基于家庭的虚拟现实上肢康复对慢性卒中患者的影响：一项随机对照试验。
Effects of home-based virtual reality upper extremity rehabilitation in persons with chronic stroke: a randomized controlled trial.
作者信息
Ase Hiroyuki, Honaga Kaoru, Tani Mami, Takakura Tomokazu, Wada Futoshi, Murakami Yuhei, Isayama Reina, Tanuma Akira, Fujiwara Toshiyuki
机构信息
Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Physical Therapy, Juntendo University Faculty of Health Science, Tokyo, Japan.
出版信息
J Neuroeng Rehabil. 2025 Feb 3;22(1):20. doi: 10.1186/s12984-025-01564-5.
BACKGROUND
Upper extremity rehabilitation in persons with stroke should be dose-dependent and task-oriented. Virtual reality (VR) has the potential to be used safely and effectively in home-based rehabilitation. This study aimed to investigate the effects of home-based virtual reality upper extremity rehabilitation in persons with chronic stroke.
METHODS
This was a single-blind, randomized, controlled trial conducted at two centers. The subjects were 14 outpatients with chronic stroke more than 6 months after the onset of the stroke. The participants were randomly divided into two groups. The intervention group (n = 7) performed a home rehabilitation program for the paretic hand (30 min/day, five days/week) using a VR device (RAPAEL Smart Glove™; NEOFECT Co., Yung-in, Korea) for four weeks. The control group (n = 7) participated in a conventional home rehabilitation program at the same frequency. All participants received outpatient occupational therapy once a week during the study period. The outcome measures included the Fugl-Meyer Assessment of upper extremity motor function (FMA-UE), Motor Activity Log-14 (MAL), Jebsen-Taylor Hand Function Test (JTT), and Box and Block Test (BBT) scores.
RESULTS
All 14 participants completed the study. Compared to the control group, the intervention group showed more significant improvements in FMA-UE (p = 0.027), MAL (p = 0.014), JTT (p = 0.002), and BBT (p = 0.014). No adverse events were observed during or after the intervention.
CONCLUSION
Compared to a conventional home program, combining a task-oriented virtual reality home program and outpatient occupational therapy might lead to greater improvements in upper extremity function and the frequency of use of the paretic hand.
TRIAL REGISTRATION
This study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trial Registry in Japan (Unique Identifier: UMIN000038469) on November 1, 2019; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043836 .
背景
中风患者的上肢康复应具有剂量依赖性且以任务为导向。虚拟现实（VR）有潜力安全有效地用于居家康复。本研究旨在调查居家虚拟现实上肢康复对慢性中风患者的影响。
方法
这是一项在两个中心进行的单盲、随机、对照试验。研究对象为14名中风发病6个月以上的慢性中风门诊患者。参与者被随机分为两组。干预组（n = 7）使用VR设备（RAPAEL Smart Glove™；韩国龙仁市NEOFECT公司）为患侧手进行居家康复计划（每天30分钟，每周5天），为期四周。对照组（n = 7）以相同频率参加传统居家康复计划。在研究期间，所有参与者每周接受一次门诊职业治疗。结局指标包括上肢运动功能的Fugl-Meyer评估（FMA-UE）、运动活动日志-14（MAL）、Jebsen-Taylor手功能测试（JTT）和箱块测试（BBT）分数。
结果
14名参与者均完成研究。与对照组相比，干预组在FMA-UE（p = 0.027）、MAL（p = 0.014）、JTT（p = 0.002）和BBT（p = 0.014）方面有更显著改善。干预期间及之后未观察到不良事件。
结论
与传统居家计划相比，将以任务为导向的虚拟现实居家计划与门诊职业治疗相结合可能会使上肢功能及患侧手的使用频率有更大改善。
试验注册
本研究于2019年11月1日在日本大学医院医学信息网络（UMIN）临床试验注册中心注册（唯一标识符：UMIN000038469）；https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043836 。
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