Bioengineering Department, University of Strathclyde, Glasgow, UK.
Trials. 2012 Sep 11;13:163. doi: 10.1186/1745-6215-13-163.
Increasing evidence suggests that use of augmented visual feedback could be a useful approach to stroke rehabilitation. In current clinical practice, visual feedback of movement performance is often limited to the use of mirrors or video. However, neither approach is optimal since cognitive and self-image issues can distract or distress patients and their movement can be obscured by clothing or limited viewpoints. Three-dimensional motion capture has the potential to provide accurate kinematic data required for objective assessment and feedback in the clinical environment. However, such data are currently presented in numerical or graphical format, which is often impractical in a clinical setting. Our hypothesis is that presenting this kinematic data using bespoke visualisation software, which is tailored for gait rehabilitation after stroke, will provide a means whereby feedback of movement performance can be communicated in a more meaningful way to patients. This will result in increased patient understanding of their rehabilitation and will enable progress to be tracked in a more accessible way.
The hypothesis will be assessed using an exploratory (phase II) randomised controlled trial. Stroke survivors eligible for this trial will be in the subacute stage of stroke and have impaired walking ability (Functional Ambulation Classification of 1 or more). Participants (n = 45) will be randomised into three groups to compare the use of the visualisation software during overground physical therapy gait training against an intensity-matched and attention-matched placebo group and a usual care control group. The primary outcome measure will be walking speed. Secondary measures will be Functional Ambulation Category, Timed Up and Go, Rivermead Visual Gait Assessment, Stroke Impact Scale-16 and spatiotemporal parameters associated with walking. Additional qualitative measures will be used to assess the participant's experience of the visual feedback provided in the study.
Results from the trial will explore whether the early provision of visual feedback of biomechanical movement performance during gait rehabilitation demonstrates improved mobility outcomes after stroke and increased patient understanding of their rehabilitation.
Current Controlled Trials ISRCTN79005974.
越来越多的证据表明，使用增强的视觉反馈可能是一种治疗中风的有效方法。在当前的临床实践中，运动表现的视觉反馈通常仅限于使用镜子或视频。然而，这两种方法都不理想，因为认知和自我形象问题会分散或困扰患者，而且他们的运动可能会被衣服或有限的视角遮挡。三维运动捕捉具有提供临床环境中客观评估和反馈所需的精确运动学数据的潜力。然而，此类数据目前以数字或图形格式呈现，在临床环境中通常不切实际。我们的假设是，使用专为中风后步态康复设计的定制可视化软件呈现这些运动学数据，将为以更有意义的方式向患者传达运动表现反馈提供一种手段。这将增加患者对康复的理解，并使进展以更易访问的方式进行跟踪。
该假设将通过一项探索性（二期）随机对照试验进行评估。有资格参加这项试验的中风幸存者将处于中风的亚急性期，且步行能力受损（功能性步行分类为 1 或更高）。参与者（n=45）将被随机分为三组，以比较在地面物理治疗步态训练中使用可视化软件与强度匹配和注意力匹配的安慰剂组和常规护理对照组的效果。主要结果测量指标是步行速度。次要结果测量指标是功能性步行分类、计时起立行走测试、Rivermead 视觉步态评估、中风影响量表-16 和与步行相关的时空参数。将使用额外的定性措施来评估参与者对研究中提供的视觉反馈的体验。
试验结果将探讨在步态康复期间早期提供生物力学运动表现的视觉反馈是否能改善中风后的移动能力结果，并增加患者对康复的理解。
当前对照试验 ISRCTN79005974。
