other scales used to assess it. North Start result were kept stable in both treatments (P value = .199). Furthermore, Time up and go test was shorter in 0.1 seconds in telerehabilitation time and Motor Function Measure in all of the 3 dimensions shown no significant differences with a P value = .084. Finally, Infant effort (EPInfant) shown that during the training the fatigue increased in the middle and decreased by the end but the perception throughout the sessions, was lower even though the exercise intensity increased.

Conclusions: There is no difference between a conventional and telerehabilitation treatment, so the telerehabilitation tool could be used without harming this type of children, facilitating their access to therapies and stimulating learning to maintain their functional capacity. Telerehabilitation may helpful maintain motor function in children with DMD and BMD. The learning effect helped to reduce the feeling of fatigue in children during the program.

Clinicaltrial: This trial has the approval of the Andalucía Ethics Committee with PEIBA code 0107-N-20. The results of the research will be disseminated by the investigators to peer-reviewed journals. Trial registration no. NCT03879304.

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来源期刊
JMIR Serious Games
JMIR Serious Games Medicine-Rehabilitation
CiteScore
7.30
自引率
10.00%
发文量
91
审稿时长
12 weeks
期刊介绍: JMIR Serious Games (JSG, ISSN 2291-9279) is a sister journal of the Journal of Medical Internet Research (JMIR), one of the most cited journals in health informatics (Impact Factor 2016: 5.175). JSG has a projected impact factor (2016) of 3.32. JSG is a multidisciplinary journal devoted to computer/web/mobile applications that incorporate elements of gaming to solve serious problems such as health education/promotion, teaching and education, or social change.The journal also considers commentary and research in the fields of video games violence and video games addiction.
期刊最新文献
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