沉浸式虚拟现实镜像治疗脑卒中后上肢康复：一项初步研究。
Immersive Virtual Reality Mirror Therapy for Upper Limb Recovery After Stroke: A Pilot Study.
机构信息
From the Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, New York (LMW); Programs in Occupational Therapy, Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York (DMN, GG); Columbia University Vagelos College of Physicians and Surgeons, New York, New York (JY); Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons, New York, New York (JS); and Department of Rehabilitation Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (JS).
出版信息
Am J Phys Med Rehabil. 2019 Sep;98(9):783-788. doi: 10.1097/PHM.0000000000001190.
OBJECTIVE
This study was designed to examine the feasibility of immersive virtual reality mirror therapy for upper limb paresis after stroke using a head-mounted display and provide preliminary evidence of efficacy.
DESIGN
Ten outpatients with chronic stroke, upper limb hemiparesis, and a low predisposition for motion sickness completed a 12-session program of 30 mins each of immersive virtual reality mirror therapy. The virtual reality system provided the illusion of movement in the hemiparetic upper limb while suppressing the visual representation of the nonparetic side. Feasibility was assessed via patient compliance, adverse event tracking, the System Usability Scale, and the Simulator Sickness Questionnaire. Preliminary efficacy was evaluated using the Fugl-Meyer Upper Extremity and Action Research Arm Test.
RESULTS
Immersive virtual reality mirror therapy for patients with chronic stroke was safe, well-tolerated, and without adverse events, such as simulator sickness. Motor outcomes revealed a small improvement for the Fugl-Meyer Upper Extremity from 21.7 (SD = 8.68) to 22.8 (SD = 9.19) that did not achieve statistical significance (P = 0.084).
CONCLUSIONS
Four weeks of immersive virtual reality mirror therapy was well-tolerated by chronic stroke patients. Our findings support further clinical trials of immersive virtual reality technologies and visually enhanced mirror therapies for stroke survivors.
目的
本研究旨在检验头戴式显示器沉浸式虚拟现实镜像疗法治疗脑卒中后上肢瘫痪的可行性，并初步验证其疗效。
设计
10 名慢性脑卒中、上肢偏瘫且运动病易感性低的门诊患者完成了 12 次 30 分钟的沉浸式虚拟现实镜像疗法疗程。虚拟现实系统在抑制非瘫痪侧视觉呈现的同时，提供了偏瘫上肢运动的错觉。通过患者依从性、不良事件跟踪、系统可用性量表和模拟器疾病问卷评估可行性。使用 Fugl-Meyer 上肢和动作研究臂测试评估初步疗效。
结果
慢性脑卒中患者的沉浸式虚拟现实镜像疗法安全、耐受良好，无模拟器疾病等不良反应。运动功能结果显示，Fugl-Meyer 上肢评分从 21.7（SD=8.68）增加到 22.8（SD=9.19），但无统计学意义（P=0.084）。
结论
慢性脑卒中患者能耐受 4 周的沉浸式虚拟现实镜像疗法。我们的研究结果支持进一步开展沉浸式虚拟现实技术和视觉增强镜像疗法治疗脑卒中幸存者的临床试验。
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