虚拟现实同步减重训练脑梗死患者可改善下肢运动功能

Virtual reality-enhanced body weight-supported treadmill training improved lower limb motor function in patients with cerebral infarction

背景:脑卒中患者多有步行功能障碍,虚拟现实同步减重训练开始运用于脑梗死患者的步态训练。目的:评估虚拟现实同步减重训练对亚急性期脑梗死患者下肢运动功能的影响。方法:20例起病3个月内的脑梗死患者随机分配至实验组(虚拟现实同步减重训练)和常规组(常规物理治疗)。在3周步态训练前后各做一次三维步态并进行下肢运动功能评估。对以下参数进行训练前后组内和组间对比:步行速度、步调、步行时间、单腿支撑时间(%)、双腿支撑时间(%)、摆动时间、步长、步幅、下肢各关节活动度、功能性步行分类、下肢Fugl-Meyer评分和Brunel平衡评分。结果与结论:训练前两组患者的性别、年龄、病程、偏瘫侧、步行速度、功能性步行分类、下肢Fugl-Meyer评分和Brunel平衡评分差异无显著性(P>0.05)。训练后两组患者的下肢Fugl-Meyer评分和功能性步行分类均有改善(P<0.05)。实验组在步行速度、步调、患侧步行时间、健侧步行时间、患侧单腿支撑时间、患侧摆动时间、健侧摆动时间、步幅、患侧步长和健侧步长的改善方面较常规组有优势。

BACKGROUND：Most stroke patients affected walking dysfunction. Virtual reality-enhanced body weight-supported treadmil training has been proposed as a strategy for gait training of cerebral infarction subjects. OBJECTIVE：To evaluate the effectiveness of virtual reality-enhanced body weight-supported treadmil training on lower limb motor function in subacute cerebral infarction patients. METHODS：Twenty cerebral infarction patients （within 3 months of onset） were randomly divided into experiment group （virtual reality-enhanced body weight-supported treadmil training） and control group （conventional physiotherapy）. Three-dimensional gait analysis in lower limb motor function was carried out before and after 3-week gait training. Intergroup and intragroup comparisons in the fol owing parameters were done before and after training：walking speed, cadence, step time, single limb support time （%）, double limb support time （%）, nonparetic swing （%）, step length, pace, range of motion in the lower limb, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment. RESULTS AND CONCLUSION：No significant differences in patient’s gender, age, course of disease, affected.＆nbsp;side, walking speed, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment were detected between the two groups before training （P〉0.05）. Fugl-Meyer Assessment and functional ambulation category were improved in patients of the two groups after training （P〈0.05）. The improvement in walking speed, cadence, step time in affected side, step time in healthy side, single limb support time in affected side （%）, nonparetic swing （%）, pace, step lengths in affected and healthy sides were better in the experimental group than those in the control group.