基于虚拟现实技术指导下的功能锻炼对脑出血患者术后神经功能康复、平衡功能及姿势控制能力的影响
|
摘要
目的分析基于虚拟现实技术指导下的功能锻炼对脑出血患者术后神经功能康复、平衡功能及姿势控制能力的影响。方法选取2015年10月至2017年10月于本院接受手术治疗的72例脑出血患者为研究对象,按照随机数表法将其分为研究组(38例)和对照组(34例)。所有患者术后均行常规药物治疗和常规康复治疗,在此基础上,对照组患者进行传统平衡训练,研究组患者进行基于虚拟现实技术指导下的功能锻炼。比较两组患者治疗前后的平衡功能、姿势控制能力、日常生活活动能力及神经功能恢复情况。结果治疗后,两组患者的轨迹移动速度均显著慢于本组治疗前(P_均<0.05)、轨迹外周面积均显著小于本组治疗前(P_均<0.05),轨迹长度均显著短于本组治疗前(P_均<0.05),且研究组患者上述指标下降幅度均显著大于对照组(P_均<0.05)。治疗后,两组患者Berg平衡量表(Berg balance scale,BBS)评分和Barthel指数(Barthel index,BI)量表评分均显著高于本组治疗前(P_均<0.05),美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分均显著低于本组治疗前(P_均<0.05),且研究组患者BBS评分和BI量表评分均显著高于对照组(P_均<0.05),NIHSS评分显著低于对照组(P <0.05)。结论基于虚拟现实技术指导下的功能锻炼能有效改善脑出血患者术后的平衡功能和姿势控制能力,促进神经功能恢复,提高日常生活活动能力。
Objective To analyze the effect of functional exercise based on virtual reality technology on postoperative neurological function rehabilitation, balance function and postural control capacity in patients with cerebral hemorrhage. Method 72 patients with cerebral hemorrhage who underwent surgical treatment in our hospital from October 2015 to October 2017 were collected and divided into study group(38 cases) and control group(34 cases) according to the random number table. All patients were treated with conventional drug therapy and rehabilitation training, on this basis, patients in control group were treated with traditional balance training, and patients in study group were treated with functional exercise based on virtual reality technology. The balance ability, postural control ability, activity of daily living(ADL) and recovery of neurological function were compared between the two groups before and after treatment. Result After treatment, the track movement speed of the two groups were significantly slower than those before treatment(P_(all)< 0.05), the peripheral area of the track were significantly smaller than those before treatment(P_(all)< 0.05), the track length were significantly shorter than those before treatment(P_(all)< 0.05), and the decrease of the above indexes of study group were significantly higher than those of control group(P_(all)< 0.05). After treatment, the scores of Berg balance scale(BBS) and Barthel index(BI) in both groups were significantly higher than those before treatment(P_(all)< 0.05), and the scores of National Institutes of Health stroke scale(NIHSS) were significantly lower than those before treatment(P_(all)< 0.05), and the scores of BBS and BI of study group were significantly higher than those of control group(P_(all)< 0.05), the score of NIHSS was lower than that of control group(P < 0.05). Conclusion Functional exercise based on virtual reality technology can effectively improve the balance ability and postural control capacity of patients with cerebral hemorrhage after operation, promote the recovery of their neurological function, and improve their ability of daily life.
Objective To analyze the effect of functional exercise based on virtual reality technology on postoperative neurological function rehabilitation, balance function and postural control capacity in patients with cerebral hemorrhage. Method 72 patients with cerebral hemorrhage who underwent surgical treatment in our hospital from October 2015 to October 2017 were collected and divided into study group(38 cases) and control group(34 cases) according to the random number table. All patients were treated with conventional drug therapy and rehabilitation training, on this basis, patients in control group were treated with traditional balance training, and patients in study group were treated with functional exercise based on virtual reality technology. The balance ability, postural control ability, activity of daily living(ADL) and recovery of neurological function were compared between the two groups before and after treatment. Result After treatment, the track movement speed of the two groups were significantly slower than those before treatment(P_(all)< 0.05), the peripheral area of the track were significantly smaller than those before treatment(P_(all)< 0.05), the track length were significantly shorter than those before treatment(P_(all)< 0.05), and the decrease of the above indexes of study group were significantly higher than those of control group(P_(all)< 0.05). After treatment, the scores of Berg balance scale(BBS) and Barthel index(BI) in both groups were significantly higher than those before treatment(P_(all)< 0.05), and the scores of National Institutes of Health stroke scale(NIHSS) were significantly lower than those before treatment(P_(all)< 0.05), and the scores of BBS and BI of study group were significantly higher than those of control group(P_(all)< 0.05), the score of NIHSS was lower than that of control group(P < 0.05). Conclusion Functional exercise based on virtual reality technology can effectively improve the balance ability and postural control capacity of patients with cerebral hemorrhage after operation, promote the recovery of their neurological function, and improve their ability of daily life.
引文
[1]范存刚,张庆俊.2015版AHA/ASA《自发性脑出血处理指南》解读[J].中华神经医学杂志,2017,16(1):2-5.
[2]Winstein CJ,Stein J,Arena R,et al.Guidelines for adult stroke rehabilitation and recovery:a guideline for healthcare professionals from the American heart association/American stroke association[J].Stroke,2016,47(6):e98-e119.
[3]张弛,迟风令,骆纯.高压氧联合丹红注射液对高血压脑出血微创术后患者早期神经功能康复的临床疗效分析[J].中国医学前沿杂志(电子版),2017,9(4):40-43.
[4]石晓卉,刘艳,肖东.高血压脑出血术后不同目标值收缩压对血肿体积及神经损伤的影响研究[J].中国医学前沿杂志(电子版),2016,8(10):99-104.
[5]李艾群,王敏,危科丽.早期康复护理对脑出血患者术后神经功能恢复及生活质量的影响[J].山西医药杂志,2016,45(7):858-860.
[6]王云霞,沈梅芬,徐颖.老年脑出血患者康复指导对四肢运动功能及恢复的效果探讨[J].中国地方病防治杂志,2017,32(6):707-708.
[7]李海燕,武欣.早期康复训练对老年高血压基底节区脑出血患者预后、心理状况及生活质量的影响分析[J].中国医学前沿杂志(电子版),2017,9(10):67-70.
[8]谢艺婷,柳维林,吴劲松,等.虚拟现实技术在脑卒中患者运动功能康复中的应用进展[J].中国康复理论与实践,2017,23(11):1294-1298.
[9]王静,于纪魁.虚拟现实技术结合作业治疗对脑卒中患者肢体功能及步行能力的影响[J].中国临床医生杂志,2017,45(10):27-29.
[10]康海燕,许光旭.虚拟现实技术对脑卒中患者平衡及步行能力康复效果的meta分析[J].中国康复医学杂志,2016,31(5):554-557.
[11]李伯炜,陆华,蔚钧弛,等.血肿穿刺术与血肿清除术治疗脑出血的临床疗效及对认知功能影响的比较[J].立体定向和功能性神经外科杂志,2017,30(5):293.
[12]徐桂珍,沈朝东,陈永茂.早期康复训练联合高压氧治疗对脑卒中后神经功能及日常生活活动能力的影响[J].实用临床医药杂志,2017,21(15):180.
[13]刘远文,潘翠环,叶正茂,等.虚拟现实机器手对脑卒中患者手运动功能及日常生活活动的效果[J].中国康复理论与实践,2017,23(1):19-22.
[14]韩晓晓,柯将琼,蒋松鹤,等.虚拟现实游戏训练对脑卒中患者偏瘫上肢功能恢复的影响[J].中华物理医学与康复杂志,2016,38(6):401-405.
[15]徐英,邹志浩.脑外伤恢复期患者接受基于虚拟现实技术康复训练后平衡功能和姿势控制能力的变化观察[J].神经损伤与功能重建,2017,12(6):563-564.
[16]金星,许光旭,孟兆祥,等.基于虚拟现实技术的康复训练对脑外伤恢复期患者平衡功能的影响[J].中华物理医学与康复杂志,2016,38(6):406-408.
[17]Saposnik G,Cohen LG,Mamdani M,et al.Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation(EVREST):a randomised,multicentre,single-blind,controlled trial[J].Lancet Neurol,2016,15(10):1019-1027.
[18]朱茜,张秀芳.虚拟现实技术在不同类型脑卒中偏瘫患者上肢功能康复中的应用效果[J].中国急救医学,2017,37(12):282-283.
[19]程秀燕,郭卫东.虚拟现实康复技术对脑卒中下肢功能障碍恢复的疗效分析[J].临床医学文献电子杂志,2016,3(11):2005,2008.
[20]李元进,李金东,周雪莉,等.天轨步行结合虚拟现实康复训练改善脑卒中患者下肢运动功能及平衡能力的疗效观察[J].中国康复,2016,31(5):370-371.
[2]Winstein CJ,Stein J,Arena R,et al.Guidelines for adult stroke rehabilitation and recovery:a guideline for healthcare professionals from the American heart association/American stroke association[J].Stroke,2016,47(6):e98-e119.
[3]张弛,迟风令,骆纯.高压氧联合丹红注射液对高血压脑出血微创术后患者早期神经功能康复的临床疗效分析[J].中国医学前沿杂志(电子版),2017,9(4):40-43.
[4]石晓卉,刘艳,肖东.高血压脑出血术后不同目标值收缩压对血肿体积及神经损伤的影响研究[J].中国医学前沿杂志(电子版),2016,8(10):99-104.
[5]李艾群,王敏,危科丽.早期康复护理对脑出血患者术后神经功能恢复及生活质量的影响[J].山西医药杂志,2016,45(7):858-860.
[6]王云霞,沈梅芬,徐颖.老年脑出血患者康复指导对四肢运动功能及恢复的效果探讨[J].中国地方病防治杂志,2017,32(6):707-708.
[7]李海燕,武欣.早期康复训练对老年高血压基底节区脑出血患者预后、心理状况及生活质量的影响分析[J].中国医学前沿杂志(电子版),2017,9(10):67-70.
[8]谢艺婷,柳维林,吴劲松,等.虚拟现实技术在脑卒中患者运动功能康复中的应用进展[J].中国康复理论与实践,2017,23(11):1294-1298.
[9]王静,于纪魁.虚拟现实技术结合作业治疗对脑卒中患者肢体功能及步行能力的影响[J].中国临床医生杂志,2017,45(10):27-29.
[10]康海燕,许光旭.虚拟现实技术对脑卒中患者平衡及步行能力康复效果的meta分析[J].中国康复医学杂志,2016,31(5):554-557.
[11]李伯炜,陆华,蔚钧弛,等.血肿穿刺术与血肿清除术治疗脑出血的临床疗效及对认知功能影响的比较[J].立体定向和功能性神经外科杂志,2017,30(5):293.
[12]徐桂珍,沈朝东,陈永茂.早期康复训练联合高压氧治疗对脑卒中后神经功能及日常生活活动能力的影响[J].实用临床医药杂志,2017,21(15):180.
[13]刘远文,潘翠环,叶正茂,等.虚拟现实机器手对脑卒中患者手运动功能及日常生活活动的效果[J].中国康复理论与实践,2017,23(1):19-22.
[14]韩晓晓,柯将琼,蒋松鹤,等.虚拟现实游戏训练对脑卒中患者偏瘫上肢功能恢复的影响[J].中华物理医学与康复杂志,2016,38(6):401-405.
[15]徐英,邹志浩.脑外伤恢复期患者接受基于虚拟现实技术康复训练后平衡功能和姿势控制能力的变化观察[J].神经损伤与功能重建,2017,12(6):563-564.
[16]金星,许光旭,孟兆祥,等.基于虚拟现实技术的康复训练对脑外伤恢复期患者平衡功能的影响[J].中华物理医学与康复杂志,2016,38(6):406-408.
[17]Saposnik G,Cohen LG,Mamdani M,et al.Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation(EVREST):a randomised,multicentre,single-blind,controlled trial[J].Lancet Neurol,2016,15(10):1019-1027.
[18]朱茜,张秀芳.虚拟现实技术在不同类型脑卒中偏瘫患者上肢功能康复中的应用效果[J].中国急救医学,2017,37(12):282-283.
[19]程秀燕,郭卫东.虚拟现实康复技术对脑卒中下肢功能障碍恢复的疗效分析[J].临床医学文献电子杂志,2016,3(11):2005,2008.
[20]李元进,李金东,周雪莉,等.天轨步行结合虚拟现实康复训练改善脑卒中患者下肢运动功能及平衡能力的疗效观察[J].中国康复,2016,31(5):370-371.