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使用康复训练软件对帕金森综合征患者进行功能改善

Functional improvement of patients with Parkinson syndromes using a rehabilitation training software.

作者信息

Barth Marcus, Möbius Robert, Themann Peter, Güresir Erdem, Matzke Cornelia, Winkler Dirk, Grunert Ronny

机构信息

Department of Neurosurgery, Faculty of Medicine, Leipzig University, Leipzig, Germany.

Clinic at Tharandter Forest, Department of Neurology and Parkinson, Halsbruecke, Germany.

出版信息

Front Neurol. 2023 Aug 14;14:1210926. doi: 10.3389/fneur.2023.1210926. eCollection 2023.

Abstract

INTRODUCTION

Individuals with Parkinsonian disorders often face limited access to specialized physiotherapy and movement training due to staff shortages and increasing disease incidence, resulting in a rapid decline in mobility and feelings of despair. Addressing these challenges requires allocating adequate resources and implementing specialized training programs to ensure comprehensive care and support. Regarding these problems, a computer software was invented that might serve as an additional home-based extension to conventional physiotherapy.

METHODS

The trial took place in a rehabilitation center where every patient received equivalent treatment apart from the training program that was set up to be investigated over 3 weeks. Seventy four Patients were included and randomized between two intervention and one control group. Intervention group 1 (IG1) trained with the computer-based system two times a week while Intervention group 2 (IG2) received five training sessions a week. Using the markerless Microsoft Kinect® camera, participants controlled a digital avatar with their own body movements. UPDRS-III and Clinical measurements were performed before and after the three-week period.

RESULTS

Patients in all groups improved in UPDRS-III pre and post intervention whereas reduction rates were higher for IG1 (-10.89%) and IG2 (-14.04%) than for CG (-7.74%). Differences between the groups were not significant (value of ps CG/IG1 0.225, CG/IG2 0.347). Growth rates for the arm abduction angle were significantly higher in IG1 (11.6%) and IG2 (9.97%) than in CG (1.87%) (value of ps CG/IG1 0.006 and CG/IG2 0.018), as was the 5-steps-distance (CG 10.86% vs. IG1 24.5% vs. UG2 26.22%, value of ps CG/IG1 0.011 and CG/IG2 0.031).

DISCUSSION

The study shows the beneficial effects of computer-based training and substantiates the assumption of a similar impact in a home-based setting. The utilized software is feasible for such interventions and meets with the patient's approval. Group dynamics seem to have an additional supporting effect for the aspired objective of improving mobility and should be seen as an essential aspect of video games in therapy.

摘要

引言

帕金森氏症患者常常由于工作人员短缺和疾病发病率上升,而难以获得专业的物理治疗和运动训练,这导致他们的活动能力迅速下降,并产生绝望感。应对这些挑战需要分配足够的资源并实施专业培训计划,以确保全面的护理和支持。针对这些问题,人们发明了一种计算机软件,它可以作为传统物理治疗的一种额外的居家延伸方式。

方法

该试验在一家康复中心进行,除了为期3周的待研究训练计划外,每位患者都接受了同等的治疗。74名患者被纳入研究,并随机分为两个干预组和一个对照组。干预组1(IG1)每周使用基于计算机的系统训练两次,而干预组2(IG2)每周接受五次训练。参与者使用无标记的微软Kinect®摄像头,通过自己的身体动作控制一个数字虚拟形象。在为期三周的前后分别进行了统一帕金森病评定量表第三部分(UPDRS-III)和临床测量。

结果

所有组的患者在干预前后的UPDRS-III评分均有所改善,而干预组1(-10.89%)和干预组2(-14.04%)的降低率高于对照组(-7.74%)。组间差异不显著(对照组与干预组1的p值为0.225,对照组与干预组2的p值为0.347)。干预组1(11.6%)和干预组2(9.97%)的手臂外展角度增长率显著高于对照组(1.87%)(对照组与干预组1的p值为0.006,对照组与干预组2的p值为0.018),五步距离增长率也是如此(对照组为10.86%,干预组1为24.5%,干预组2为26.22%,对照组与干预组1的p值为0.011,对照组与干预组2的p值为0.031)。

讨论

该研究显示了基于计算机训练的有益效果,并证实了在居家环境中也有类似影响的假设。所使用的软件对于此类干预是可行的,并得到了患者的认可。群体动态似乎对改善活动能力这一预期目标有额外的支持作用,应被视为治疗中电子游戏的一个重要方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/325c/10461806/523e514ce2ef/fneur-14-1210926-g001.jpg

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