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基于家庭的虚拟现实远程康复系统对多发性硬化症患者的影响:一项随机对照试验。

Effects of home-based virtual reality telerehabilitation system in people with multiple sclerosis: A randomized controlled trial.

机构信息

IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.

Department of Psychology, Università Cattolica del Sacro Cuore, Italy.

出版信息

J Telemed Telecare. 2024 Feb;30(2):344-355. doi: 10.1177/1357633X211054839. Epub 2021 Dec 1.

Abstract

BACKGROUND AND OBJECTIVE

Multiple sclerosis is an inflammatory and neurodegenerative disorder of the central nervous system that can lead to severe motor disability. The aim of this study was to verify the health care effects of an integrated telerehabilitation approach involving dual-domains (motor and cognitive) in people with multiple sclerosis using a virtual reality rehabilitation system compared to a home-based conventional rehabilitative intervention usual care for patient-relevant outcomes (motor, cognitive and participation).

METHODS

This multicentre interventional, randomized controlled trial included 70 participants with multiple sclerosis, 35 in the telerehabilitation group (30 sessions of home-based virtual reality rehabilitation system training, five sessions for week each lasting 45 min) and 35 in the usual care group (30 sessions of conventional treatment, five sessions for week). Participants completed the assessment of motor, cognitive and participation outcomes at baseline and after 6 weeks of treatment.

RESULTS

In total, 63.3% of the telerehabilitation group exhibited improvement in the physical domain of the quality of life ( = 0.045). The telerehabilitation group showed greater improvement than the usual care group in Mini-BESTest domains of balance ( = 0.014), postural control ( = 0.024), and dynamic walking ( = 0.020) at post-treatment. Higher adherence was registered for telerehabilitation compared with usual care (86.67% vs 80.0%).

DISCUSSION

This study provides evidence that people with multiple sclerosis can benefit from telerehabilitation treatment in the physical domain of the quality of life and motor symptoms. Moreover, considering the persistent COVID-19 emergency, telerehabilitation can represent an effective telemedicine solution for safely delivering effective rehabilitation care to people with multiple sclerosis.

TRIAL REGISTRATION NUMBER AND TRIAL REGISTER

This trial was registered at ClinicalTrials.gov (NCT03444454).

摘要

背景与目的

多发性硬化症是一种中枢神经系统的炎症性和神经退行性疾病,可导致严重的运动残疾。本研究旨在通过虚拟现实康复系统,比较综合远程康复(涉及运动和认知两个领域)与常规家庭康复治疗对多发性硬化症患者相关结局(运动、认知和参与)的疗效,验证该系统在多发性硬化症患者中的应用效果。

方法

这是一项多中心干预性、随机对照试验,共纳入 70 名多发性硬化症患者,其中 35 名患者接受远程康复组(30 次家庭虚拟现实康复系统训练,每周 5 次,每次 45 分钟),35 名患者接受常规治疗组(30 次常规治疗,每周 5 次)。所有患者在基线和 6 周治疗后完成运动、认知和参与结局的评估。

结果

远程康复组的生活质量物理领域有 63.3%的患者( = 0.045)改善。与常规治疗组相比,远程康复组在 Mini-BESTest 的平衡( = 0.014)、姿势控制( = 0.024)和动态行走( = 0.020)领域的改善更明显。远程康复组的依从性更高(86.67%比 80.0%)。

讨论

本研究表明,多发性硬化症患者可以从远程康复治疗中获益,包括生活质量的物理领域和运动症状。此外,考虑到持续的 COVID-19 紧急情况,远程康复可以作为一种有效的远程医疗解决方案,为多发性硬化症患者提供安全有效的康复护理。

试验注册号和试验注册库

本试验在 ClinicalTrials.gov 注册(NCT03444454)。

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