互动式、基于运动捕捉的康复治疗对住院脑卒中患者功能结局的疗效:一项随机对照试验。

The efficacy of interactive, motion capture-based rehabilitation on functional outcomes in an inpatient stroke population: a randomized controlled trial.

机构信息

1 Faculty of Health, University of Tasmania, Hobart, TAS, Australia.

2 Tasmanian Health Service, Hobart, TAS, Australia.

出版信息

Clin Rehabil. 2018 Feb;32(2):191-200. doi: 10.1177/0269215517720790. Epub 2017 Jul 19.

Abstract

OBJECTIVE

To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function.

DESIGN

Randomized controlled clinical trial.

SETTING

Two subacute hospital rehabilitation units in Australia.

PARTICIPANTS

In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve.

INTERVENTIONS

Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched). For the intervention group, this individualized program used motivating virtual reality rehabilitation and novel gesture controlled interactive motion capture software. For usual care, the individualized program was delivered in a group class on one unit and by rehabilitation assistant 1:1 on the other.

MAIN MEASURES

Primary outcome was standing balance (functional reach). Secondary outcomes were lateral reach, step test, sitting balance, arm function, and walking.

RESULTS

Participants (mean 22 days post-stroke) attended mean 14 sessions. Both groups improved (mean (95% confidence interval)) on primary outcome functional reach (usual care 3.3 (0.6 to 5.9), intervention 4.1 (-3.0 to 5.0) cm) with no difference between groups ( P = 0.69) on this or any secondary measures. No differences between the rehabilitation units were seen except in lateral reach (less affected side) ( P = 0.04). No adverse events were recorded during therapy.

CONCLUSION

Interactive, motion capture rehabilitation for inpatients post stroke produced functional improvements that were similar to those achieved by usual care stroke rehabilitation, safely delivered by either a physical therapist or a rehabilitation assistant.

摘要

目的

比较新型互动、运动捕捉康复软件与常规康复治疗对脑卒中患者身体功能的疗效。

设计

随机对照临床试验。

地点

澳大利亚两家亚急性医院康复科。

参与者

共有 73 名脑卒中后不到 6 个月且活动能力下降和临床医生认为有改善能力的患者。

干预措施

两组患者均接受功能再训练和个体化方案治疗,每周 5 天,每天 1 小时,治疗 8-40 次(剂量匹配)。对于干预组,个体化方案采用激励性虚拟现实康复和新型手势控制互动运动捕捉软件。对于常规护理组,个体化方案在一个单元的小组课上进行,另一个单元则由康复助理 1:1 进行。

主要测量指标

主要结局指标为站立平衡(功能伸手距离)。次要结局指标为横向伸手距离、步距测试、坐立平衡、上肢功能和行走。

结果

参与者(平均发病后 22 天)平均参加 14 次治疗。两组患者的主要结局指标功能伸手距离(常规护理组 3.3(0.6 至 5.9)cm,干预组 4.1(-3.0 至 5.0)cm)均有改善,但组间差异无统计学意义( P=0.69),其他次要指标也未见差异。除了在横向伸手距离(患侧)方面( P=0.04),两个康复科之间也没有差异。治疗期间未发生任何不良事件。

结论

对于脑卒中住院患者,互动式运动捕捉康复治疗可改善患者的功能,与常规康复治疗效果相当,可由物理治疗师或康复助理安全实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1453/5777543/9231fed438a1/10.1177_0269215517720790-fig1.jpg

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