基于丰富环境的增强现实训练对脑卒中步行功能的影响

doi:10.3969/j.issn.1006-9771.2023.12.008

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (12): 1439-1445.doi: 10.3969/j.issn.1006-9771.2023.12.008

基于丰富环境的增强现实训练对脑卒中步行功能的影响

魏天祺, 罗家麒, 李紫娟, 吴雪良, 许攀攀, 张艳美, 赵晓萌, 吴勤峰()

南京大学医学院附属苏州医院康复医学科，江苏苏州市 215153

收稿日期:2023-04-03 修回日期:2023-11-09 出版日期:2023-12-25 发布日期:2023-12-28
通讯作者: 吴勤峰(1976-)，男，汉族，江苏苏州市人，博士，主任医师，主要研究方向：神经康复。E-mail： wuqinfeng0911@163.com
作者简介:魏天祺(1990-)，女，汉族，江苏苏州市人，硕士，主治医师，主要研究方向：神经系统疾病的康复治疗。
基金资助:
苏州市高新区医疗卫生科技计划项目(青年科技项目)(2019Q008)

Effect of augmented reality training based on enriched environment on walking function after stroke

WEI Tianqi, LUO Jiaqi, LI Zijuan, WU Xueliang, XU Panpan, ZHANG Yanmei, ZHAO Xiaomeng, WU Qinfeng()

Department of Rehabilitation Medicine, the Affiliated Suzhou Hospital of Nanjing University Medical School, Suzhou, Jiangsu 215153, China

Received:2023-04-03 Revised:2023-11-09 Published:2023-12-25 Online:2023-12-28
Contact: WU Qinfeng, E-mail: wuqinfeng0911@163.com
Supported by:
Suzhou High-tech District Medical and Health Science and Technology Project (Youth Science and Technology Project)(2019Q008)

摘要/Abstract

摘要：

目的观察基于丰富环境的增强现实(AR)技术对脑卒中步行功能障碍的临床疗效。

方法 2021年1月至2022年6月，南京大学医学院附属苏州医院脑卒中患者36例，随机分为对照组(n = 18)和试验组(n = 18)。两组均接受常规康复治疗，对照组辅以常规步行训练，试验组辅以基于丰富环境的AR训练，共4周。治疗前后分别采用Berg平衡量表(BBS)、计时-起立行走测试(TUGT)、10米步行测试(10MWT)、Barthel指数(BI)进行评定，并比较两组步态参数。

结果治疗期间无不良事件发生。治疗后，两组BBS评分、TUGT时间、10MWT步速、BI、步速、步频、患侧单腿支撑相占比均显著提高(|t| > 5.161, P < 0.001)；除BI外(t = 1.099, P = 0.282)，试验组各项指标均优于对照组(|t| > 2.106, P < 0.05)。

结论基于丰富环境的AR训练可以改善脑卒中患者步行功能，效果优于常规步行训练。

关键词: 脑卒中, 增强现实, 丰富环境, 步行功能, 日常生活活动能力

Abstract:

Objective To observe the effect of augmented reality training based on enriched environment on walking dysfunction after stroke.

Methods From January, 2021 to June, 2022, 36 stroke patients in the Affiliated Suzhou Hospital of Nanjing University Medical School were randomly divided into control group (n = 18) and experimental group (n = 18). Both groups received conventional rehabilitation treatment. The control group was supplemented with conventional walking training, and the experimental group was supplemented with augmented reality training based on enriched environment, for four weeks. They were assessed with Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), 10-meter walk test (10MWT) and Barthel Index (BI) before and after treatment, and the gait parameter was compared.

Results No adverse event occurred during treatment. After treatment, the BBS score, TUGT time, 10MWT speed, BI, gait speed, gait frequency and the proportion of single-leg support on the affected side significantly improved in both groups (|t| > 5.161, P< 0.001). All the above indexes were better in the experimental group than in the control group (|t| > 2.106, P < 0.05), except for BI (t = 1.099, P = 0.282).

Conclusion Augmented reality training based on enriched environment could improve the walking function of paitents after stroke, which is better than conventional walking training.

Key words: stroke, augmented reality, enriched environment, walking function, activities of daily living

中图分类号:

R743.3

魏天祺, 罗家麒, 李紫娟, 吴雪良, 许攀攀, 张艳美, 赵晓萌, 吴勤峰. 基于丰富环境的增强现实训练对脑卒中步行功能的影响[J]. 《中国康复理论与实践》, 2023, 29(12): 1439-1445.

WEI Tianqi, LUO Jiaqi, LI Zijuan, WU Xueliang, XU Panpan, ZHANG Yanmei, ZHAO Xiaomeng, WU Qinfeng. Effect of augmented reality training based on enriched environment on walking function after stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(12): 1439-1445.

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组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中类型(梗死/出血)/n	偏瘫侧(左/右)/n	MMSE评分	FAC分级/级
对照组	18	10/8	52.44±9.46	9.78±8.74	12/6	10/8	27.72±1.53	4.11±0.83
试验组	18	7/11	58.61±11.00	5.70±6.30	9/9	8/10	27.39±1.94	3.94±0.08
χ²/F值		1.003	1.803	-1.608	1.029	0.000	-0.572	-0.612
P值		0.317	0.080	0.117	0.310	1.000	0.571	0.545

组别	n	治疗前	治疗后	t值	P值
对照组	18	32.11±10.13	38.72±7.87	-5.202	< 0.001
试验组	18	34.67±9.04	44.78±8.01	-13.047	< 0.001
t值		0.799	2.288
P值		0.430	0.028

组别	n	治疗前	治疗后	t值	P值
对照组	18	24.17±5.98	19.94±5.43	10.135	< 0.001
试验组	18	19.83±8.13	12.05±4.56	6.102	< 0.001
t值		-1.822	-4.723
P值		0.077	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	18	0.68±0.25	0.97±0.38	-5.161	< 0.001
试验组	18	0.60±0.33	1.30±0.55	-7.342	< 0.001
t值		-0.800	2.106
P值		0.429	0.043

组别	n	治疗前	治疗后	t值	P值
对照组	18	68.33±13.28	84.44±6.39	-6.985	< 0.001
试验组	18	66.94±17.08	88.06±12.38	-11.519	< 0.001
t值		-0.272	1.099
P值		0.787	0.282

基于丰富环境的增强现实训练对脑卒中步行功能的影响

Effect of augmented reality training based on enriched environment on walking function after stroke

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组别	n	治疗前	治疗后	t值	P值
对照组	18	0.66±0.31	0.93±0.31	-12.467	< 0.001
试验组	18	0.81±0.33	1.18±0.35	-11.231	< 0.001
t值		1.419	2.324
P值		0.165	0.026

组别	n	治疗前	治疗后	t值	P值
对照组	18	67.83±16.51	71.61±16.47	-19.825	< 0.001
试验组	18	66.22±15.56	83.39±15.74	-14.541	< 0.001
t值		-0.301	2.193
P值		0.765	0.035

组别	n	治疗前	治疗后	t值	P值
对照组	18	20.99±8.34	30.08±8.56	-10.652	< 0.001
试验组	18	20.08±9.60	36.28±7.30	-13.335	< 0.001
t值		-0.304	2.334
P值		0.763	0.026

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