三维步态分析系统在评价虚拟现实技术干预脑卒中后偏瘫步态效果中的研究

3D Gait Analysis System in Evaluating the Intervention Effect of Virtual Reality Technique on Gait Rehabilitation of Post-Stroke Hemiplegia

目的应用三维步态分析系统评价虚拟现实技术对脑卒中患者步态的影响。方法共有脑卒中后偏瘫患者60例纳入本研究,采用随机数字法将其分为观察组和对照组,各组均为30例;2组患者均给予常规康复训练,观察组在此基础上进行虚拟现实步态训练。采用的评估量表有功能性步行量表(FAC)和下肢Fugl-Meyer运动功能量表,采用GaitWatch步态分析系统,对患者的步态时空参数以及关节运动学参数进行评定,所有受试者均由同一位医师在实验前和实验后6周进行评估。结果2组患者的性别、年龄、病变性质及干预前的FAC等级、FMA-L评分、步态等参数差异均无统计学意义(P>0.05)。干预后,观察组患者的步幅、步速、步频、FMA下肢评分、FAC等级均较治疗前有提高(P<0.05),步行周期、双支撑相(%)、健侧支撑相时间(%)、患侧支撑相时间(%)均较治疗前减小(P<0.05),健侧摆动相时间(%)、患侧摆动相时间(%)均较治疗前提高(P<0.05);组间比较显示,观察组患者的步幅、步频、步速、步行周期、双支撑相(%)、健侧支撑相(%)、健侧摆动相(%)改善均优于对照组(P<0.05)。结论GaitWatch步态分析系统能够量化测定脑卒中患者的步态参数,为其步行康复训练提供定量参考;基于虚拟现实技术的步态训练能够有效提高脑卒中患者的步行能力。

Objective To evaluate the clinical effect of virtual reality technique(VR)on gait rehabilitation of poststroke hemiplegia with 3D gait analysis system.Methods 60 cases with post-stroke hemiplegia were randomly divided into 2 groups:observation group and control group,30 in each;regular rehabilitation training was given to the cases in both groups while additional VR-assisted training was added to cases in observation group;function ambulation category scale(FAC)and Fugl-Meyer assessment for lower extremity(FMA-LE)were applied to all the cases and Gait Watch kinematic analysis system was adopted in evaluating the gait temporal-spatial parameters and lower extremity motions;the evaluation before training and 6 weeks after training was conducted by the same doctor.Results No statistical differences were found in sex,age,nature of the diseases and in FAC level,FMA-LE score and gait parameter before training between the cases in the 2 groups(P>0.05);the values of stride length,walking velocity,FAC levels and FAM-LE scores of the cases in observation group after training increased significantly(P<0.05);the length of gait cycle,double support phase,nonparetic stance phase and paretic stance phase decreased significantly while the lengths of nonparetic paretic swing phase and paretic swing phase increased obviously in cases in observation group after training(P<0.05);after training,the improvement in stride length,cadence,walking velocity,gait cycle,double support phase,nonparetic stance phase,nonparetic leg swing phase in observation group was much superior to that in control group(P<0.05).Conslusons Gait Watch kinematic analysis system can quantitatively measure the gait parameters of post-stroke cases,providing evidence for further walking rehabilitation;VR-assisted training can effectively promote their ambulation ability.