发表机构
Kennesaw State University; University of Texas - San Antonio（肯尼索州立大学; 德克萨斯大学圣安东尼奥分校）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
本研究提出阈值锚定帕累托框架，评估MS患者VR步态反馈的性能与负担，发现空间听觉反馈效率最优，多模态虽改善最大但负担最高。
AI 中文摘要
多发性硬化症（MS）患者的步行速度降低与跌倒风险增加相关。然而，基于虚拟现实（VR）的康复研究往往强调性能改善，而未考虑实现这些改善所需的认知和体力消耗。本研究引入了一种阈值锚定的效率框架，该框架同时评估步态表现和总体消耗。从独立MS步态数据集中非跌倒者的平均步行速度得出规范性步行速度目标\(T=1.29\) m/s，并将其用作临床动机参考点。对34名患有多发性硬化症的成年人进行了评估，涵盖八种VR反馈条件，包括单模态、双模态和多模态反馈。对于每种条件，我们量化了速度差距中闭合至目标的比例以及相关的认知和体力负担。帕累托效率分析确定了五种非支配条件：静态视觉、空间听觉、听觉+视觉、听觉+振动触觉和多模态，而空间振动触觉和振动触觉+视觉被支配。空间听觉显示出有利的性能-努力权衡，闭合了72.7%的速度差距，同时保持低于平均水平的负担。多模态反馈实现了最大的差距闭合（95.6%），但也施加了最高的负担。这些发现表明，更大的步态改善不一定对应更高的康复效率，并提供了一个定量框架，用于根据性能增益和参与者负担比较VR反馈策略。
英文摘要
Reduced walking speed in people with multiple sclerosis (MS) is associated with an increased risk of falls. However, virtual reality (VR)-based rehabilitation studies often emphasize performance improvements without considering the cognitive and physical effort required to achieve them. This study introduces a threshold-anchored efficiency framework that jointly evaluates gait performance and overall effort. A normative walking-velocity target of \(T=1.29\) m/s was derived from the mean walking speed of non-fallers in an independent MS gait dataset and used as a clinically motivated reference point. Thirty-four adults with MS were evaluated across eight VR feedback conditions spanning unimodal, bimodal, and multimodal feedback. For each condition, we quantified the proportion of the velocity gap to the target that was closed and the associated cognitive and physical burden. Pareto efficiency analysis identified five non-dominated conditions: Static Visual, Spatial Auditory, Auditory+Visual, Auditory+Vibrotactile, and Multimodal, whereas Spatial Vibrotactile and Vibrotactile+Visual were dominated. Spatial Auditory showed a favorable performance-effort trade-off, closing 72.7% of the velocity gap while maintaining below-average burden. Multimodal feedback achieved the greatest gap closure (95.6%) but also imposed the highest burden. These findings demonstrate that greater gait improvement does not necessarily correspond to greater rehabilitation efficiency and provide a quantitative framework for comparing VR feedback strategies according to both performance gains and participant burden.
