摘要
目的 研究肢体协调辅助装置结合虚拟现实技术(virtual reality,VR)对急性脑梗死颅内血管介入治疗患者步态平衡和表面肌电图的影响。方法 前瞻性连续纳入2019年6月—2021年6月于邢台医学高等专科学校第二附属医院神经内科收治的颅内血管介入术后的急性脑梗死患者,按照随机数字表法分为对照组和观察组。对照组患者采用肢体协调辅助装置训练联合常规训练,观察组患者则采用肢体协调辅助装置训练联合VR训练。训练2个月后,采用躯干障碍量表(trunk impairment scale,TIS)、Fugl-Meyer平衡测试评分(Fugl-Meyer balance assessment score,FMA-B)、Holden功能性步行分级(functional ambulation classification,FAC)、改良Barthel量表(modified Barthel index,MBI)评估患者的躯干功能、平衡功能、步行能力和日常生活能力,记录患者的三维步态参数和表面肌电图(surface electromyography,sEMG)情况。结果 共纳入152例急性脑梗死患者,平均(42.64±4.17)岁,男性81例,女性71例,对照组和观察组各76例。训练后,观察组TIS量表的协调[(3.93±0.46)分vs.(2.88±0.25)分,P<0.001]、静态坐位平衡[(5.63±1.35)分vs.(4.99±1.04)分,P=0.004]、动态坐位平衡评分[(3.95±0.62)分vs.(3.19±0.54),P<0.001]与FMA-B评分[(7.95±1.99)分vs.(7.04±1.84分),P=0.010]均高于对照组,差异有统计学意义;观察组FAC等级高于对照组,观察组步速[(52.46±4.98)cm/s vs.(48.34±4.28)cm/s,P<0.001]、步频[(89.42±8.48)次/分钟vs.(80.47±7.96)次/分钟,P<0.001]和患肢摆动相(38.45%±4.02%vs. 34.26%±3.87%,P<0.001)高于对照组,差异有统计学意义。观察组左右步长差[(0.62±0.06)cm vs.(0.93±0.11)cm,P<0.001]和不对称指数[(0.07±0.03)vs.(0.12±0.02),P<0.001]低于对照组,差异有统计学意义。观察组股四头肌[(0.10±0.02)cm/s vs.(0.08±0.01)cm/s,P<0.001]、胫骨前肌[(0.11±0.02)cm/s vs.(0.08±0.02)cm/s,P<0.001]和腓肠肌[(0.09±0.02)cm/s vs.(0.07±0.01)cm/s,P<0.001]的肌电图积分数�
Objective To investigate the effects of limb coordination device combined with virtual reality(VR)on gait balance and surface electromyography(EMG)in patients with acute cerebral infarction after intracranial endovascular therapy.Methods Patients with acute cerebral infarction admitted to the Department of Neurology ofthe Second Affiliated Hospital of Xingtai Medical College from June 2019 to June 2021 wereprospectively enrolled in this study. All patients received intracranial endovascular therapy andwere divided into control group and observation group according to random number table method.Patients in the control group received limb coordination auxiliary device training combined withconventional training, and patients in the observation group received limb coordination auxiliarydevice training combined with VR training. After two months of training, the trunk impairmentscale (TIS), Fugl-Meyer balance assessment score (FMA-B), Holden functional ambulationclassification (FAC), modified Barthel index (MBI) were used to assess the trunk function, balancefunction, walking ability, and daily living ability of the patients, and the patient's three-dimensionalgait parameters and surface EMG status were recorded.Results A total of 152 patients were included in this study, with a mean age of 42.64±4.17 yearsold and 81 males(53.29%), and 76 cases in each group. After training, the TIS scale coordination[(3.93±0.46) points vs . (2.88±0.25) points, P <0.001], static sitting balance [(5.63±1.35) points vs .(4.99±1.04) points, P =0.004], dynamic sitting balance score [(3.95±0.62) points vs . (3.19±0.54),P <0.001] and FMA-B score [(7.95±1.99) points vs . (7.04±1.84 points), P =0.010] in the observationgroup were all higher than those in the control group;the FAC level of the observation groupwas higher than that of the control group, and the gait speed [(52.46±4.98) cm/s vs . (48.34±4.28) cm/s,P <0.001], stride frequency [(89.42±8.48) times/min vs . (80.47±7.96) times/min, P <0.001] andlimb swing phase (38.45%�
作者
樊振梅
王春钚
谢婷
郜风清
FAN Zhenmei;WANG Chunbu;XIE Ting;GAO Fengqing(Department of Neurology,The Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,China)
出处
《中国卒中杂志》
2023年第2期194-200,共7页
Chinese Journal of Stroke
关键词
肢体协调辅助装置
VR技术
步态平衡
表面肌电图
急性脑梗死
康复训练
Limb coordination auxiliary device
VR technology
Gait balance
Surface electromyography
Acute cerebral infarction
Rehabilitation training
