Assistive Technology Lab, Faculty of Electrical Engineering, Federal University of Uberlandia, Uberlandia, Brazil; Laboratory of Design, Optimization and Modeling of Systems (LCOMS), University of Lorraine, Metz, France.
Assistive Technology Lab, Faculty of Electrical Engineering, Federal University of Uberlandia, Uberlandia, Brazil.
Complement Ther Clin Pract. 2022 Nov;49:101681. doi: 10.1016/j.ctcp.2022.101681. Epub 2022 Nov 5.
The current study proposed the development and preliminary validation of a humanized training approach for upper limb rehabilitation of chronic post-stroke individuals, using serious game (SG) and virtual reality (VR) technologies.
Ten individuals with chronic stroke participated in the study. Accompanied by a health professional, 15 sessions of the SG were performed in a laboratory, in a humanized way, lasting between 30 and 45 min each. The assessments were made pre- and post-intervention with the SG, and the following parameters were evaluated (considering the elbow joint): Modified Ashworth Scale (MAS), range of movement (ROM) and tonic stretch reflex threshold (TSRT). Global measures such as quality of life (QOL) were also assessed by the Stroke-Specific Quality of Life Scale (SSQL), Brunnstrom Recovery Scale (BRS) and General Health Questionnaire (GHQ-28). The following tests were applied to verify statistically significant differences: Shapiro-Wilk test, t-test, and Wilcoxon-Mann-Whitney test.
The parameters ROM, TSRT, BRS, and SSQL showed statistically significant differences between pre- and post-intervention (p < 0.01). The ROM increase was about 8%. The objective evaluation of spasticity (provided by the TRST) showed an increase of 28% over the average pre- and post-intervention values. Three participants showed decreased resistance to passive stretching according to the results of the MAS, and seven participants moved to the next stage of the BRS. For QOL, the scores indicated around 20% of post-intervention improvement.
The intervention had no adverse effects, showed a high degree of compliance, provided increased ROM, improved QOL, reduced spasticity and allowed these individuals the opportunity to test a promising technology for upper limb rehabilitation with emphasis in humanized aspects of therapy.
本研究提出了一种基于严重游戏(SG)和虚拟现实(VR)技术的慢性脑卒中患者上肢康复的人性化训练方法,并对其进行了开发和初步验证。
10 名慢性脑卒中患者参与了本研究。在健康专业人员的陪同下,患者在实验室中以人性化的方式进行了 15 次 SG,每次时长 30 至 45 分钟。在干预前后对 SG 进行评估,并评估以下参数(考虑肘关节):改良 Ashworth 量表(MAS)、活动范围(ROM)和紧张性牵张反射阈值(TSRT)。还通过脑卒中特定生活质量量表(SSQL)、Brunnstrom 恢复量表(BRS)和一般健康问卷(GHQ-28)评估了整体生活质量(QOL)等指标。应用 Shapiro-Wilk 检验、t 检验和 Wilcoxon-Mann-Whitney 检验来验证统计学差异。
ROM、TSRT、BRS 和 SSQL 等参数在干预前后均显示出统计学差异(p<0.01)。ROM 增加了约 8%。通过 TSRT 对痉挛进行客观评估,发现平均干预前后值增加了 28%。根据 MAS 的结果,有 3 名患者对被动拉伸的阻力降低,7 名患者的 BRS 进入下一阶段。在 QOL 方面,得分表明干预后改善了约 20%。
该干预措施无不良反应,具有较高的依从性,可增加 ROM,提高 QOL,减轻痉挛,并为患者提供了体验上肢康复新技术的机会,强调治疗的人性化方面。