Effect of Constraint-Induced Gaming Therapy in an Acute Care Setting

约束诱导游戏疗法在急性护理环境中的效果

• 批准号: 10177968
• 负责人: Andrew H. Hansen
• 金额: --
• 依托单位: MINNEAPOLIS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10177968
• 关键词: Activities of Daily Living; Acute; Address; Adverse effects; Affect; Animal Experimentation; Applications Grants; Appointment; Artificial Intelligence; Behavioral; Brain; Caring; Chronic; Clinic; Clinical effectiveness; Communities; Continuity of Patient Care; Disabled Persons; Equilibrium; Health; Hemiplegia; Home environment; Hospitals; Hour; Impairment; Inpatients; Intervention; Ischemic Stroke; Journals; Learning; Length of Stay; Life; Limb structure; Literature; Logistics; Maintenance Therapy; Medical; Modeling; Motor; Movement; Occupational Therapist; Outcome; Outcome Measure; Patients; Peer Review; Persons; Play; Policies; Protocols documentation; Quality of life; Recovery; Rehabilitation Outcome; Rehabilitation therapy; Research; Site; Stroke; Structure; System; Techniques; Technology; Testing; Therapeutic; Therapeutic Intervention; Time; Training; Translating; Transportation; Travel; Treatment Protocols; Upper Extremity; Veterans; Video Games; Work; acute care; acute stroke; arm; base; care costs; community based participatory research; comparative; constraint induced movement therapy; constraint induced therapy; cost; experience; follow-up; functional decline; functional gain; functional outcomes; gaming environment; healing; improved; medical specialties; motor function improvement; motor learning; portability; post stroke; preference; programs; recruit; relative effectiveness; rural area; rural setting; standard care; standard of care; stroke patient; stroke recovery; stroke rehabilitation; stroke survivor; stroke therapy; symposium; therapy duration; treatment group; treatment program; virtual

More than 6000 Veterans each year have an ischemic stroke that often results in some level of hemiplegia. Poor outcomes in stroke therapy leave the Veteran less able to participate in follow- up therapy post-discharge, reduces ability to complete activities of daily living, and contributes to an average cost of care three times the typical Veteran. Current protocols for therapy on a rehabilitation unit call for intensive rehabilitation composed of high intensity, long duration therapy. Evidence from brain healing and animal research, along with motor learning principles suggest that a treatment program composed of short duration therapy sessions distributed throughout the day may provide better rehabilitation outcomes for stroke patients. Such a program can be implemented using constraint-induced therapy in which the Veteran is provided with opportunities to use the affected limb while participating in a video game and completing complementary tasks in therapy. Additionally, rehabilitation outcomes may improve if Veterans are provided with regular opportunities to participate in gaming therapy at home after discharge from the hospital rather than having to travel to a clinic or receive limited or no follow-up in rural areas. This project will develop a therapeutic model for applying constraint-induced therapy via a video gaming environment that has movements paired with motor retraining performed in therapy sessions. A small group of patients will participate in a question and answer session about preferences for activities which make up transfer tasks. Transfer tasks are paired with movement performed while playing the video game. Patients will also receive automated reminders to use the impaired arm throughout the day. Ten Veterans will be recruited annually from the inpatient Stroke Specialty Program. Five patients will be assigned to the Treatment group and receive the intervention. The remaining five will receive the current standard of care. Outcome measures will include motor function tests that evaluate upper extremity function. Preliminary results will be presented at a major conference with project results submitted to a relevant peer-reviewed journal. Norms from this project will serve as the basis for a larger, multi-site Merit grant proposal. We believe this project will lead to substantive change in the treatment of acute stroke that will lead to improved functional outcomes for Veterans and reduced care costs for the VA.

每年有6000多名退伍军人有缺血性中风，通常会导致一定程度 偏瘫。中风疗法的不良预后使退伍军人的能力较低，无法参与后续 解雇后的治疗，降低了完成日常生活活动的能力，并做出贡献 平均护理费用是典型退伍军人的三倍。 康复单元的当前治疗方案要求密集康复 高强度，持续时间长。大脑康复和动物研究的证据 有运动原则表明，一个由短期持续时间组成的治疗计划 全天分发的治疗课程可能会为您提供更好的康复结果 中风患者。可以使用约束诱导的治疗来实施这样的程序 在参加视频时，为退伍军人提供了使用受影响肢体的机会 游戏并完成治疗中的互补任务。此外，康复结果 如果为退伍军人提供常规机会参加游戏疗法，可能会有所改善 从医院出院后在家，而不必去诊所或接收 农村地区有限或没有随访。 该项目将开发一种治疗模型，用于通过视频应用约束诱导的治疗 游戏环境具有与运动疗法进行的运动再培训配对的游戏环境 会议。一小部分患者将参加有关的问答环节 构成转移任务的活动的偏好。转移任务与 运动在玩电子游戏时进行的动作。患者还将自动化 提醒整天使用受损的手臂。每年将招募十名退伍军人 来自住院中风专业计划。将五名患者分配给治疗 分组并接受干预。其余五个将获得当前的护理标准。 结果指标将包括评估上肢功能的运动功能测试。 初步结果将在一次重大会议上提出，项目结果提交给 相关的同行评审期刊。该项目的规范将成为更大，更大的基础 多站点优异赠款提案。我们认为该项目将导致实质性变化 急性中风的治疗将导致退伍军人的功能结果改善 VA的护理费用降低。