Department of Rehabilitation, Xiangya Hospital Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
J Neuroeng Rehabil. 2020 Nov 13;17(1):150. doi: 10.1186/s12984-020-00783-2.
BACKGROUND: Virtual reality (VR) has been broadly applied in post-stroke rehabilitation. However, studies on occupational performance and self-efficacy as primary outcomes of stroke rehabilitation using VR are lacking. Thus, this study aims to investigate the effects of VR training on occupational performance and self-efficacy in patients with stroke. METHODS: This was an assessor-blinded, randomized controlled trial. Sixty participants with first-ever stroke (< 1-year onset) underwent rehabilitation in a single acute hospital. Participants were randomly assigned to either the VR group (n = 30) or control group (n = 30). Both groups received dose-matched conventional rehabilitation (i.e., 45 min, five times per week over 3 weeks). The VR group received additional 45-min VR training for five weekdays over 3 weeks. The primary outcome measures were the Canadian Occupational Performance Measure and Stroke Self-Efficacy Questionnaire. Secondary outcome measures included Modified Barthel Index, Fugl-Meyer Assessment-Upper Extremity, and Functional Test for the Hemiplegic Upper Extremity. The assessment was conducted at baseline and after the 3-week intervention. RESULTS: A total of 52 participants (86.7%) completed the trial. Significant between-group differences in Stroke Self-Efficacy Questionnaire (Median Difference = 8, P = 0.043) and Modified Barthel Index (Median Difference = 10, P = 0.030) were found; however, no significant between-group differences in Canadian Occupational Performance Measure, Fugl-Meyer Assessment-Upper Extremity, and Functional Test for the Hemiplegic Upper Extremity were noted. No serious adverse reactions related to the program were reported. CONCLUSIONS: Additional VR training could help improve the self-efficacy and activities of daily living of patients with stroke; however, it was not superior to conventional training in the improvement of upper limb functions, occupational performance, and satisfaction. Nevertheless, VR could be integrated into conventional rehabilitation programs to enhance self-efficacy of patients after stroke. TRIAL REGISTRATION: This study was successfully registered under the title "Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke" on October 13 2019 and could be located in https://www.chictr.org with the study identifier ChiCTR1900026550.
背景：虚拟现实（VR）已广泛应用于脑卒中后的康复。然而，在脑卒中康复中以作业表现和自我效能为主要结局的 VR 研究还很少。因此，本研究旨在探讨 VR 训练对脑卒中患者作业表现和自我效能的影响。
方法：这是一项评估者设盲、随机对照试验。60 名首发脑卒中（发病<1 年）患者在一家急性医院接受康复治疗。参与者被随机分配到 VR 组（n=30）或对照组（n=30）。两组均接受匹配剂量的常规康复治疗（即每周 5 次，每次 45 分钟，共 3 周）。VR 组在 3 周内接受额外的 5 天每天 45 分钟的 VR 训练。主要结局指标为加拿大职业表现量表和脑卒中自我效能问卷。次要结局指标包括改良巴氏指数、Fugl-Meyer 上肢评估和偏瘫上肢功能测试。评估在基线和 3 周干预后进行。
结果：共有 52 名参与者（86.7%）完成了试验。脑卒中自我效能问卷（中位数差值 8，P=0.043）和改良巴氏指数（中位数差值 10，P=0.030）存在显著的组间差异；然而，加拿大职业表现量表、Fugl-Meyer 上肢评估和偏瘫上肢功能测试的组间差异无统计学意义。未报告与方案相关的严重不良反应。
结论：额外的 VR 训练有助于提高脑卒中患者的自我效能和日常生活活动能力；然而，与常规训练相比，其在改善上肢功能、作业表现和满意度方面并无优势。尽管如此，VR 可以整合到常规康复方案中，以增强脑卒中后患者的自我效能。
试验注册：本研究于 2019 年 10 月 13 日成功注册，标题为“虚拟现实训练对脑卒中患者作业表现和自我效能的影响”，可在 https://www.chictr.org 上通过研究标识符 ChiCTR1900026550 找到。
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