Cano-Manas M J, Collado-Vazquez S, Cano-de-la-Cuerda R
Hospital La Fuenfria (Servicio Madrileno de Salud), Cercedilla, Espana
Universidad Rey Juan Carlos, 28922 Alcorcon, Espana
Rev Neurol. 2017 Oct 16;65(8):337-347.
Stroke generates dependence on the patients due to the various impairments associated. The use of low-cost technologies for neurological rehabilitation may be beneficial for the treatment of these patients.
To determine whether combined treatment using a semi-immersive virtual reality protocol to an interdisciplinary rehabilitation approach, improve balance and postural control, functional independence, quality of life, motivation, self-esteem and adherence to intervention in stroke patients in subacute stage.
A longitudinal prospective study with pre and post-intervention evaluation was carried out. Fourteen were recruited at La Fuenfria Hospital (Spain) and completed the intervention. Experimental intervention was performed during eight weeks in combination with conventional treatment of physiotherapy and occupational therapy. Each session was increased in time and intensity, using commercial video games linked to Xbox 360° videoconsole and Kinect sensor.
There were statistical significant improvements in modified Rankin scale (p = 0.04), baropodometry (load distribution, p = 0.03; support surface, p = 0.01), Barthel Index (p = 0.01), EQ-5D Questionnaire (p = 0.01), motivation (p = 0.02), self-esteem (p = 0.01) and adherence to the intervention (p = 0.02).
An interdisciplinary rehabilitation approach supplemented with semi-immersive virtual reality seems to be useful for improving balance and postural control, functional independence in basic activities of daily living, quality of life, as well as motivation and self-esteem, with excellent adherence. This intervention modality could be adopted as a therapeutic tool in neurological rehabilitation of stroke patients in subacute stage.
由于中风会引发各种相关损伤，导致患者产生依赖性。使用低成本技术进行神经康复治疗可能对这些患者的治疗有益。
确定采用半沉浸式虚拟现实方案结合多学科康复方法的联合治疗，是否能改善亚急性期中风患者的平衡和姿势控制、功能独立性、生活质量、动机、自尊以及对干预的依从性。
开展一项进行干预前和干预后评估的纵向前瞻性研究。在西班牙拉丰弗里亚医院招募了14名患者并完成了干预。实验性干预为期八周，与物理治疗和职业治疗的传统治疗相结合。每次治疗通过与Xbox 360°视频游戏机和Kinect传感器相连的商业视频游戏，在时间和强度上逐步增加。
改良Rankin量表（p = 0.04）、压力觉测量（负荷分布，p = 0.03；支撑面，p = 0.01）、Barthel指数（p = 0.01）、EQ - 5D问卷（p = 0.01）、动机（p = 0.02）、自尊（p = 0.01）以及对干预的依从性（p = 0.02）均有统计学显著改善。
多学科康复方法辅以半沉浸式虚拟现实似乎有助于改善平衡和姿势控制、日常生活基本活动中的功能独立性、生活质量以及动机和自尊，且依从性良好。这种干预方式可作为亚急性期中风患者神经康复的治疗工具采用。
