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前庭康复治疗与虚拟现实对亚急性脑卒中患者平衡、头晕和步态的影响:一项随机对照试验。

Effects of vestibular rehabilitation therapy versus virtual reality on balance, dizziness, and gait in patients with subacute stroke: A randomized controlled trial.

机构信息

Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan.

Islam College of Physical Therapy, Sialkot, Pakistan.

出版信息

Medicine (Baltimore). 2023 Jun 16;102(24):e33203. doi: 10.1097/MD.0000000000033203.

Abstract

BACKGROUND

Stroke is a neurological disorder with a vascular cause, such as cerebral infarction or hemorrhage, and causes dizziness, balance, and gait impairments in patients. Vestibular rehabilitation therapy (VRT) involves a variety of exercises that can improve balance, gait, and gaze stability in stroke patients by affecting the vestibular system and improving dynamic balance. By providing a virtual environment, the use of virtual reality (VR) can aid stroke patients in improving their balance and gait.

OBJECTIVE

This study aimed to evaluate the comparative effects of vestibular rehabilitation with virtual reality on dizziness, balance, and gait in patients with subacute stroke.

METHODS

The randomized clinical trial involved 34 subacute stroke patients randomly assigned to 2 groups; 1 received VRT and the other VR treatment. To assess mobility and balance, the Time Up and Go test was used, the Dynamic Gait Index was used to assess the gait, and the Dizziness Handicap Inventory was used to determine the level of dizziness symptoms. Each group received 24 sessions of allocated treatment, 3 sessions every week for 8 weeks. Using SPSS 20, both groups pretest and posttest readings were analyzed and compared.

RESULTS

Between the VR and VRT groups, balance (P-.01) and gait (P-.01) were significantly improved in the VR group, while dizziness was significantly improved in the VRT group with P < .001. On within-group comparison, both groups showed significant improvements in balance, gait, and dizziness with P < .001.

CONCLUSION

Both vestibular rehabilitation therapy and VR improved dizziness, balance, and gait in subacute stroke patients. However, VR was more effective in improving balance and gait among patients with subacute strokes.

摘要

背景

中风是一种血管性病因引起的神经系统疾病,如脑梗死或出血,可导致患者出现头晕、平衡和步态障碍。前庭康复疗法(VRT)涉及多种运动,通过影响前庭系统和改善动态平衡,可改善中风患者的平衡、步态和凝视稳定性。虚拟现实(VR)的使用通过提供虚拟环境,可以帮助中风患者改善平衡和步态。

目的

本研究旨在评估前庭康复与虚拟现实在亚急性中风患者头晕、平衡和步态方面的比较效果。

方法

这项随机临床试验纳入了 34 名亚急性中风患者,随机分为 2 组,一组接受 VRT,另一组接受 VR 治疗。使用“计时起立行走测试”评估移动性和平衡,使用“动态步态指数”评估步态,使用“头晕残障量表”评估头晕症状的严重程度。两组均接受 24 次分配治疗,每周 3 次,共 8 周。使用 SPSS 20 对两组的预测试和后测试读数进行分析和比较。

结果

VR 组的平衡(P<.01)和步态(P<.01)显著改善,而 VRT 组的头晕显著改善(P<.001)。在组内比较中,两组在平衡、步态和头晕方面均显示出显著改善(P<.001)。

结论

前庭康复疗法和 VR 均可改善亚急性中风患者的头晕、平衡和步态,但 VR 在改善亚急性中风患者的平衡和步态方面更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6098/10270552/1cdda723281c/medi-102-e33203-g001.jpg

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