虚拟现实训练对有平衡障碍的小脑梗死患者平衡和步态的影响

关键词：小脑梗死  虚拟现实  步态分析  平衡训练

Keywords:cerebellar infarction  virtual reality  gait analysis  balance training

摘要：

      摘要 目的：探讨虚拟现实训练对有平衡障碍的小脑梗死患者平衡和步态的影响。 方法：前瞻性收集2016年6月—2017年12月浙江中医药大学附属第二医院神经内科和康复科住院的急性小脑梗死患者54例，随机分为对照组(n=27)和观察组(n=27)。对照组接受传统平衡训练3周，观察组接受基于虚拟现实技术的平衡训练3周。治疗前后采用Berg平衡量表（BBS）评定平衡功能，Gait Watch三维步态分析系统分析患者步态。 结果：治疗3周后，观察组BBS动态评分，BBS静态评分及BBS总分均较对照组明显升高（t=2.029, P=0.048；t=2.115, P=0.039；t=2.757, P=0.008）。步态分析结果提示：观察组步频和患侧摆动相较对照组明显升高（t=2.235, P=0.030；t=2.148, P=0.036），步态不对称指数较对照组明显下降（t=-2.107, P=0.040）；观察组步速和跨步长较对照组明显增高（t=2.395, P=0.020；t=2.451, P=0.018），步宽较对照组明显降低（t=-2.035, P=0.047）；观察组步行时患侧髋关节和膝关节最大活动角度较对照组明显增大（t=2.054, P=0.045；t=2.324, P=0.024）。 结论：虚拟现实训练较传统平衡训练能更有效改善小脑梗死患者的平衡功能和步态异常。

Abstract:

      Abstract Objective: To explore the effect of virtual reality training on balance and gait of Balance dysfunction patients with cerebelum infarction. Method: From June 2016 to December 2017, 54 patients with acute cerebelum infarction were randomly divided into control group (n=27) and observation group (n=27). The control group received traditional balance training for 3 weeks, besides，the observation group received balance training based on virtual reality technology for 3 weeks. Before and after treatment, the balance function was assessed by berg balance scale (BBS), and the patients' gait was analyzed by gait watch three-dimensional gait analysis system. Result: After 3 weeks of training, BBS dynamic score, BBS static score and BBS total score in the observation group were significantly higher than those in the control group (t=2.029, P=0.048；t=2.115, P=0.039；t=2.757, P=0.008). Gait analysis indicated that gait frequency and swing phase in the observation group were significantly higher than those in the control group (t=2.235, P=0.030；t=2.148, P=0.036), and gait asymmetry index was significantly lower than that in the control group (t=2.107, P=0.040). The gait speed and stride length of the observation group were significantly higher than those of the control group (t=2.395, P=0.020； t=2.451, P=0.018), and the stride width was significantly lower than that of the control group (t=2.035, P=0.047). The maximal angle of motion of the affected hip and knee joint in the observation group was significantly higher than that in the control group (t=2.054, P=0.045；t=2.324, P=0.024). Conclusion: Virtual reality training is more effective than traditional balance training in improving balance function and gait abnormality in patients with cerebelum infarction.