虚拟现实技术结合作业治疗训练对脑卒中偏瘫患者上肢功能影响的临床研究

Effects of virtual reality technology combined with occupational therapy training on upper limb function in stroke patients with hemiplegia

目的:观察虚拟现实技术(virtual reality, VR)结合作业治疗(occupational therapy, OT)对脑卒中偏瘫患者上肢运动功能、日常生活能力的影响。方法:将70例脑卒中患者随机分为试验组与对照组各35例。两组患者均给予常规治疗(即常规药物及运动治疗),对照组在常规治疗基础上,予传统OT训练,每次50min,每周5次,疗程4周;试验组予VR联合传统OT治疗,其中传统OT训练每次20min,VR治疗包括BioMaster数字OT训练及Flextable数字OT训练每次各15min,共50min,每周5次,疗程4周。采用简化的Fugl-Meyer上肢运动功能评定量表(FMA-UE)和香港版偏瘫上肢功能测试(FTHUEHK)、Barthel指数(BI)于治疗前、治疗4周后评估各组患者的上肢运动功能和日常生活活动能力,用以判断患者上肢功能的恢复情况。结果:治疗前两组患者的基线资料、FMA-UE评分、FTHUE-HK分级、BI评分差异均无显著性意义(P>0.05)。治疗4周后,两组患者的FMA-UE评分、FTHUE-HK分级、BI评分均较治疗前明显提高(P<0.05),且试验组优于对照组(P<0.05)。结论:虚拟现实技术结合作业治疗比单侧传统作业治疗更能有效改善脑卒中患者上肢运动功能,提高患者日常生活能力。

Objective: To observe the effect of virtual reality technology combined with occupational therapy training on upper limb motor function and daily living ability of stroke patients with hemiplegia.Method: Totally 70 stroke patients with hemiplegia were randomly divided into the experimental group and the control group,35 patients in each group. Both groups were given routine treatment, that is, routine medicine and exercise therapy. On the basis of routine treatment, the control group accepted occupational therapy training 50 minutes each time, five times a week, a total of 4 weeks. At the same time,the experimental group, on the basis of routine treatment, accepted occupational therapy training 20 minutes combined with BioMaster digital OT training 15 minutes and Flextable digital OT training 15 minutes,totally 50 minutes each time, five times a week, a total of 4 weeks. In order to assess the recovery of upper limb function, the simplified Fugl-Meyer Motor Function Assessment Scale(FMA-UE), the Hong Kong Version of the Upper Limb Function Test(FTHUE-HK) and the Barthel index(BI) were used to assess the upper limb motor function and the ability of daily living of the patients before and after treatment for 4 weeks.Result: There were no significant differences in basic data, FMA-UE score, FTHUE-HK grade and BI score between the two groups before treatment(P>0.05). After 4 weeks of treatment, FMA-UE score, FTHUE-HK grade and BI score of the two groups were significantly higher than those before treatment(P<0.05), and the experimental group was superior to the control group(P<0.05).Conclusion: Compared to the simply conventional occupational therapy, virtual reality technology combined with occupational therapy training can more effectively improve the recovery of upper limb motor function in stroke patients and improve their daily living ability.