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病例报告:基于虚拟现实的手臂和腿部骑行结合经皮脊髓电刺激用于一名颈脊髓损伤患者的早期治疗。

Case report: Virtual reality-based arm and leg cycling combined with transcutaneous electrical spinal cord stimulation for early treatment of a cervical spinal cord injured patient.

作者信息

Chu Xiaolei, Liu Shuaiyi, Zhao Xiaoxuan, Liu Tao, Xing Zheng, Li Qingwen, Li Qi

机构信息

Department of Rehabilitation, Tianjin University Tianjin Hospital, Tianjin, China.

Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise and Health, Tianjin University of Sport, Tianjin, China.

出版信息

Front Neurosci. 2024 May 17;18:1380467. doi: 10.3389/fnins.2024.1380467. eCollection 2024.

Abstract

Spinal cord injury is a condition affecting the central nervous system, causing different levels of dysfunction below the point of nerve damage. A 50-year-old woman suffered a neck injury as a result of a car accident. After undergoing posterior cervical C3-C6 internal fixation with titanium plates on one side and C7 lamina decompression, the patient, who had been diagnosed with C3-C7 cervical disk herniation and spinal stenosis causing persistent compression of the spinal cord, was transferred to the rehabilitation department. After implementing the combined therapy of Virtual Reality-based arm and leg cycling along with transcutaneous electrical stimulation of the spinal cord, the patients experienced a notable enhancement in both sensory and motor abilities as per the ASIA scores. The patient's anxiety and depression were reduced as measured by the Hamilton Anxiety and Hamilton Depression Tests. As evaluated by the SCIM-III, the patient's self-reliance and capacity to carry out everyday tasks showed ongoing enhancement, leading to the restoration of their functionality. Hence, the use of Virtual Reality-based arm and leg cycling along with transcutaneous electrical spinal cord stimulation has potential to positively impact function in patients with spinal cord injury. However, as this is a case report, the small number of patients and the fact that the intervention was initiated early after the injury, we were unable to separate the recovery due to the intervention from the natural recovery that is known to occur in the initial weeks and months after SCI. Therefore, further randomized controlled trials with a large sample size is necessary.

摘要

脊髓损伤是一种影响中枢神经系统的疾病,会导致神经损伤部位以下不同程度的功能障碍。一名50岁女性因车祸颈部受伤。在接受单侧C3 - C6颈椎后路钛板内固定及C7椎板减压术后,该患者被诊断为C3 - C7颈椎间盘突出症和脊髓狭窄,导致脊髓持续受压,随后被转至康复科。在实施基于虚拟现实的手臂和腿部循环训练联合脊髓经皮电刺激的综合治疗后,根据美国脊髓损伤协会(ASIA)评分,患者的感觉和运动能力均有显著提高。通过汉密尔顿焦虑量表和汉密尔顿抑郁量表测量,患者的焦虑和抑郁情绪有所减轻。根据脊髓损伤功能独立性测量量表(SCIM - III)评估,患者的自理能力和完成日常任务的能力持续增强,其功能得以恢复。因此,基于虚拟现实的手臂和腿部循环训练联合脊髓经皮电刺激有可能对脊髓损伤患者的功能产生积极影响。然而,由于这是一篇病例报告,患者数量较少且干预在受伤后早期开始,我们无法将干预导致的恢复与脊髓损伤后最初几周和几个月内自然发生的恢复区分开来。因此,有必要进行进一步的大样本随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c080/11140104/2702288cdef7/fnins-18-1380467-g001.jpg

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