虚拟现实技术在老年慢性阻塞性肺疾病并轻度认知障碍患者肺康复训练中的应用效果

Application Effect of Virtual Reality Technology in the Pulmonary Rehabilitation Program for Elderly COPD Patients Complicated with Mild Cognitive Impairment

目的分析虚拟现实技术在老年慢性阻塞性肺疾病(COPD)并轻度认知障碍(MCI)患者肺康复训练中的应用效果。方法选取2017年1月—2018年2月常州市德安医院收治的老年COPD并MCI患者60例,采用随机数字表法分为对照组与研究组,每组30例。在常规药物治疗、健康教育及呼吸肌训练基础上,对照组患者进行常规肺康复训练,研究组患者利用Bio Master虚拟情景互动康复训练系统进行肺康复训练;两组患者均持续训练12周。比较两组患者训练前及训练后4周、8周、12周肺功能指标,训练前及训练后12周6分钟步行距离、COPD评估测试(CAT)评分、蒙特利尔认知功能评估量表(Mo CA)评分。结果时间与方法在第1秒用力呼气容积(FEV1)占预计值的百分比、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)上存在交互作用(P<0.05);时间和方法在FEV1占预计值的百分比、FEV1/FVC上主效应显著(P<0.05);研究组患者训练后8周FEV1占预计值的百分比及训练后12周FEV1占预计值的百分比、FEV1/FVC高于对照组(P<0.05)。训练前两组患者6分钟步行距离、CAT评分、Mo CA评分比较,差异无统计学意义(P>0.05);训练后12周研究组患者6分钟步行距离长于对照组,CAT评分低于对照组,Mo CA评分高于对照组(P<0.05)。结论虚拟现实技术在老年COPD并MCI患者肺康复训练中的应用效果良好,可有效改善患者肺功能、认知功能及运动耐量,减轻呼吸困难症状。

Objective To analyze the application effect of virtual reality technology in the pulmonary rehabilitation program for elderly COPD patients complicated with mild cognitive impairment(MCI).Methods A total of 60 elderly COPD patients complicated with MCI were selected in Dean Hospital of Changzhou from January 2017 to February 2018,and they were divided into control group and study group according to random number table,each of 30 cases.Based on conventional drug therapy,health education and respiratory muscle training,patients in control group received conventional pulmonary rehabilitation program,while patients in study group received BioMaster Virtual Scene Interactive Rehabilitation Training System guided pulmonary rehabilitation program;both group continuously trained for 12 weeks.Index of pulmonary function before training,4,8 and 12 weeks after training,6-minute walking distance,CAT score and MoCA score before training and 12 weeks after training were compared between the two groups.Results There was statistically significant interaction between time and method in FEV1%pred and FEV1/FVC(P<0.05);main effects of time and method were statistically significant in time and method(P<0.05);FEV1%pred 8 weeks after training,FEV1%pred and FEV1/FVC 12 weeks after training in study group were statistically significantly higher than those in control group(P<0.05).No statistically significant differences of 6-minute walking distance,CAT score or MoCA score was found between the two groups before training(P>0.05);12 weeks after training,6-minute walking distance in study group was statistically significantly longer than that in control group,CAT score in study group was statistically significantly lower than that in control group,while MoCA score in study group was statistically significantly higher than that in control group(P<0.05).Conclusion Virtual reality technology has good application effect in the pulmonary rehabilitation program for elderly COPD patients complicated with MCI,can effectively improve the pulmonary function,cognitive function and exercise tolerance,relieve the dyspnea.