沉浸式虚拟现实训练结合作业治疗 对脑卒中单侧忽略的疗效观察  

Effect of immersive virtual reality training combined with occupational therapy in treatment of stroke patients with unilateral neglect

作　　者：袁景 王年 林桦 刘智岚 李果 成巍 仇丽雯 徐冰 YUAN Jing;WANG Nian;LIN Hua;LIU Zhilan;LI Guo;CHENG Wei;QIU Liwen;XU Bing(Department of Geriatric Rehabilitation,Shanghai Fourth Rehabilitation Hospital,Shanghai,200040)

机构地区：[1]上海市第四康复医院老年康复科,上海200040

出　　处：《实用临床医药杂志》2024年第2期18-22,共5页Journal of Clinical Medicine in Practice

基　　金：上海市静安区卫生科研课题(2022MS15,2021QN06)。

摘　　要：目的观察沉浸式虚拟现实(IVR)训练结合作业治疗(OT)对脑卒中单侧忽略的疗效。方法将上海市第四康复医院收治的50例脑卒中单侧忽略患者随机分为IVR联合OT组和OT组,每组25例。OT组予以常规的单侧忽略OT,IVR联合OT组予以IVR训练结合OT,2组疗程均为4周。治疗前后采用凯瑟琳-伯哥量表(CBS)、线段划消测试、星星划消测试、画钟试验评价单侧忽略症状;采用Fugl-Meyer评定量表上肢部分(FMA-UE)和Barthel指数(BI)评估上肢运动和日常生活能力。结果2组治疗后CBS、线段划消测试、星星划消测试、画钟试验、FMA-UE、BI评分均较治疗前改善,且IVR联合OT组改善效果优于OT组,差异均有统计学意义(P<0.05或P<0.01)。结论IVR训练联合OT能改善脑卒中患者的单侧忽略症状、患侧上肢运动功能和生活自理能力。Objective To observe the effect of immersion virtual reality(IVR)training combined with occupational therapy(OT)in the treatment of stroke patients with unilateral neglect.Methods Fifty stroke patients with unilateral neglect in Shanghai Fourth Rehabilitation Hospital were randomly divided into IVR plus OT group and OT group,with 25 cases in each group.The OT group received conventional OT for unilateral neglect,and the IVR plus OT group received IVR training and OT.Both groups were treated for 4 weeks.Before and after treatment,the Catherine Bergego Scale(CBS),line cancellation test,star cancellation test,and drawing clock test were used to evaluate unilateral neglect symptoms;the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)and Barthel index(BI)were used to evaluate motor function of upper extremity and activities of daily living.Results After treatment,the results of CBS,line cancellation test,star cancellation test,drawing clock test,FMA-UE and BI scores were significantly improved when compared with those before treatment in both groups,and the improvement effects in the IVR plus OT group were significantly better than those in the OT group(P<0.05 or P<0.01).Conclusion IVR training combined with OT can improve unilateral neglect symptoms,motor function of affected upper extremity,and activities of daily living in stroke patients.

关 键 词：单侧空间忽略 脑卒中 虚拟现实训练系统 作业治疗 Fugl-Meyer评定量表上肢部分 BARTHEL指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学] R319