Aramaki Alberto Luiz, Sampaio Rosana Ferreira, Cavalcanti Alessandra, Dutra Fabiana Caetano Martins Silva E
Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG, Brasil.
Universidade Federal do Triângulo Mineiro, Núcleo de Estudos e Pesquisas em Trabalho, Participação Social e Saúde (NETRAS), Uberaba MG, Brasil.
Arq Neuropsiquiatr. 2019 Sep 23;77(9):622-631. doi: 10.1590/0004-282X20190103. eCollection 2019.
Patient-centered virtual reality (VR) programs could assist in the functional recovery of people after a stroke. OBJECTIVES To analyze the feasibility of a rehabilitation protocol using client-centered VR and to evaluate changes in occupational performance and social participation. METHODS This was a mixed methods study. Ten subacute and chronic stroke patients participated in the rehabilitation program using games in non-immersive VR for 40 minutes/day, three days/week, for 12 weeks. Sociodemographic information was collected and the outcome variables included were the Canadian Occupational Performance Measure (COPM) and the Participation Scale. A field diary was used to record the frequency of attendance and adherence of participants and an interview was conducted at the end of program. RESULTS There were significant and clinically-relevant statistical improvements in the COPM performance score (p < 0.001; CI = 1.29 - 4.858) and in the COPM satisfaction score (p < 0.001; CI = 1.37 - 5.124), with a difference greater than 4.28 points for performance and 4.58 points for satisfaction. The change in the scores for participation was statistically significant (p = 0.046), but there was no clinical improvement (dcohen = -0.596, CI = -1.862 - 0.671). The majority of participants reported more than 75% consecutive attendance of sessions and there was 100% adherence to the program. In the interviews, the participants described their post-stroke difficulties; how the video game motivated their engagement in rehabilitation; and the improvement of occupational performance and social participation after participating in the program. CONCLUSIONS VR is a viable tool for the rehabilitation of stroke patients with functional gains, mainly regarding occupational performance and performance satisfaction.
以患者为中心的虚拟现实（VR）程序有助于中风患者的功能恢复。目的：分析使用以客户为中心的VR康复方案的可行性，并评估职业表现和社会参与度的变化。方法：这是一项混合方法研究。10名亚急性和慢性中风患者参加了康复计划，使用非沉浸式VR游戏，每天40分钟，每周三天，共12周。收集了社会人口学信息，纳入的结果变量包括加拿大职业表现测量量表（COPM）和参与量表。使用现场日记记录参与者的出勤频率和依从性，并在项目结束时进行访谈。结果：COPM表现得分（p < 0.001；CI =
1.29 - 4.858）和COPM满意度得分（p < 0.001；CI = 1.37 - 5.124）有显著且具有临床相关性的统计学改善，表现得分差异大于4.28分，满意度得分差异大于4.58分。参与得分的变化具有统计学意义（p = 0.046），但没有临床改善（dcohen = -0.596，CI = -1.862 - 0.671）。大多数参与者报告连续参加课程的比例超过75%，并且对该计划的依从性为100%。在访谈中，参与者描述了他们中风后的困难；电子游戏如何激发他们参与康复的积极性；以及参与该计划后职业表现和社会参与度的改善。结论：VR是中风患者康复的一种可行工具，能带来功能改善，主要体现在职业表现和表现满意度方面。
