Feasibility of Using Tetrax Biofeedback Video Games for Balance Training in Patients With Chronic Hemiplegic Stroke
Feasibility of Using Tetrax Biofeedback Video Games for Balance Training in Patients With Chronic Hemiplegic Stroke
复制标题
DOI：
10.1016/j.pmrj.2016.02.009
复制
发表时间：
2016-10-01
期刊：
影响因子：
2.1
通讯作者：
Chen, Po-Chih
中科院分区：
文献类型：
--
作者：
Hung, Jen-Wen;Yu, Min-Yuan;Chen, Po-Chih
背景：中风发生后，患肢负重减少和体重转移不良是常见的。Tetrax生物反馈系统是一种压力中心控制的视频游戏系统，专为平衡缺陷患者设计。虽然它是一种商业产品，但有关其在中风患者中的临床应用的信息有限。目的：探讨Tetrax生物反馈系统用于慢性脑卒中患者平衡训练的可行性及潜在疗效。设计：可行性研究。地点：某医疗中心康复科。参与者：在入组前至少6个月患有偏瘫中风，但仍能独立站立5分钟以上的参与者。方法：将受试者随机分为干预组（IG）和对照组（CG）。所有参与者均接受常规康复训练。IG还接受了20分钟的四合生物反馈游戏，游戏由压力中心的变化控制，每周3次，持续6周。主要结局测量：主要结局是可行性，包括依从性、安全性和满意度。次要结果是疗效，通过生理特征评估、姿势测量、计时向上和向前伸展测试的子测试来评估。我们使用百分比变化（训练后得分-训练前得分/训练前得分）来量化干预效果。使用Mann-Whitney U检验来分析组间变化百分比的差异。结果：IG组14人，CG组13人；IG组12人，CG组11人完成了研究。在IG组中，那些完成了6周干预的人参加了89.5%的计划会议。在干预期间没有发生重大不良事件或跌倒。使用李克特5分量表，参与者将他们对四边形游戏的享受程度评为4.33 +/- 0.78，他们的动机为4.17 +/- 1.03，感知到的帮助程度为4.25 +/- 0.97。与CG相比，IG组在反应时间（P = 0.002）、本体感觉（P < 0.001）、对称负重（P = 0.027）、计时向上和向前伸展（P < 0.001）和前伸（P < 0.001）方面均有显著改善。结论：使用Tetrax生物反馈视频游戏进行平衡训练是一种可行的辅助方案，可以增强慢性偏瘫卒中患者的常规治疗。证据水平：II
Background: Decreased weight bearing on the affected lower limb and poor weight shifting are common after a stroke occurs. The Tetrax biofeedback system is a center-of-pressure controlled video game system designed for patients with balance deficits. Although it is a commercial product, information about its clinical use for patients affected by stroke is limited.Objective: To investigate the feasibility and potential efficacy of the Tetrax biofeedback system for balance training in patients with chronic stroke.Design: Feasibility study.Setting: Rehabilitation department of a medical center.Participants: Participants who had sustained a hemiplegic stroke at least 6 months prior to enrollment but were still able to stand independently for more than 5 minutes.Methods: Participants were randomly assigned to an intervention group (IG) or control group (CG). All participants received conventional rehabilitation training. The IG also received 20 minutes of exposure to Tetrax biofeedback games controlled by change in center of pressure 3 times a week for 6 weeks.Main Outcome Measurements: The primary outcome was feasibility, addressed by adherence, safety, and satisfaction. The secondary outcome was efficacy, which was evaluated by the subtests of physiological profile assessment, posturography, Timed Up and Go, and Forward Reach tests. We used percentage change (post-training score - pretraining score/pretraining score) to quantify the intervention effects. Mann-Whitney U tests were used to analyze differences in percentage of change between groups.Results: A total of 14 participants were assigned to the IG, and 13 were assigned to the CG; 12 participants in the IG and 11 in the CG completed the study. In the IG group, those who completed the 6-week intervention attended 89.5% of planned sessions. No major adverse events or falls occurred within the intervention sessions. With use of 5-point Likert scales, participants rated their enjoyment of Tetrax games as 4.33 +/- 0.78, their motivation as 4.17 +/- 1.03, and perceived helpfulness as 4.25 +/- 0.97. The IG demonstrated a significantly greater improvement in reaction time (P = .002), proprioception (P < .001), symmetric weight bearing (P = .027), Timed Up and Go (P < .001), and Forward Reach (P < .001) compared with the CG.Conclusions: Using Tetrax biofeedback video games for balance training is a feasible adjunctive program that may augment conventional therapy in persons affected by chronic hemiplegic stroke.Level of Evidence: II