The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia.
School of Design, RMIT, Melbourne, VIC, Australia.
J Neuroeng Rehabil. 2019 May 15;16(1):56. doi: 10.1186/s12984-019-0531-y.
Virtual reality technologies show potential as effective rehabilitation tools following neuro-trauma. In particular, the Elements system, involving customized surface computing and tangible interfaces, produces strong treatment effects for upper-limb and cognitive function following traumatic brain injury. The present study evaluated the efficacy of Elements as a virtual rehabilitation approach for stroke survivors.
Twenty-one adults (42-94 years old) with sub-acute stroke were randomized to four weeks of Elements virtual rehabilitation (three weekly 30-40 min sessions) combined with treatment as usual (conventional occupational and physiotherapy) or to treatment as usual alone. Upper-limb skill (Box and Blocks Test), cognition (Montreal Cognitive Assessment and selected CogState subtests), and everyday participation (Neurobehavioral Functioning Inventory) were examined before and after inpatient training, and one-month later.
Effect sizes for the experimental group (d = 1.05-2.51) were larger compared with controls (d = 0.11-0.86), with Elements training showing statistically greater improvements in motor function of the most affected hand (p = 0.008), and general intellectual status and executive function (p ≤ 0.001). Proportional recovery was two- to three-fold greater than control participants, with superior transfer to everyday motor, cognitive, and communication behaviors. All gains were maintained at follow-up.
A course of Elements virtual rehabilitation using goal-directed and exploratory upper-limb movement tasks facilitates both motor and cognitive recovery after stroke. The magnitude of training effects, maintenance of gains at follow-up, and generalization to daily activities provide compelling preliminary evidence of the power of virtual rehabilitation when applied in a targeted and principled manner.
this pilot study was not registered.
虚拟现实技术在神经创伤后显示出作为有效康复工具的潜力。特别是，涉及定制的表面计算和有形界面的 Elements 系统，在创伤性脑损伤后对上臂和认知功能产生强烈的治疗效果。本研究评估了 Elements 作为一种针对中风幸存者的虚拟康复方法的疗效。
21 名亚急性中风成人（42-94 岁）随机分为四组，分别接受四周的 Elements 虚拟康复（每周三次，每次 30-40 分钟）联合常规治疗（常规职业和物理治疗）或单独常规治疗。在住院治疗前后以及一个月后，评估上肢技能（Box and Blocks 测试）、认知（蒙特利尔认知评估和选定的 CogState 子测试）和日常参与（神经行为功能量表）。
实验组（d=1.05-2.51）的效果大小明显大于对照组（d=0.11-0.86），Elements 训练在受影响最严重的手的运动功能（p=0.008）和一般智力状况和执行功能（p≤0.001）方面显示出统计学上更大的改善。与对照组相比，比例恢复高两倍至三倍，对日常运动、认知和沟通行为的转移效果更好。所有的收益在随访中都得到了维持。
使用目标导向和探索性上肢运动任务的 Elements 虚拟康复课程促进中风后的运动和认知恢复。训练效果的大小、随访时收益的维持以及对日常活动的推广，为虚拟康复在有针对性和有原则的应用中提供了有力的初步证据。
本研究为试点研究，未进行注册。
