Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children
Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children
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DOI：
10.1186/1743-0003-7-15
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发表时间：
2010-04-22
影响因子：
5.1
通讯作者：
Meyer-Heim, Andreas
中科院分区：
文献类型：
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作者：
Bruetsch, Karin;Schuler, Tabea;Meyer-Heim, Andreas
背景：虚拟现实（VR）在功能性，目的性和激励性的背景下提供了强大的治疗选择。一些研究表明，患者的动机在决定治疗结果方面起着至关重要的作用。然而，很少有研究表明VR在儿科康复中的潜力。因此，我们开发了一个基于VR的足球场景，它提供了互动元素，让患者在机器人辅助跑步机训练（RAGT）。本研究的目的是比较不同的支持条件（VR与非VR条件）对运动输出的患者和健康对照组儿童在训练期间与驱动步态矫形器Lokomat（R）的即时效果。方法：共有18名儿童（10名患者与不同的神经步态障碍，8名健康对照）参加了这项研究。他们被指示在四种不同的随机呈现的条件下在Lokomat上行走：（1）在没有支撑辅助的情况下正常行走，（2）在治疗师的指导下促进积极参与，（3）将VR作为积极行走的激励工具，以及（4）将VR工具与治疗师的指导相结合。Lokomat步态矫形器在髋关节和膝关节处配备了传感器，用于测量人机交互力。此外，受试者的接受RAGT与VR进行了评估，使用questionnaire.Results：混合方差分析显示，显着的主效应的因素条件（p < 0.001）和显着的交互条件x组（p = 0.01）。受试者间效应检验显示，该组无显著主效应（p = 0.592）。与基线测量“正常行走”相比，患者和对照组儿童的主动参与在治疗师的指导或VR场景的支持和激励下显著增加（p < 0.001）。结论：这里使用的VR场景对运动输出产生了与治疗师口头指导产生的效果相似的即时效果。进一步的研究需要关注交互式设计元素的实施，这些元素在RAGT会议期间和之后保持高动力，特别是在儿科康复中。
Background: Virtual reality (VR) offers powerful therapy options within a functional, purposeful and motivating context. Several studies have shown that patients' motivation plays a crucial role in determining therapy outcome. However, few studies have demonstrated the potential of VR in pediatric rehabilitation. Therefore, we developed a VR-based soccer scenario, which provided interactive elements to engage patients during robotic assisted treadmill training (RAGT). The aim of this study was to compare the immediate effect of different supportive conditions (VR versus non-VR conditions) on motor output in patients and healthy control children during training with the driven gait orthosis Lokomat (R).Methods: A total of 18 children (ten patients with different neurological gait disorders, eight healthy controls) took part in this study. They were instructed to walk on the Lokomat in four different, randomly-presented conditions: (1) walk normally without supporting assistance, (2) with therapists' instructions to promote active participation, (3) with VR as a motivating tool to walk actively and (4) with the VR tool combined with therapists' instructions. The Lokomat gait orthosis is equipped with sensors at hip and knee joint to measure man-machine interaction forces. Additionally, subjects' acceptance of the RAGT with VR was assessed using a questionnaire.Results: The mixed ANOVA revealed significant main effects for the factor CONDITIONS (p < 0.001) and a significant interaction CONDITIONS x GROUP (p = 0.01). Tests of between-subjects effects showed no significant main effect for the GROUP (p = 0.592). Active participation in patients and control children increased significantly when supported and motivated either by therapists' instructions or by a VR scenario compared with the baseline measurement "normal walking" (p < 0.001).Conclusions: The VR scenario used here induces an immediate effect on motor output to a similar degree as the effect resulting from verbal instructions by the therapists. Further research needs to focus on the implementation of interactive design elements, which keep motivation high across and beyond RAGT sessions, especially in pediatric rehabilitation.