Percepciones clínicas y análisis de factibilidad de un juego de realidad virtual para la rehabilitación Post-ACV
Resumen
La creciente prevalencia de accidentes cerebrovasculares (ACV) ha impulsado la búsqueda de métodos de rehabilitación innovadores. La realidad virtual inmersiva (RV), especialmente los juegos personalizados, ofrece un enfoque interactivo y motivador para la adherencia a la terapia. La percepción y aceptación de los fisioterapeutas son cruciales para su implementación y requieren mayor investigación. El objetivo de esta investigación consistió en evaluar las actitudes y percepciones de los fisioterapeutas con respecto a la viabilidad y eficacia de un juego de realidad virtual personalizado llamado Motion Health VR para la rehabilitación posterior al ACV. La metodología empleada consistió en utilizar tres estrategias para recopilar datos subjetivos. Primero, se administró un cuestionario de opción múltiple a 73 médicos y fisiatras durante la Conferencia ISPRM 2023 (Sociedad Internacional de Medicina Física y de Rehabilitación) para obtener datos cuantitativos sobre la utilidad y viabilidad de Motion Health VR. Seguidamente, se realizó un grupo de discusión con 4 fisioterapeutas para obtener información cualitativa sobre la usabilidad, accesibilidad y rentabilidad del juego. Luego, se realizó un análisis de viabilidad y costo-efectividad para evaluar los posibles beneficios a largo plazo y las implicaciones financieras de la implementación de Motion Health VR en Colombia. Los resultados obtenidos fueron una amplia aceptación de la RV como herramienta complementaria en la rehabilitación post-ACV y el reconocimiento de los juegos personalizados como motivadores para la participación del paciente. Los fisioterapeutas destacaron su jugabilidad e inmersión, aunque señalaron limitaciones relacionadas con costos y espasticidad del paciente. El análisis indicó que los costos iniciales, aunque significativos, pueden justificarse por los ahorros a largo plazo y los mejores resultados para los pacientes. Finalmente, se concluye que Motion Health VR mostró un potencial significativo para complementar la rehabilitación post-ACV, siendo bien recibido por los fisioterapeutas. Los desafíos clave incluyen mejorar el acceso, reducir costos y brindar capacitación en RV para optimizar los resultados de rehabilitación.Referencias bibliográficas
K. C. Wagle, and C. S. Ivan, “Cerebrovascular Disease,” in Family Medicine, P. M. Paulman, R. B. Taylor, A. A. Paulman, and L. S. Nasir, Eds., Cham: Springer International Publishing, 2022, pp. 905–922. https://doi.org/10.1007/978-3-030-54441-6_72
Z. Adey-Wakeling, and M. Crotty, “Upper Limb Rehabilitation Following Stroke: Current Evidence and Future Perspectives,” Aging health, vol. 9, no. 6, pp. 629–647, Nov. 2013. https://doi.org/10.2217/ahe.13.67
R. L. Harvey MD, “Predictors of Functional Outcome Following Stroke,” Phys. Med. Rehabil. Clin. N. Am., vol. 26, no. 4, pp. 583–598, Nov. 2015. https://doi.org/10.1016/j.pmr.2015.07.002
K. S. Hayward et al., “A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke,” Syst. Rev., vol. 8, no. 1, p. 187, Jul. 2019. https://doi.org/10.1186/S13643-019-1093-6
N. Aderinto, G. Olatunji, M. Opeyemi Abdulbasit, M. Edun, G. Aboderin, and E. Egbunu, “Exploring the efficacy of virtual reality-based rehabilitation in stroke: a narrative review of current evidence,” Ann Med., vol. 55, no. 2, Dec. 2023. https://doi.org/10.1080/07853890.2023.2285907
I. Göttgens, and S. Oertelt-Prigione, “The Application of Human-Centered Design Approaches in Health Research and Innovation: A Narrative Review of Current Practices,” JMIR Mhealth Uhealth, vol. 9, no. 12, p. e28102, Dec. 2021. https://doi.org/10.2196/28102
O. Postolache, D. Jude Hemanth, R. Alexandre, D. Gupta, O. Geman, and A. Khanna, “Remote Monitoring of Physical Rehabilitation of Stroke Patients Using IoT and Virtual Reality,” IEEE journal on selected areas in communications, vol. 39, no. 2, Feb. 2021. https://doi.org/10.1109/JSAC.2020.3020600
M. Jones et al., “Big Data Analytics and Sensor-Enhanced Activity Management to Improve Effectiveness and Efficiency of Outpatient Medical Rehabilitation,” Int. J. Environ. Res. Public Health., vol. 17, no. 3, p. 748, Jan. 2020. https://doi.org/10.3390/ijerph17030748
P. C. Alves Brepohl, and H. Leite, “Virtual reality applied to physiotherapy: a review of current knowledge,” Virtual Real, vol. 27, pp. 71–95, Mar. 2023. https://doi.org/10.1007/s10055-022-00654-2
W.-S. Kim et al., “Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence,” Journal Clinical Medicine, vol. 9, no. 10, p. 3369, Oct. 2020. https://doi.org/10.3390/jcm9103369
C. Tuena et al., “Usability Issues of Clinical and Research Applications of Virtual Reality in Older People: A Systematic Review,” Front. Hum. Neurosci., vol. 14, Apr. 2020. https://doi.org/10.3389/fnhum.2020.00093
C. Vieira, C. Ferreira da Silva Pais-Vieira, J. Novais, and A. Perrotta, “Serious Game Design and Clinical Improvement in Physical Rehabilitation: Systematic Review,” JMIR Serious Games, vol. 9, no. 3, p. e20066, Sep. 2021. https://doi.org/10.2196/20066
J. Seinsche et al., “A Newly Developed Exergame-Based Telerehabilitation System for Older Adults: Usability and Technology Acceptance Study,” JMIR Hum Factors, vol. 10, p. e48845, May. 2023. https://doi.org/10.2196/48845
L. Bryant et al., “Collaborative co-design and evaluation of an immersive virtual reality application prototype for communication rehabilitation (DISCOVR prototype),” Disability and Rehabilitation: Assistive Technology, vol. 19, no. 1, pp. 90–99, Apr. 2024. https://doi.org/10.1080/17483107.2022.2063423
S. Krishnan, M. A. Mandala, S. L. Wolf, A. Howard, and T. M. Kesar, “Perceptions of stroke survivors regarding factors affecting adoption of technology and exergames for rehabilitation,” PM&R, vol. 15, no. 11, pp. 1403–1410, Nov. 2023. https://doi.org/10.1002/pmrj.12963
G. A. Albanese et al., “Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments,” Front Robot AI, vol. 11, Feb. 2024. https://doi.org/10.3389/frobt.2024.1335147
A. Vaezipour, D. Aldridge, S. Koenig, D. Theodoros, and T. Russell, “‘It’s really exciting to think where it could go’: a mixed-method investigation of clinician acceptance, barriers and enablers of virtual reality technology in communication rehabilitation,” Disabil. Rehabil., vol. 44, no. 15, pp. 3946–3958, Mar. 2022. https://doi.org/10.1080/09638288.2021.1895333
M. M. T. E. Kouijzer, H. Kip, Y. H. A. Bouman, and S. M. Kelders, “Implementation of virtual reality in healthcare: a scoping review on the implementation process of virtual reality in various healthcare settings,” Implementation Science Communications, vol. 4, p. 67, Jun. 2023. https://doi.org/10.1186/s43058-023-00442-2
M. Endresen Moan, E. Klaebo Vonstad, X. Su, B. Vereijken, M. Solbjør, and N. Skjæret-Maroni, “Experiences of Stroke Survivors and Clinicians with a Fully Immersive Virtual Reality Treadmill Exergame for Stroke Rehabilitation: A Qualitative Pilot Study,” Front Aging Neurosci, vol. 13, p. 735251, Nov. 2021. https://doi.org/10.3389/FNAGI.2021.735251
R. C. Stockley, and D. L. Christian, “A focus group study of therapists’ views on using a novel neuroanimation virtual reality game to deliver intensive upper-limb rehabilitation early after stroke,” Arch. Physiother., vol. 12, no. 1, Jan-Dec. 2022. https://doi.org/10.1186/S40945-022-00139-0
J.-A. Lee, J.-G. Kim, and H. Kweon, “A Study on Rehabilitation Specialists’ Perception of Experience with a Virtual Reality Program,” Healthcare, vol. 11, no. 6, p. 814, Mar. 2023. https://doi.org/10.3390/HEALTHCARE11060814
N. Roman et al., “The Benefits of Combining Mixed Virtual Reality Exergaming with Occupational Therapy for Upper Extremity Dexterity,” Electronics, vol. 12, no. 6, p. 1431, Mar. 2023. https://doi.org/10.3390/electronics12061431
M. Gustavsson, E. K. Kjörk, M. Erhardsson, and M. Alt Murphy, “Virtual reality gaming in rehabilitation after stroke – user experiences and perceptions,” Disabil. Rehabil., vol. 44, no. 22, pp. 6759–6765, Aug. 2021. https://doi.org/10.1080/09638288.2021.1972351
H. Morse, L. Biggart, V. Pomeroy, and S. Rossit, “Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke,” Neuropsychol Rehabil, vol. 32, no. 5, pp. 767–791, Sep. 2020. https://doi.org/10.1080/09602011.2020.1819827
L. Wang, J.-L. Chen, A. M. K. Wong, K.-C. Liang, and K. C. Tseng, “Game-Based Virtual Reality System for Upper Limb Rehabilitation After Stroke in a Clinical Environment: Systematic Review and Meta-Analysis,” Games Health, vol. 11, no. 5, pp. 277–297, Oct. 2022. https://doi.org/10.1089/G4H.2022.0086
K. J. Miller, B. S. Adair, A. J. Pearce, C. M. Said, E. Ozanne, and M. M. Morris, “Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review,” Age and Ageing, vol. 43, no. 2, pp. 188–195, Dec. 2013. https://doi.org/10.1093/AGEING/AFT194
I. Laffont et al., “Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial,” Annals of Physical and Rehabilitation Medicine, vol. 63, no. 3, pp. 173–180, May. 2020. https://doi.org/10.1016/J.REHAB.2019.10.009
D. B. Mekbib et al., “Virtual reality therapy for upper limb rehabilitation in patients with stroke: a meta-análisis of randomized clinical trials,” Brain Injury, vol. 34, no. 4, pp. 456–465, Feb. 2020. https://doi.org/10.1080/02699052.2020.1725126
D. E. Levac, and P. A. Miller, “Integrating virtual reality video games into practice: Clinicians’ experiences,” Physiother. Theory Pract., vol. 29, no. 7, pp. 504–512, Jan. 2013. https://doi.org/10.3109/09593985.2012.762078
C. J. Winstein et al., “Guidelines for Adult Stroke Rehabilitation and Recovery,” Stroke, vol. 47, no. 6, May. 2016. https://doi.org/10.1161/STR.0000000000000098
P. M. Kato, “Video games in health care: Closing the gap,” Rev. Gen. Psychol., vol. 14, no. 2, pp. 113–121, Jun. 2010. https://doi.org/10.1037/a0019441
M. Matamala-Gomez et al., “Telemedicine and Virtual Reality at Time of COVID-19 Pandemic: An Overview for Future Perspectives in Neurorehabilitation,” Front Neurol, vol. 12, Mar. 2021. https://doi.org/10.3389/fneur.2021.646902
A. Nuara, M. Fabbri-Destro, E. Scalona, S. E. Lenzi, G. Rizzolatti, and P. Avanzini, “Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines,” J. Neurol., vol. 269, no. 2, pp. 627–638, Jan. 2021. https://doi.org/10.1007/s00415-021-10397-w
B. J. Hernández, P. Benjumea, and L. Tuso, “Indicadores del desempeño clínico fisioterapéutico en el manejo hospitalario temprano del accidente,” Revista Ciencias de la salud, vol. 11, no. 1, Apr. 2013. https://revistas.urosario.edu.co/index.php/revsalud/article/view/2456
M. F. Montoya, J. F. Villada Villada, J. E. Muñoz Cardona, O. A. Henao Gallo, and J. F. López, “Diseño contextual para la creación de videojuego basado en Realidad Virtual usado en terapia de rehabilitación física en personas con accidente cerebrovascular,” Rev. EIA, vol. 19, no. 38, Jun. 2022. https://doi.org/10.24050/reia.v19i38.1549
J. F. Villada Castillo et al., “Design of Virtual Reality Exergames for Upper Limb Stroke Rehabilitation Following Iterative Design Methods: Usability Study,” JMIR Serious Games, vol. 12, no. 1, p. e48900, Jan. 2024. https://doi.org/10.2196/48900
O. Espinosa, G. Puentes, J. Rodríguez, A. Robayo, and J.-M. Anaya, “Science, technology, and innovation in health for the next twenty years: A survey analysis in Colombia,” Health Care Science, vol. 3, no. 2, pp. 78–87, Feb. 2024. https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.87?src=getftr
N. J. García Ríos, D. M. Sánchez Moriones, and O. L. Montoya Hurtado, “Estrategias de intervención de fisioterapia en neurorehabilitación utilizadas en Colombia: Revisión bibliográfica,” Mov. cient., vol. 9, no. 1, pp. 60–66, May. 2015. https://revmovimientocientifico.ibero.edu.co/article/view/857
J. Suárez-Escudero, S. Restrepo Cano, E. Ramírez, C. L. Bedoya, and I. Jiménez, “Descripción clínica, social, laboral y de la percepción funcional individual en pacientes con ataque cerebrovascular,” Acta Neurol. Colomb., vol. 27, no. 2, pp. 97–105, Apr-Jun. 2011. https://www.actaneurologica.com/index.php/anc/article/view/1478/1175
K. Sevcenko, and I. Lindgren, “The effects of virtual reality training in stroke and Parkinson’s disease rehabilitation: a systematic review and a perspective on usability,” European Review of Aging and Physical Activity, vol. 19, no. 1, Jan. 2022. https://doi.org/10.1186/S11556-022-00283-3
A. Cormican, S. P. Hirani, and E. McKeown, “Healthcare professionals’ perceived barriers and facilitators of implementing clinical practice guidelines for stroke rehabilitation: A systematic review,” Clin. Rehabil., vol. 37, no. 5, pp. 701–712, May. 2023. https://doi.org/10.1177/02692155221141036
F. A. Silva-Sieger, J. P. Garzón-Hernández, J. A. Mendoza-Sánchez, J. E. Arias, and C. Ortiz, “Costos directos asumidos por pacientes y gastos de bolsillo en ACV isquémico durante el primer año,” Rev. Salud Pública, vol. 23, no. 4, p. 1, Jul-Aug. 2021. https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/91507
I. Patsaki et al., “The effectiveness of immersive virtual reality in physical recovery of stroke patients: A systematic review,” Front. Syst. Neurosci., vol. 16, Sep. 2022. https://doi.org/10.3389/fnsys.2022.880447
O. Espinosa, G. Puentes, J. Rodríguez, A. Robayo, and J.-M. Anaya, “Science, technology, and innovation in health for the next twenty years: A survey analysis in Colombia,” Health Care Science, vol. 3, no. 2, pp. 78–87, Apr. 2024. https://doi.org/10.1002/HCS2.87
R. Kapur, Digital platforms and transformation of healthcare organizations: Integrating digital platforms with advanced IT systems and work transformation. Boca Ratón, FL, USA: CRC Press, 2023. https://doi.org/10.4324/9781003366584
J. Powles, and H. Hodson, “Google DeepMind and healthcare in an age of algorithms,” Health Technol, vol. 7, no. 4, pp. 351–367, Dec. 2017. https://doi.org/10.1007/s12553-017-0179-1
E. A. Moreno Vargas, K. Sánchez Acosta, L. A. Parada, J. Zuluaga, and H. Bayona Ortíz, “Análisis de costos de la atención hospitalaria en un paciente con fibrilación auricular no valvular y accidente cerebrovascular a repetición,” Acta Neurol. Colomb., vol. 38, no. 3, pp. 139–147, Jul-Sep. 2022. https://doi.org/10.22379/24224022419
L. Baatiema, A. de‐Graft Aikins, F. S. Sarfo, S. Abimbola, J. K. Ganle, and S. Somerset, “Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives,” Health Expectations, vol. 23, no. 2, pp. 450–460, Apr. 2020. https://doi.org/10.1111/hex.13027
G. Sampaio Silva, and E. Rocha, “Developing Systems of Care for Stroke in Resource-limited Settings,” Semin Neurol, vol. 44, no. 2, pp. 119–129, Mar. 2024. https://doi.org/10.1055/S-0044-1782617
K. J. Bower, M. Verdonck, A. Hamilton, G. Williams, D. Tan, and R. A. Clark, “What factors influence clinicians’ use of technology in neurorehabilitation? A multisite qualitative study,” Phys. Ther., vol. 101, no. 5, May. 2021. https://doi.org/10.1093/ptj/pzab031
B. Ferreira, and P. Menezes, “Gamifying motor rehabilitation therapies: Challenges and opportunities of immersive technologies,” Information, vol. 11, no. 2, p. 88, Feb. 2020. https://doi.org/10.3390/info11020088
R. Proffitt, and B. Lange, “Considerations in the efficacy and effectiveness of virtual reality interventions for stroke rehabilitation: Moving the field forward,” Phys. Ther., vol. 95, no. 3, pp. 441–448, Mar. 2015. https://doi.org/10.2522/ptj.20130571
Y. Chen, K. Travis Abel, J. T. Janecek, Y. Chen, K. Zheng, and S. C. Cramer, “Home-based technologies for stroke rehabilitation: A systematic review,” Int J Med Inform., vol. 123, pp. 11–22, Mar. 2019. https://doi.org/10.1016/j.ijmedinf.2018.12.001
N. W. Moon, P. Ma Baker, and K. Goughnour, “Designing wearable technologies for users with disabilities: Accessibility, usability, and connectivity factors,” Journal of Rehabilitation and Assistive Technologies Engineering, vol. 6, Aug. 2019. https://doi.org/10.1177/2055668319862137
J. L. Pérez Medina, P. Acosta-Vargas, and Y. Rybarczyk, “A systematic review of usability and accessibility in Tele-rehabilitation systems,” in Assistive and Rehabilitation Engineering, England, UK: IntechOpen, 2019. https://doi.org/10.5772/INTECHOPEN.85869
I. Lehmann, G. Baer, and C. Schuster-Amft, “Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study,” Physiotherapy, vol. 107, pp. 317–326, Jun. 2020. https://doi.org/10.1016/j.physio.2017.03.001
R.-C. Lin et al., “Effectiveness of early rehabilitation combined with virtual reality training on muscle strength, mood state, and functional status in patients with acute stroke: A randomized controlled trial,” Worldviews Evid. Based. Nurs., vol. 17, no. 2, pp. 158–167, 2020. https://doi.org/10.1111/wvn.12429
F. Zanatta, A. Giardini, A. Pierobon, M. D’Addario, and P. Steca, “A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients’ and healthcare professionals’ perspective,” BMC Health Serv. Res., vol. 22, p. 523, Apr. 2021. https://doi.org/10.1186/s12913-022-07821-w
R. Teasell et al., “Canadian Stroke Best Practice Recommendations: Rehabilitation, recovery, and Community Participation following Stroke. part one: Rehabilitation and Recovery Following Stroke; 6th edition update 2019,” Int. J. Stroke, vol. 15, no. 7, pp. 763–788, Jan. 2020. https://doi.org/10.1177/1747493019897843
R. Cano-de-la-Cuerda et al., “Economic Cost of Rehabilitation with Robotic and Virtual Reality Systems in People with Neurological Disorders: A Systematic Review,” Journal of Clinical Medicine, vol. 13, no. 6, p. 1531, Mar. Mar. 2024. https://doi.org/10.3390/jcm13061531
G. Fregna, N. Schincaglia, A. Baroni, S. Straudi, and A. Casile, “A novel immersive virtual reality environment for the motor rehabilitation of stroke patients: A feasibility study,” Front. Robot. AI, vol. 9, Aug. 2022. https://doi.org/10.3389/frobt.2022.906424
Z. Liu, L. Ren, C. Xiao, K. Zhang, and P. Demian, “Virtual Reality Aided Therapandtowards Health 4.0: A Two-Decade Bibliometric Analysis,” International Journal of Environmental Research and Public Health, vol. 19, no. 3, p. 1525, Jan. 2022. https://doi.org/10.3390/IJERPH19031525
M. Veras et al., “Cost Analysis of a Home-Based Virtual Reality Rehabilitation to Improve Upper Limb Function in Stroke Survivors,” Global Journal Health Sci., vol. 12, no. 2, p. 98, Jan. 2020. https://doi.org/10.5539/gjhs.v12n2p98
J. Jonsdottir et al., “Virtual Reality for Motor and Cognitive Rehabilitation From Clinic to Home: A Pilot Feasibility and Efficacy Study for Persons With Chronic Stroke,” Front. Neurol., vol. 12, Apr. 2021. https://doi.org/10.3389/fneur.2021.601131
Descargas
Derechos de autor 2024 TecnoLógicas
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
| Estadísticas de artículo | |
|---|---|
| Vistas de resúmenes | |
| Vistas de PDF | |
| Descargas de PDF | |
| Vistas de HTML | |
| Otras vistas | |
