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虚拟现实技术在脊髓损伤认知和运动功能障碍治疗中的新应用:一例报告

A novel use of virtual reality in the treatment of cognitive and motor deficit in spinal cord injury: A case report.

作者信息

Maresca Giuseppa, Maggio Maria Grazia, Buda Antonio, La Rosa Gianluca, Manuli Alfredo, Bramanti Placido, De Luca Rosaria, Calabrò Rocco Salvatore

机构信息

IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.

出版信息

Medicine (Baltimore). 2018 Dec;97(50):e13559. doi: 10.1097/MD.0000000000013559.

Abstract

RATIONALE

Aim of this study is to evaluate the cognitive and motor outcomes after a combined rehabilitative training using a standard cognitive approach and virtual reality (VR), in a patient with spinal cord injury (SCI).

PATIENT'S CONCERNS: A 60-year-old right-handed man, affected by incomplete cervical SCI, came to our observation for a moderate tetraparesis, mainly involving the left side, after about 6-months from the acute event. The neurological examination showed imbalance with upper limb incoordination, besides the paresis mainly involving the left side. At a neuropsychological evaluation, he presented important impairment in cognitive and behavioural status, with temporal and spatial disorientation, a reduction of attention and memory process, deficit of executive function and a severe depression of mood, which was not detected during the previous recovery.

DIAGNOSIS

Motor and cognitive deficits in SCI.

INTERVENTIONS

The patient was 1st submitted to standard cognitive training and traditional physiotherapy, and then to a combined therapeutic approach, in which virtual reality training was provided by means of the virtual reality rehabilitation system (VRRS, Khymeia, Italy).

OUTCOMES

After the combined therapeutic approach with the VRRS training, we observed a significant improvement in different cognitive domains, a notable reduction of anxiety and depressive symptoms, as well as motor performance, and balance improvement.

LESSONS

Virtual reality can be considered a promising tool for the rehabilitation of different neurological disorders, including patients with both motor and cognitive deficits following SCI.

摘要

原理

本研究的目的是评估一名脊髓损伤(SCI)患者采用标准认知方法和虚拟现实(VR)相结合的康复训练后的认知和运动结果。

患者情况

一名60岁右利手男性,患有不完全性颈髓损伤,在急性事件发生约6个月后来我院就诊,存在中度四肢轻瘫,主要累及左侧。神经学检查显示除主要累及左侧的轻瘫外,上肢不协调导致平衡障碍。在神经心理学评估中,他在认知和行为状态方面存在重要损害,有时间和空间定向障碍、注意力和记忆过程减退、执行功能缺陷以及严重的情绪低落,而在之前的恢复过程中未检测到这些情况。

诊断

脊髓损伤中的运动和认知缺陷。

干预措施

患者首先接受标准认知训练和传统物理治疗,然后接受一种联合治疗方法,其中通过虚拟现实康复系统(VRRS,意大利Khymeia公司)进行虚拟现实训练。

结果

在采用VRRS训练的联合治疗方法后,我们观察到不同认知领域有显著改善,焦虑和抑郁症状明显减轻,运动表现以及平衡能力也有所改善。

经验教训

虚拟现实可被视为一种有前景的工具,用于包括脊髓损伤后有运动和认知缺陷患者在内的不同神经系统疾病 的康复治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a83/6320010/8af0d753e15b/medi-97-e13559-g004.jpg

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