KU Leuven, Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium; University Hospitals of KU Leuven, Department of Intensive Care Medicine, Leuven, Belgium.
University Hospitals of KU Leuven, Department of Intensive Care Medicine, Leuven, Belgium.
Aust Crit Care. 2024 Nov;37(6):949-956. doi: 10.1016/j.aucc.2024.06.004. Epub 2024 Jul 25.
This study investigated the feasibility and safety of interactive virtual reality rehabilitation (VRR) for patients with a critical illness and a long stay in the intensive care unit (ICU), as a motivational tool for rehabilitation.
Single-centre, non-randomised proof-of-concept clinical trial.
Adult, calm, and alert critically ill patients with a prolonged stay (≥8 days) in the ICU.
Patients received interactive VRR therapy for upper limb rehabilitation with a VR-app designed specifically for use in bedridden patients in the supine position. Feasibility was assessed by time registrations, questionnaires for patients and physiotherapists, as well as recording of all perceived barriers. Safety was assessed by recording (changes in) vital clinical parameters, as well as minor and major adverse events.
Twenty patients participated in 79 VRR sessions. Median durations of different session components were 2 minutes (interquartile range [IQR] = 2min, 3min) for set-up and explanation to the patient, 10 minutes (IQR = 10min, 15min) for training time, and 2 minutes (IQR = 2min, 2min) for ending the session and cleaning. The median fun score given by the patients after each session was 9 (IQR = 8, 10) out of 10. Physiotherapists reported no barriers other than a few time-consuming technical problems. Reported problems by patients were all minor and mostly technical. No major and no minor adverse events occurred.
Interactive upper limb VRR is a feasible, safe, and appreciated tool to use in rehabilitation of critically ill patients during their prolonged ICU stay. Subsequent future studies should focus on the effects of VRR on neuromuscular and cognitive function and the socioeconomic impact of exergaming for rehabilitation purposes of ICU patients.
本研究旨在探讨互动虚拟现实康复（VRR）对患有重病且在重症监护病房（ICU）中长时间停留的患者的可行性和安全性，将其作为一种康复激励工具。
单中心、非随机概念验证临床试验。
成人、镇静且意识清醒的危重症患者，在 ICU 中长时间停留（≥8 天）。
患者接受特定设计用于卧床患者仰卧位的上肢康复 VR 应用的互动 VRR 治疗。通过时间记录、患者和物理治疗师的问卷调查以及记录所有感知到的障碍来评估可行性。通过记录（变化）生命临床参数以及轻微和重大不良事件来评估安全性。
20 名患者参与了 79 次 VRR 治疗。不同治疗环节的中位数持续时间分别为：患者准备和解释（2 分钟[四分位距（IQR）=2 分钟，3 分钟]）、训练时间（10 分钟[IQR=10 分钟，15 分钟]）和治疗结束和清理（2 分钟[IQR=2 分钟，2 分钟]）。每位患者在每次治疗后给出的 FUN 评分中位数为 10 分（IQR=8 分，10 分）。物理治疗师报告除了一些耗时的技术问题外，没有其他障碍。患者报告的问题均为轻微且主要为技术问题。没有发生重大或轻微不良事件。
互动式上肢 VRR 是一种可行、安全且受患者欢迎的工具，可用于在 ICU 长时间停留期间对危重症患者进行康复治疗。未来的研究应重点关注 VRR 对神经肌肉和认知功能的影响，以及 Exergaming 对 ICU 患者康复的社会经济影响。
