虚拟现实视频游戏对脑性瘫痪患儿粗大运动功能的影响

Effect of virtual reality video games on gross motor function of children with cerebral palsy

目的研究虚拟现实视频游戏对脑性瘫痪(脑瘫)患儿粗大运动功能的影响。方法选择2015年4月至2017年4月于郑州大学第五附属医院就诊的56例脑瘫患儿为研究对象,患儿年龄为(5.4±1.2)岁(5~7岁)。根据粗大运动功能分级系统(GMFCS)评估结果患儿均位于Ⅰ~Ⅱ级。所有患儿按照随机数字表法分为视频游戏组和常规锻炼组,分别进行为期6周的功能锻炼,评价指标包括平均练习时间,6min步行测试(6MWT)及粗大运动功能测量挑战模块(GMFMS-CM)测量评估。结果视频游戏组患儿的视频游戏平均练习时间为(44.2±6.1)min,干预过程中治疗者的鼓励工作较为重要,技术方面的问题也占较高比例,需重视研究起始的技术指导和培训;Likert量表平均反馈情况提示,研究中采用的练习项目适合患者群体;视频游戏组GMFMS-CM研究结果显示,经干预后患者的评分显著改善[平均差值为4.8分,四分位数(IQR)4.68,Z=-2.025,P=0.035],常规锻炼组整体呈上升趋势但无显著性差异;6MWT测试结果显示,视频游戏组的平均水平显著增加(平均差值69.1m,IQR40.2m,Z=-2.108,P=0.045),常规锻炼组则显著低于视频游戏组研究对象的平均水平,并且在研究时间段内基本无显著性改变。结论对于脑瘫患儿,在常规功能康复锻炼的基础上予家庭式的虚拟现实视频游戏练习能够延长患儿锻炼的时间,另一方面能够显著改善患儿的肢体运动功能,从而有利于提高患儿的生活质量和自理能力。

Objective To explore the effect of virtual reality video games on gross motor skills of children with cerebral palsy. Methods The 56 patients with cerebral palsy treated in the Fifth Affiliated Hospital of Zhengzhou University from April 2015 to April 2017 were selected as the subjects.The age of the patients was (5.4±1.2) years old (5-7 years old). According to the results of Gross Motor Function Classification System (GMFCS) assessment, all patients belonged to level Ⅰ-Ⅱ.All patients were randomly divided-into 2 groups: video-game group and conventional exercise group for 6 weeks of functional exercise.The evaluation criteria included the average exercise time, the 6-minute walk test (6MWT) and general motion function challenge module (GMFMS-CM) measurement and evaluation. Results The average exercise time of video games in video game group was (44.2 ± 6.1) minutes.The encouragement from the therapists in the intervention process was very important.The technical problems also had a relatively high proportion, and the technical guidance and training should be emphasized at the beginning of the study.The ave-rage score of the Likert scale showed that the practice program was suitable for the patients; GMFMS-CM in video-game group was significantly higher [mean difference was 4.8, the quartile (IQP) was 4.68, Z=-2.025, P=0.035], while conventional exercise group showed an increasing trend which was not significantly different; 6MWT showed a significant increase in the mean level of video-game group (mean difference was 69.1 m, IQR was 40.2 m, Z=-2.108, P=0.045), conventional exercise group was significantly lower than the average level of subjects in video-game group and there was no significant change in the study period. Conclusion For children with cerebral palsy, routine functional rehabilitation exercise plus family-style virtual reality video game practice, on the one hand to improve patient compliance with the treatment, on the other hand can significantly improve their physical movement function, which is conducive for the patients′ quality of life and self-care ability.