虚拟现实游戏训练对脑卒中患者偏瘫上肢功能恢复的影响  

Gaming-based virtual reality therapy for the rehabilitation of upper extremity function after stroke

作　　者：韩晓晓[1] 柯将琼[2] 蒋松鹤[1] 张丹迎[1] 

机构地区：[1]温州医科大学附属第二医院康复医学科,温州325027 [2]温州医科大学附属第二医院神经内科,温州325027

出　　处：《中华物理医学与康复杂志》2016年第6期401-405,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：温州市高层次人才重点资助创新项目（2013-118）

摘　　要：目的探讨虚拟现实游戏训练对脑卒中患者偏瘫上肢功能恢复的影响。方法采用随机数字表法将30例脑卒中偏瘫患者分为治疗组（15例）及对照组（15例），2组患者均给予常规药物治疗及物理治疗，治疗组在此基础上给予Wii（任天堂）虚拟现实游戏训练，对照组则辅以常规作业治疗。于治疗前、治疗2周后分别采用上肢部分Fugl-Meyer评定量表（FMA-UE）及上肢Brunnstrom分期量表对2组患者上肢运动功能恢复情况进行评定，同时采用表面肌电图检测2组患者患肘最大等长屈曲、伸展时肱二头肌、三头肌积分肌电值，并计算相应的共同收缩率（CR）。结果治疗前2组患者FMA-UE评分、Brunnstrom分期评分、患肘屈曲时肱二头肌CR及患肘伸展时肱三头肌CR组间差异均无统计学意义（P〉0．05）；治疗2周后发现治疗组及对照组患者FMA-UE评分[分别为（33．5±12．6）分、（30．9±15．6）分]、Brunnstrom分期评分[分别为（4．1±1．0）分、（4．0±1．2）分]、患肘屈曲时肱二头肌CR[分别为（14．6±5．7）％、（13．7±6．0）％]及患肘伸展时肱三头肌CR[分别为（27．4±8．2）％、（30．3±9．5）％]均较组内治疗前明显改善（P〈0．05），且治疗后2组患者上述疗效指标组间差异仍无统计学意义（P〉0．05）。结论Wii虚拟现实游戏训练在促进脑卒中患者偏瘫上肢运动功能恢复以及改善患肘屈伸运动协调性方面与常规作业治疗具有相同疗效。Objective To investigate the effects of playing virtual reality games on the recovery of hemiplegic upper extremities after stroke. Methods Thirty stroke patients with hemiplegic upper extremities were randomly assigned to a treatment group （n= 15） or a control group （n= 15）. Both groups received routine medication and conventional physical therapy, while the treatment group was additionally given （Nintendo） gam- ing-based virtual reality therapy. Before and after 2 weeks of treatment, the patients in both groups were evalua- ted using the Fugl-Meyer Assessment for the Upper Extremities （FMA-UE） , Brunnstrom staging and co-contrac- tion ratios （CRs）. Surface electromyogram signals from the biceps brachii and triceps brachii were also recorded during maximum isometric voluntary flexion and extension of the affected elbow. Results No significant differ- ences in any of the measurements were observed between the 2 groups before or after the intervention. Both groups demonstrated significant increases in their average FMA-UE score, Brunnstrom staging and CRs. Con- clusions Virtual reality gaming using a Wii controller is as effective as conventional therapy in enhancing upper extremity motor function and elbow flexion and extension after stroke.

关 键 词：脑卒中 偏瘫 虚拟现实游戏训练 上肢功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]