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使用虚拟现实中的严肃游戏对多发性硬化症患者进行单侧手臂康复:是否有双侧治疗效果?

Unilateral arm rehabilitation for persons with multiple sclerosis using serious games in a virtual reality approach: Bilateral treatment effect?

机构信息

IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.

IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.

出版信息

Mult Scler Relat Disord. 2019 Oct;35:76-82. doi: 10.1016/j.msard.2019.07.010. Epub 2019 Jul 20.

DOI:10.1016/j.msard.2019.07.010
PMID:31352180
Abstract

UNLABELLED

IMPAIRED: arm function and loss of manual dexterity can lead to decreased independence in activities of daily living in persons with Multiple Sclerosis (MS). In this study we verified the feasibility and efficacy of a serious games approach to supervised upper limb rehabilitation of the more affected arm in persons with MS and the cross-over effect to the nontreated arm.

METHODS

Eighteen persons with moderate to severe MS symptoms participated (mean age 56.1 (range 28-73) years; mean disease duration 17.6 (4-35) years). Each participant received 12 supervised sessions of serious games (45 min, 12 sessions) aimed at improving the most affected upper limb. Primary outcomes were the Nine Hole Peg Test (9HPT) and the Box and Blocks Test (BBT). Perceived health was evaluated pre and post intervention with SF-12 and the VAS of the EuroQual-5DL. Non parametric tests were used and P was set at 0.05.

RESULTS

After the serious games training participants improved dexterity and arm function bilaterally (10-18%), however, there was a statistically significant improvement only in the treated arm (P<0.05). Perceived menthal health improved follwing training (P<0.05) but not perceived physical health.

CONCLUSION

An in clinic intervention with a serious-games virtual reality approach positively influenced arm recovery in persons moderately to severely affected by MS, improving mainly the treated arm but with positive effects on the nontreated arm. The persons were motivated during the intervention and expressed being willing to continue this kind of training at home as part of continuity of care.

摘要

未加标签

受损:手臂功能和手灵巧度下降会导致多发性硬化症(MS)患者日常生活活动的独立性降低。在这项研究中,我们验证了一种严肃游戏方法对 MS 患者更严重的上肢进行监督性上肢康复的可行性和疗效,以及对未治疗手臂的交叉效应。

方法

18 名中度至重度 MS 症状患者参与了这项研究(平均年龄 56.1(28-73)岁;平均疾病持续时间 17.6(4-35)年)。每位患者接受 12 次监督性严肃游戏(45 分钟,12 次),旨在改善最严重的上肢。主要结局是 9 孔钉测试(9HPT)和方块和积木测试(BBT)。在干预前后使用 SF-12 和 EuroQual-5DL 的 VAS 评估感知健康。使用非参数检验,P 值设为 0.05。

结果

在严肃游戏训练后,参与者的双侧灵巧度和手臂功能均得到改善(10-18%),但仅在治疗手臂中具有统计学意义的改善(P<0.05)。训练后感知心理健康得到改善(P<0.05),但感知身体健康没有改善。

结论

在诊所中进行的严肃游戏虚拟现实干预对中度至重度 MS 患者的手臂恢复产生了积极影响,主要改善了治疗手臂,但对未治疗手臂也有积极影响。患者在干预过程中表现出积极性,并表示愿意将这种训练作为连续性护理的一部分,在家中继续进行。

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