Effectiveness of a 5-Week Virtual Reality Telerehabilitation Program for Children With Duchenne and Becker Muscular Dystrophy: Prospective Quasi-Experimental Study
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".