Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patien...Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.展开更多
目的在卒中伴上肢功能障碍的患者中,评价Wolf运动功能测试(Wolf motor function test,WMFT)量表的效度和信度。方法本研究招募2020年1月-2021年7月于首都医科大学附属北京天坛医院等3家医院的200例卒中患者,并由两名评定者分别对受试者...目的在卒中伴上肢功能障碍的患者中,评价Wolf运动功能测试(Wolf motor function test,WMFT)量表的效度和信度。方法本研究招募2020年1月-2021年7月于首都医科大学附属北京天坛医院等3家医院的200例卒中患者,并由两名评定者分别对受试者进行WMFT量表的评估。同时完成Fugl-Meyer运动功能评定量表上肢部分(Fugl-Meyer assessment-upper extremity,FMA-UE)作为校标。分别采用Spearman相关分析及因子分析法评价WMFT量表的校标效度及结构效度;采用Cronbach’sα系数及组内相关系数(intraclass correlation coefficient,ICC)评价WMFT量表的内部及外部信度。结果以FMA-UE总分为校标,Wolf量表总分与其呈正相关(r=0.904,P<0.001)。在结构效度分析中,本研究提取出2个特征值>1的公因子,其中第一个因子与上肢近端关节有关,第二个因子与手的精细功能及力量有关。内部一致性检验中,评分等级Cronbach’sα系数为0.806,作业时间Cronbach’sα系数为0.958。外部一致性检验中,WMFT量表各项内容时间均数和等级均数的ICC分别为0.990和0.998。结论WMFT量表测试上肢功能具有良好的效度和信度,适用于对卒中患者偏瘫侧上肢功能的评定。展开更多
基金supported by the Sub-Project under National "Twelfth Five-Year" Plan for Science&Technology Support Project in China,No.2011BAI08B11the Research Project of China Rehabilitation Research Center,No.2014-3
文摘Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.
文摘目的在卒中伴上肢功能障碍的患者中,评价Wolf运动功能测试(Wolf motor function test,WMFT)量表的效度和信度。方法本研究招募2020年1月-2021年7月于首都医科大学附属北京天坛医院等3家医院的200例卒中患者,并由两名评定者分别对受试者进行WMFT量表的评估。同时完成Fugl-Meyer运动功能评定量表上肢部分(Fugl-Meyer assessment-upper extremity,FMA-UE)作为校标。分别采用Spearman相关分析及因子分析法评价WMFT量表的校标效度及结构效度;采用Cronbach’sα系数及组内相关系数(intraclass correlation coefficient,ICC)评价WMFT量表的内部及外部信度。结果以FMA-UE总分为校标,Wolf量表总分与其呈正相关(r=0.904,P<0.001)。在结构效度分析中,本研究提取出2个特征值>1的公因子,其中第一个因子与上肢近端关节有关,第二个因子与手的精细功能及力量有关。内部一致性检验中,评分等级Cronbach’sα系数为0.806,作业时间Cronbach’sα系数为0.958。外部一致性检验中,WMFT量表各项内容时间均数和等级均数的ICC分别为0.990和0.998。结论WMFT量表测试上肢功能具有良好的效度和信度,适用于对卒中患者偏瘫侧上肢功能的评定。
