沉浸式虚拟现实技术结合早期康复训练对肩袖损伤术后患者的临床疗效评价  

Clinical efficacy of immersive virtual reality technology combined with early rehabilitation training for postoperative patients with rotator cuff injuries

作　　者：李飞飞 蔡晨晨 吴巧云 姜西西 郑余银[1] 蒋松鹤[1] LI Feifei;CAI Chenchen;WU Qiaoyun;Jiang Xixi;Zheng Yuyin;Jiang Songhe(Center of Physical Medicine and Rehabilitation,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第二医院康复医学中心,浙江温州325000

出　　处：《温州医科大学学报》2024年第5期371-377,共7页Journal of Wenzhou Medical University

摘　　要：目的:观察沉浸式虚拟现实技术(VR)结合早期康复训练对肩袖损伤术后患者早中期康复治疗的效果。方法:选取2023年4月至2023年11月期间在温州医科大学附属第二医院进行首次肩袖修补术且符合纳入标准的45例患者为研究对象,用随机数字表法分为实验组22例和对照组23例。术后0~2周,两组均行常规被动康复训练;术后2~6周,对照组采用早期康复训练,实验组在早期康复的基础上,予以沉浸式虚拟现实系统进行上肢运动功能训练。分别在治疗前、治疗4周后评估两组疼痛视觉模拟量表(VAS)评分、美国加州大学洛杉矶分校(UCLA)肩关节评分、肩关节主被动前屈和贴臂外旋活动度、患侧冈上肌横截面积(CSA)。结果:研究过程中部分病例脱落予以剔除(实验组1例,对照组2例),两组各完成21例,纳入最终疗效分析。治疗后,两组患者VAS评分降低,UCLA评分增高,主被动前屈活动度和患侧冈上肌CSA均较治疗前增加,实验组主被动贴臂外旋角度较治疗前增加,且实验组各项指标均较对照组明显改善,差异有统计学意义(P<0.05)。对照组主被动贴臂外旋角度较治疗前无显著增加(P>0.05),两组患者冈上肌CSA与UCLA肩关节评分呈显著正相关(P<0.05)。结论:沉浸式VR结合早期康复治疗能有效减轻患者的疼痛,提高肩关节活动度,改善患者功能活动,并促进冈上肌肌腱的修复。Objective:To observe the effect of immersive virtual reality technology(VR)combined with early rehabilitation training on the early and mid-term rehabilitation treatment of postoperative patients with rotator cuff injury.Methods:Forty-five patients who underwent the initial rotator cuff repair in the Second Affiliated Hospital of Wenzhou Medical University between April 2023 and November 2023 and met the inclusion criteria were selected as subjects.They were randomly divided as the experimental group(n=22)cases and the control group(n=23).From 0 to 2 weeks after the operation,routine passive rehabilitation training was performed in both groups;from 2 to 6 weeks post-operation,the control group adopted early rehabilitation training,and the experimental group,on the basis of early rehabilitation,was given immersive virtual reality system for upper limb motor function training.The VAS pain visual analog scale score,UCLA shoulder score,shoulder joint active and passive forward flexion and external rotation mobility,and cross-sectional area of the supraspinatus muscle on the affected side(CSA)were evaluated before and after 4 weeks of treatment,respectively,in both groups.Results:During the study 1 case in the experimental group and 2 cases in the control group who failed to finish were thus excluded.There were 21 cases who completed in either group and were included in the final efficacy analysis.After treatment,VAS score decreased,UCLA score increased,active and passive forward flexion activity and CSA of the affected supraspinatus muscle increased compared with the pre-treatment period,and active and passive external rotation of the arm increased compared with the pre-treatment period in the experimental group,and all the indexes of the experimental group improved significantly compared with the control group,with significant difference(P<0.05).In the control group,there was no significant increase in the active-passive posting arm external rotation angle compared with the pre-treatment period(P>0.05),and both grou

关 键 词：虚拟现实技术 肩袖修补术 肌骨超声 早期康复 

分 类 号：R493[医药卫生—康复医学]