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基于虚拟现实实时反馈的慢性中风后患者步态训练:一项初步研究。

Gait Training with Virtual Reality-Based Real-Time Feedback for Chronic Post-Stroke Patients: A Pilot Study.

作者信息

Kim Sunmin, Lee Yangjin, Kim Kyunghun

机构信息

Department of Physical Therapy, Gimcheon University, Gimcheon 39528, Republic of Korea.

Department of Physical Therapy, Kyungbuk College, Yeongju 36133, Republic of Korea.

出版信息

Healthcare (Basel). 2025 Jan 20;13(2):203. doi: 10.3390/healthcare13020203.

Abstract

BACKGROUND

Virtual reality-based training has been widely used for post-stroke patients due to its positive effects on functional aspects by promoting brain plasticity.

OBJECTIVE

This study aimed to investigate the effectiveness of gait training with virtual reality-based real-time feedback on motor function, balance, and spatiotemporal gait parameters in post-stroke patients.

METHODS

Fifteen patients ( = 15) with chronic stroke were randomly assigned to either the virtual reality-based real-time feedback with treadmill gait training (experimental group = 8) or the treadmill gait training (control group = 7). For the experimental group that participated, a treadmill, an Oculus Rift VR device, and smart insoles were used for gait training with VR-based real-time feedback. Regarding gait training with VR-based real-time feedback, the patient wore an Oculus Rift and performed gait training on a treadmill for 30 min a day, three times a week, for 5 weeks. The control group participated in treadmill gait training for 30 min a day, three times a week, for 5 weeks. Motor function was measured using the Fugl-Meyer assessment. Balance was measured using the timed up and go test and Berg balance scale. Gait performance was measured using an Optogait. The normality test was performed using the Shapiro-Wilk test, the Wilcoxon signed-rank test was used for the within-group comparison, and the Mann-Whitney U test was used for the between-group comparison.

RESULTS

In the group analyses, both groups showed significant improvements in motor function balance and gait ability. According to the pre- and post-treatment results, greater improvement in the Fugl-Meyer assessment (experimental group: 4.75 vs. control group: 1.57) was observed in the experimental group compared with the control group ( < 0.05). In balance ability, greater improvement in the timed up and go test (experimental group: -3.10 vs. control group: -1.12) and Berg balance scale (experimental group: 3.00 vs. control group: 1.71) ( < 0.05). In the spatiotemporal gait parameters, greater improvement in affected step length (5.35 vs. 2.01), stride length (3.86 vs. 1.75), affected single support (2.61 vs. 1.22), and cadence (0.07 vs. 0.02) was observed in the experimental group compared with the control group ( < 0.05).

CONCLUSIONS

This study suggested the positive effects of the virtual reality-based real-time feedback with treadmill gait training on motor function, balance, and gait performance.

摘要

背景

基于虚拟现实的训练因对功能方面有积极影响,可促进脑可塑性,已被广泛应用于中风后患者。

目的

本研究旨在探讨基于虚拟现实的实时反馈的步态训练对中风后患者运动功能、平衡及时空步态参数的有效性。

方法

15例慢性中风患者被随机分为基于虚拟现实实时反馈的跑步机步态训练组(实验组,n = 8)和跑步机步态训练组(对照组,n = 7)。对于参与的实验组,使用跑步机、Oculus Rift VR设备和智能鞋垫进行基于虚拟现实实时反馈的步态训练。关于基于虚拟现实实时反馈的步态训练,患者佩戴Oculus Rift并在跑步机上每天进行30分钟步态训练,每周三次,共5周。对照组每天进行30分钟跑步机步态训练,每周三次,共5周。使用Fugl - Meyer评估法测量运动功能。使用计时起立行走测试和Berg平衡量表测量平衡。使用Optogait测量步态表现。使用Shapiro - Wilk检验进行正态性检验,组内比较采用Wilcoxon符号秩检验,组间比较采用Mann - Whitney U检验。

结果

在组分析中,两组在运动功能、平衡和步态能力方面均有显著改善。根据治疗前后结果,与对照组相比,实验组在Fugl - Meyer评估中有更大改善(实验组:4.75 vs. 对照组:1.57)(P < 0.05)。在平衡能力方面,计时起立行走测试(实验组: - 3.10 vs. 对照组: - 1.12)和Berg平衡量表(实验组:3.00 vs. 对照组:1.71)有更大改善(P < 0.05)。在时空步态参数方面,与对照组相比,实验组在患侧步长(5.35 vs. 2.01)、步幅(3.86 vs. 1.75)、患侧单支撑时间(2.61 vs. 1.22)和步频(0.07 vs. 0.02)方面有更大改善(P < 0.05)。

结论

本研究表明基于虚拟现实实时反馈的跑步机步态训练对运动功能、平衡和步态表现有积极影响。

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