虚拟现实技术对脑卒中患者偏瘫步态训练的临床研究.doc

虚拟现实技术对脑卒中患者偏瘫步态训练的临床研究 Clinical trial of virtual reality application in stroke rehabilitation 赵一瑾1 黄国志2 谢笑3 黄杰斌4 Zhao Yijin1 Huang Guozhi2 Xie Xiao3 Huang Zhibin4 南方医科大学附属珠江医院康复医学科，广州510282,中国 Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China 【摘要】 目的：脑卒中常会造成姿势反性受损，导致行走困难。相关研究认为虚拟现实可以提供较有意义的任务性训练且精确的感觉回馈研究之目的为探讨虚拟现实脑卒中患者功能的影响。 (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 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。 关键词：虚拟现实；脑卒中；偏瘫步态；步态分析 Background and purpose：Stroke commonly disrupts the automatic postural responses which might lead to difficulty walking. Some studies suggested that VR-based training can provide a more meaningful task with precise sensory feedback. The purpose of this study is to investigate the clinical effects on walking and balance ability in hemiplegic stroke patients after virtual reality training by using gait analysis. Method：Thirty patients with hemiplegic gait post stroke, the duration range from 15weeks to 30weeks were randomly divided into experiment group (VR+ conventional physiotherapy，n=15)and control group (conventional physiotherapy，n=15). Gait parameters including gait velocity ,stride width，paretic stance phase, 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 the 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，paretic leg swing phase (P0．05)． The parameters showed more significant improvement improved more significantly in observation group than those in control group including paretic leg swing phase，gait asymmetry index, hip joint stretc