Victor Bright Alwin, R Arunachalam, Angel I Sheela, Kumar B Gnanesh
Neuro Physiotherapy, Madhav University, Pindwara, IND.
Neuro Physiotherapy, Vels Institute of Science, Technology & Advanced Studies, Chennai, IND.
Cureus. 2024 Aug 6;16(8):e66299. doi: 10.7759/cureus.66299. eCollection 2024 Aug.
Introduction Stroke is a major neurological event resulting from reduced or blocked blood flow to the brain, leading to significant morbidity. Immediate medical attention is essential to minimize brain damage and improve outcomes since it leads to many clinical deficits like locomotor impairment, instability in postural control, tonic alterations of the affected musculature, and an array of neurological dysfunctions if left unnoticed. Immersive virtual reality (VR) has emerged as a novel therapeutic tool in stroke rehabilitation, offering engaging and realistic environments for therapy. This study aims to evaluate the effectiveness of immersive VR training combined with functional gait exercises in improving dynamic balance and postural stability in stroke patients, compared to VR training alone. Methods This comparative study included 30 subjects from Madha Medical College and Hospital, Chennai, Tamil Nadu, India, divided into two groups. Group A (n=15) received immersive VR combined with functional gait exercises, while Group B (n=15) received immersive VR alone. Subjects were aged 40-60 years with stable blood pressure and a stroke duration of two weeks to six months. The study spanned 12 weeks, with 30-minute sessions on alternate days. Dynamic balance and postural stability were assessed using the Functional Gait Assessment (FGA) and Falls Efficacy Scale (FES). Pre-test and post-test scores were evaluated using parametric tests. Results Post-test mean values showed significant improvements in both groups. Group A demonstrated greater effectiveness, with lower FES scores (mean 36.66 ± 11.12) than Group B (mean 46.66 ± 9.75). FGA scores were higher in Group A (mean 28.00 ± 0.925) compared to Group B (mean 26.06 ± 1.66). Significant differences were observed in pre-test and post-test values within each group, supporting the hypothesis that combined VR and gait exercises offer superior rehabilitation outcomes. Conclusions Immersive VR combined with functional gait exercises significantly improves dynamic balance and postural stability in stroke patients compared to VR alone. This integrated approach can enhance motor function recovery, increase independence, and improve the quality of life. VR's capability to simulate real-life activities and provide immediate feedback allows for personalized rehabilitation programs. Further research is required to validate these findings and optimize VR-based rehabilitation protocols.
引言 中风是一种主要的神经学事件,由大脑血液流动减少或受阻引起,会导致严重的发病率。由于中风若不及时治疗会引发许多临床缺陷,如运动障碍、姿势控制不稳定、受影响肌肉组织的强直性改变以及一系列神经功能障碍,因此立即就医对于将脑损伤降至最低并改善预后至关重要。沉浸式虚拟现实(VR)已成为中风康复中的一种新型治疗工具,为治疗提供了引人入胜且逼真的环境。本研究旨在评估与单独的VR训练相比,沉浸式VR训练结合功能性步态训练在改善中风患者动态平衡和姿势稳定性方面的有效性。
方法 这项比较研究纳入了来自印度泰米尔纳德邦金奈马德哈医学院和医院的30名受试者,分为两组。A组(n = 15)接受沉浸式VR结合功能性步态训练,而B组(n = 15)仅接受沉浸式VR训练。受试者年龄在40至60岁之间,血压稳定,中风病程为两周至六个月。该研究为期12周,隔天进行30分钟的训练课程。使用功能性步态评估(FGA)和跌倒效能量表(FES)评估动态平衡和姿势稳定性。使用参数检验评估测试前和测试后的分数。
结果 测试后平均值显示两组均有显著改善。A组显示出更高的有效性,其FES分数(平均36.66 ± 11.12)低于B组(平均46.66 ± 9.75)。A组的FGA分数(平均28.00 ± 0.925)高于B组(平均26.06 ± 1.66)。每组测试前和测试后的值均观察到显著差异,支持了VR与步态训练相结合可提供更好康复效果的假设。
结论 与单独的VR相比,沉浸式VR结合功能性步态训练可显著改善中风患者的动态平衡和姿势稳定性。这种综合方法可增强运动功能恢复、提高独立性并改善生活质量。VR模拟现实生活活动并提供即时反馈的能力允许制定个性化的康复计划。需要进一步的研究来验证这些发现并优化基于VR的康复方案。