虚拟现实技术对脑卒中患者偏瘫步态训练的临床研究

关键词：虚拟现实  脑卒中  偏瘫步态  步态分析

Keywords:virtual reality  stroke  hemiplegic gait  gait analysis

摘要：

      摘要 目的：探讨临床中应用虚拟现实（VR）技术对脑卒中患者行走及平衡功能的影响。 方法：选择病程为8个月内的脑卒中偏瘫患者30例，随机分配到实验组（VR+基本药物+常规康复治疗）和对照组（基本药物+常规康复治疗），采用三维步态分析仪记录两组患者治疗前及治疗2周后的步速、步宽、支撑相百分比、膝关节活动度等步态参数。 结果：治疗2周后，两组患者的步速明显提高、步宽缩小，患健侧支撑相比值、步态不对称性指数、髋关节最大伸展角度、膝关节最大屈曲角度等参数于治疗前后有显著差异（P＜0.05）；治疗后两组间相比，实验组的治疗效果明显优于对照组（P＜0.05）。 结论：通过VR技术能明显改善脑卒中偏瘫患者的步态时空参数和步行中关节活动角度，对提高步态稳定性、改善步行能力、提高运动功能康复有积极的治疗效果。

Abstract:

      Abstract Objective: To investigate the clinical effects of virtual reality(VR) training on walking and balance ability in stroke hemiplegic patients by using gait analysis. Method: Thirty patients with hemiplegic gait post stroke, the duration range from 15—30 weeks were randomly divided into experiment group (VR+conventional physiotherapy, n=15) and control group (conventional physiotherapy alone, n=15). Gait parameters including gait velocity, stride width, paretic stance phase and knee joint flexion angle were collected and calculated by Gait Watch Three-dimensional (3D) gait analysis system before and after the 2-week treatment. Result: After 2 weeks of treatment, the gait parameters of two groups of patients all improved, such as gait velocity, frequency, stride width, double limb support phase, paretic stance phase, nonparetic stance phase, nonparetic leg swing phase and paretic leg swing phase (P＜0.05). The parameters showed more significant improvement in experiment group than those in control group including paretic leg swing phase, gait asymmetry index, hip joint stretching angle and knee joint flexion angle (P＜0.05). Conclusion: Virtual reality treatment can improve gait temporal-spatial parameters and joint motion of walking in patients with hemiplegic gait post stroke and show positive effects on gait stability, walking ability and motor function rehabilitation.