虚拟情景互动平衡游戏对脑卒中患者平衡功能及跌倒风险的影响

Effects of virtual reality interactive balance games on balance function and fall risk in stroke patients

目的探讨对脑卒中后偏瘫患者采用虚拟情景互动平衡游戏训练对其平衡功能及跌倒风险的影响。方法选取2018年1月至2019年1月的62例脑卒中患者随机分为虚拟训练组(n=31)和常规组(n=31),疗程均为4周。虚拟训练组采用虚拟情景互动平衡游戏训练,常规组进行常规平衡训练。治疗前及治疗4周,采用Berg平衡量表(BBS)评定患者总体平衡能力,采用BioDex平衡测试系统测量静态跌倒风险指数(SFI)、动态跌倒风险指数(DFI)及姿势稳定极限性(LOS),并在训练结束后4周和8周对患者进行随访记录跌倒次数。结果治疗4周,两组BBS、LOS评分较治疗前提高,且虚拟训练组高于常规组;两组SFI、DFI评分均较治疗前降低,且虚拟训练组低于常规组;上述各指标不同时点间、组间、时点间和组间交互作用比较差异均有统计学意义(P<0.05)。治疗4周、训练结束后4周及训练结束后8周两组患者平均跌倒次数均较治疗前减少(P<0.05),且虚拟训练组三个时点平均跌倒次数均少于常规组(P<0.05),常规组患者训练结束后8周平均跌倒次数较治疗结束后增加(P<0.05)。结论虚拟情景互动平衡游戏训练可有效促进脑卒中患者平衡功能的恢复并降低跌倒风险。

Objective To investigate the effect of virtual reality(VR)interactive balance game training on balance function and fall risk in patients with hemiplegia after stroke.Methods Sixty-two stroke patients treated from January 2018 to January 2019 were randomly divided into the virtual reality game-based training group(VR group,n=31)and the conventional balance training group(control group,n=31).Rehabilitation treatment was performed in two groups for four weeks.Berg Balance Scale(BBS)was used to evaluate the overall balance ability of the patients.The static fall risk index(SFI),dynamic fall risk index(DFI)and limit of postural stability(LOS)were measured by Biodex balance test system.The patients were followed up 4 and 8 weeks after finishing rehabilitation,and the number of falls was recorded.Results There were no significant differences in the assessment scores before treatment between two groups(P>0.05).After treatment,BBS and LOS scores increased compared with those before treatment in two groups(P<0.05)and were statistically higher in VR group than those in control group(P<0.05);SFI and DFI scores decreased compared with those before treatment in both groups(P<0.05)and were statistically lower in VR group than those in control group(P<0.05).There were significant differences in the interaction of above indicators at different time points and groups(P<0.05).The average number of falls decreased compared with that before treatment in two groups(P<0.05)and were significantly less in VR group than those in control group at the end of the trial and 4-,8-week after treatment(P<0.05).In control group,the average number of falls increased at 8 weeks after treatment compared with that at the end of treatment(P<0.05).Conclusion Virtual reality game-based training on balance can effectively promote the recovery of balance function and reduce the risk of fall in stroke patients.