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虚拟现实技术对脑卒中上肢功能影响的弥散张量成像研究 被引量:1

Effect of virtual reality on upper limb function after stroke:a study of diffusion tensor imaging
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摘要 目的采用弥散张量成像观察虚拟现实技术对脑卒中患者上肢功能的效果。方法2021年9月至2023年3月,选取福州市第二总医院收治的脑卒中患者80例,随机分为对照组(n=40)和试验组(n=40)。两组均行常规康复,试验组增加虚拟现实技术康复,共4周。治疗前、治疗4周和随访4周时,采用Fugl-Meyer评定量表上肢部分(FMA-UE)和上肢动作研究量表(ARAT)进行评定。治疗前、治疗4周时,行弥散张量成像(DTI)扫描,测量病灶侧大脑脚和内囊后肢平均各向异性分数(FA)和相对各向异性(RA)。结果两组各脱落2例。治疗4周和随访4周时,两组FMA-UE和ARAT评分均显著升高(F>2.790,P<0.001),且试验组评分优于对照组(t>2.297,P<0.05)。治疗4周时,两组内囊后肢FA和RA均增高(t>21.013,P<0.001),试验组优于对照组(t>2.006,P<0.05)。两组内囊后肢FA治疗前后差值(ΔFA)与FMA-UE治疗前后差值呈正相关(r>0.362,P<0.05),试验组内囊后肢ΔFA与ARAT治疗前后差值呈正相关(r=0.459,P<0.01)。结论虚拟现实技术可促进脑卒中患者上肢功能改善,可能与内囊后肢传导恢复有关。 Objective To explore the effect of virtual reality on upper limb function in stroke patients through diffusion tensor imaging(DTI).Methods From September,2021 to March,2023,80 stroke patients in the Fuzhou Second General Hospital were randomly divided into control group(n=40)and experimental group(n=40).Both groups received routine rehabilitation,while the experimental group received virtual reality training additionally,for four weeks.They were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and Action Research Arm Test(ARAT)before treatment,after treatment and after four-week follow-up;and they were scaned with DTI to measure the fractional anisotropy(FA)and relative anisotropy(RA)of cerebral peduncle and posterior limb of inner capsule of the affected side before and after treatment.Results Two cases dropped in each group.The FMA-UE and ARAT scores increased in both groups after treatment and follow-up(F>2.790,P<0.001),and increased more in the experimental group than in the control group(t>2.297,P<0.05).FA and RA in the posterior limb of inner capsule increased in both groups after treatment(t>21.013,P<0.001),and increased more in the experimental group(t>2.006,P<0.05).The d-value of FA of the posterior limb of internal capsule before and after treatment(ΔFA)was positively correlated with the d-value of FMA-UE score(r>0.362,P<0.05)in both groups,theΔFA of the posterior limb of internal capsule was positively correlated with the d-value of ARAT score(r=0.459,P<0.01).Conclusion Virtual reality training can promote the recovery of upper limb function in stroke patients,which may associate with the conductivity of posterior limb of inner capsule.
作者 林娜 高菡璐 卢惠苹 陈燕清 郑军凡 陈述荣 LIN Na;GAO Hanlu;LU Huiping;CHEN Yanqing;ZHENG Junfan;CHEN Shurong(Fuzhou Second General Hospital,Fuzhou,Fujian 350007,China)
出处 《中国康复理论与实践》 CSCD 北大核心 2024年第1期61-67,共7页 Chinese Journal of Rehabilitation Theory and Practice
基金 福州市卫生健康中青年科学研究项目(No.2021-S-wq13) 福建省创伤骨科急救与康复临床医学研究中心项目(No.2020Y2014)。
关键词 脑卒中 上肢 虚拟现实技术 弥散张量成像 stroke upper limb virtual reality diffusion tensor imaging
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