虚拟现实跑台训练对脑卒中患者步态的影响

关键词：脑卒中  虚拟现实跑台训练  步态

Keywords:stroke  virtual reality treadmill training  gait

摘要：

      摘要 目的：探讨虚拟现实跑台训练对脑卒中患者步态的影响。 方法：前瞻性连续入组2021年9月—2024年6月在北京市中关村医院康复医学科和神经内科住院的脑卒中患者70例，采用随机数字表法将患者分为试验组和对照组，每组各35例。对照组进行常规康复训练，试验组进行常规康复训练和虚拟现实跑台训练。康复训练前和治疗4周后采用Gaitboter步态分析系统对脑卒中患者进行步态评估。 结果：康复治疗前两组患者步速、步频、步幅、患侧单支撑相和患侧摆动相均无显著性差异。经过4周康复治疗，试验组患者步速、步频、步幅、患侧单支撑相和患侧摆动相均较治疗前明显提高，均有显著性差异（P＜0.001），对照组患者步速、步频、步幅、患侧单支撑相均较治疗前明显提高，均有显著性差异（P＜0.05），患侧摆动相无显著性差异。治疗4周后，试验组步速、步幅、患者单支撑相和患侧摆动相均高于对照组，试验组步频与对照组无显著性差异（P＞0.05）。 结论：虚拟现实跑台训练可以有助于改善脑卒中患者的步态，在改善脑卒中患者的步速、步幅、患侧单支撑相和患侧摆动相方面均有积极作用。

Abstract:

      Abstract Objective: To investigate the effects of virtual reality treadmill training on gait in stroke patients. Method: In this prospective study, 70 stroke patients admitted to the Department of Rehabilitation Medicine and Department of Neurology of Beijing Zhongguancun Hospital from September 2021 to June 2024 were consecutively enrolled. Using a random number table, patients were divided into an experimental group (n=35) and a control group (n=35). The control group received conventional rehabilitation training, while the experimental group received conventional rehabilitation training combined with virtual reality treadmill training. Gait parameters were assessed using the Gaitboter gait analysis system before and after 4 weeks of intervention. Result: At baseline, no significant differences were observed between the two groups in any gait parameters (P>0.05). After 4 weeks of treatment，the experimental group showed significant improvements in step speed，step frequency，step amplitude， affected-side single support phase，and affected-side swing phase compared to baseline (all P<0.001). The control group also demonstrated improvements in step speed，step frequency，step amplitude，and affected-side single support phase (all P<0.05), but no significant change in the affected-side swing phase (P>0.05). Post-intervention comparisons revealed that the experimental group outperformed the control group in step speed，step amplitude，affected-side single support phase，and affected-side swing phase (all P<0.05), while no significant difference was found in step frequency (P>0.05). Conclusion: Virtual reality treadmill training can effectively improve gait in stroke patients， and has shown positive effects in improving step speed，stride amplitude，and the affected-side single support phase，and affected swing phase in stroke patients.