Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
J Neurol. 2019 Mar;266(3):589-597. doi: 10.1007/s00415-018-09171-2. Epub 2019 Jan 4.
To date, the efficacy of the virtual reality (VR) application for acute stroke compared with conventional therapy (CT) remains unclear. This retrospective study aims to assess the impact of adjuvant VR technology on multidimensional therapy for patients with acute-stage stroke.
100 acute ischemic stroke patients with onset within 7 days who underwent combined adjuvant VR-based rehabilitation program and CT (intervention group-VR + CT) were compared to an equal number of cross-matched patients who received CT alone. While the intervention group received 40-min CT plus 20-min VR program (seven times for 1 week), the comparison group received time-matched CT alone. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), medical cost-effectiveness, and shortening of hospital stay were used as outcome measures.
Posttreatment, the VR + CT group revealed significantly improved NIHSS and mRS (P < 0.001), whereas only the mRS improvement was remarkable in the CT group. In between-group comparisons, the intervention group had better improvements of symptom severity (NIHSS percentage improvement from the baseline; 20.18% vs. 4.59%, P < 0.005), functional outcomes (mRS improvement from the baseline; - 0.58 vs. - 0.23, P < 0.001), and reduced medical cost (Taiwan dollar; 49474 vs. 66306, P < 0.005). Furthermore, the VR + CT group reached markedly higher proportion of functional independence in activities of daily living (mRS, 0-2) at discharge compared with the CT group (68% vs. 60%, P < 0.001).
This study suggests that the combination of VR-based rehabilitation and traditional therapy could be more effective for neurorehabilitation than CT alone in the early improvement of symptom severity, functional outcomes, and lower medical expenditure in acute stroke patients.
迄今为止，虚拟现实（VR）应用于急性脑卒中的疗效与常规治疗（CT）相比尚不清楚。本回顾性研究旨在评估辅助 VR 技术对急性脑卒中患者多模式治疗的影响。
将 100 例发病 7 天内的急性缺血性脑卒中患者分为联合辅助 VR 康复计划和 CT 治疗的干预组-VR+CT（VR+CT 组）和接受 CT 治疗的对照组。VR+CT 组患者接受 40 分钟 CT 加 20 分钟 VR 治疗（1 周内 7 次），对照组接受匹配时间的 CT 治疗。采用美国国立卫生研究院卒中量表（NIHSS）、改良 Rankin 量表（mRS）、医疗成本效益和缩短住院时间作为疗效评估指标。
治疗后，VR+CT 组 NIHSS 和 mRS 明显改善（P<0.001），而 CT 组仅 mRS 改善显著。组间比较，干预组症状严重程度改善更显著（NIHSS 从基线改善百分比；20.18%比 4.59%，P<0.005），功能结局改善更显著（mRS 从基线改善；-0.58 比-0.23，P<0.001），医疗费用降低（新台币；49474 比 66306，P<0.005）。此外，VR+CT 组在日常生活活动中达到更高比例的功能独立性（mRS，0-2），显著高于 CT 组（68%比 60%，P<0.001）。
本研究表明，与单独 CT 治疗相比，VR 康复与传统疗法相结合在急性脑卒中患者的症状严重程度、功能结局和医疗支出的早期改善方面更有效。
