Kostenko E V, Petrova L V, Martynov M Yu, Pogonchenkova I V
Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia.
Pirogov Russian National Research Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(3. Vyp. 2):68-75. doi: 10.17116/jnevro202312303268.
To evaluate the effectiveness and safety of the rehabilitation glove (RG) with virtual reality (VR) and biofeedback (BFB) on recovery of the hand function in patients during the late recovery period after first hemispheric ischemic stroke (IS).
The study was randomized and controlled. One hundred and six patients (age 58.8±4.3 years, time after stroke onset - 8.7±2.1 months) were included in the final analysis. The intervention group (=56) received rehabilitation with RG and VR. The control group (=50) received individualized physical therapy. The primary end points were a change in the Fugl-Meyer scale score (FMA-UE), in the Action Research Arm Test (ARAT), and in the nine holes peg test (NHPT). Secondary end points included changes in MRCS, MAS, MoCA, HADS, modified Barthel index (MBI) and quality of life (EQ-5D-5L).
Improvement of the motor function in the intervention group on FMA-UE scale (an increase of ≥7 points in sections A-D) was observed in 46.4% of patients, on ARAT (an increase of ≥5 points) in 53.6% of patients. There was a significant decrease in time from 36.8±6.3 sec. to 22.0±3.9 sec. on NHPT. A negative correlation was observed between the average ARAT score and anxiety (=-0.7; <0.05) and depression (=-0.67; <0.05). There was also a significant increase in EQ-5D-5L (VAS) by the end of rehabilitation in both groups with better scores in the intervention group (=0.03).
Rehabilitation based on VR, RG, and BFB is effective in the rehabilitation of dexterous hand function in patients with first hemispheric IS.
评估虚拟现实（VR）和生物反馈（BFB）康复手套（RG）对首次半球缺血性卒中（IS）后恢复期患者手部功能恢复的有效性和安全性。
本研究为随机对照研究。最终分析纳入106例患者（年龄58.8±4.3岁，卒中发病后时间 - 8.7±2.1个月）。干预组（n = 56）接受RG和VR康复治疗。对照组（n = 50）接受个体化物理治疗。主要终点为Fugl - Meyer量表评分（FMA - UE）、动作研究臂测试（ARAT）和九孔插板测试（NHPT）的变化。次要终点包括改良Rankin量表（MRCS）、肌肉活动评分量表（MAS）、蒙特利尔认知评估量表（MoCA）、医院焦虑抑郁量表（HADS）、改良Barthel指数（MBI）和生活质量（EQ - 5D - 5L）的变化。
干预组中，46.4%的患者FMA - UE量表运动功能改善（A - D部分增加≥7分），53.6%的患者ARAT（增加≥5分）运动功能改善。NHPT时间从36.8±6.3秒显著降至22.0±3.9秒。ARAT平均得分与焦虑（r = - 0.7；P < 0.05）和抑郁（r = - 0.67；P < 0.05）之间存在负相关。两组康复结束时EQ - 5D - 5L（视觉模拟量表）也显著增加，干预组得分更高（P = 0.03）。
基于VR、RG和BFB的康复治疗对首次半球IS患者的灵巧手部功能康复有效。
