de Vries Mirthe, Beumeler Lise F E, van der Meulen Johan, Bethlehem Carina, den Otter Rob, Boerma E Christiaan
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, Netherlands.
Department of Human Movement Sciences, University of Groningen, Groningen, Netherlands.
PeerJ. 2025 Jan 9;13:e18461. doi: 10.7717/peerj.18461. eCollection 2025.
Early mobilization reduces long-term muscle weakness after intensive care unit (ICU) admission, but barriers (e.g., anxiety, lack of motivation) may complicate patients' adherence to exercise. Virtual reality (VR) presents immersive stimuli, which may increase motivation and adherence. This study aimed to examine the feasibility of VR-therapy using a VR-headset during ICU- and subsequent general ward admission. Furthermore, physical parameters before and after training were explored.
MATERIALS & METHODS: Ten adult ICU-patients with a median age of 71 [63-79], 70% of male registered birth sex, mechanically ventilated for ≥48 h, and willing to participate, were included. VR-therapy was offered three times a week for 20 minutes in addition to standard care. To train upper extremity functionality, patients were instructed to complete puzzles with increasing level of difficulty. Feasibility was based on patient satisfaction, session efficiency, and adherence levels during the training. Fatigue was measured after each session using the Borg Rating of Perceived Exertion Scale. Patients' hand-grip strength and Morton Mobility Index (MMI) were evaluated at the start of VR-therapy and after four weeks of training or at hospital discharge.
On average, patients followed three VR-therapy sessions of 20 min per week with 13 min of actual training time, over the course of 1 to 3 weeks depending on their length of stay. Session efficiency ranged from 25% to 93%. In total, patients adhered to 60% of the VR-therapy sessions. MMI scores increased significantly from the start (26 [24-44]) to the end of the VR-therapy training period (57 [41-85], = 0.005), indicating improved balance and mobility.
VR-therapy for upper extremity rehabilitation in ICU-patients is feasible during stay in the ICU and general ward.
早期活动可减轻重症监护病房（ICU）住院后长期的肌肉无力，但障碍因素（如焦虑、缺乏动力）可能会使患者坚持锻炼变得复杂。虚拟现实（VR）提供沉浸式刺激，可能会增加动力和依从性。本研究旨在探讨在ICU及随后的普通病房住院期间使用VR头戴设备进行VR治疗的可行性。此外，还探究了训练前后的身体参数。
纳入10名成年ICU患者，中位年龄71岁[63 - 79岁]，登记出生性别为男性的占70%，机械通气≥48小时且愿意参与。除标准护理外，每周提供3次VR治疗，每次20分钟。为训练上肢功能，指导患者完成难度逐渐增加的拼图。可行性基于患者满意度、训练效率和训练期间的依从水平。每次训练后使用Borg自觉用力程度量表测量疲劳程度。在VR治疗开始时以及训练4周后或出院时评估患者的握力和莫顿运动指数（MMI）。
平均而言，患者在1至3周的住院期间，每周接受3次20分钟的VR治疗，实际训练时间为13分钟。训练效率在25%至93%之间。患者总共坚持了60%的VR治疗课程。MMI评分从VR治疗训练期开始时的26[24 - 44]显著提高到结束时的57[41 - 85]，差异有统计学意义（P = 0.005），表明平衡和活动能力有所改善。
在ICU和普通病房住院期间，对ICU患者进行上肢康复的VR治疗是可行的。
