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

doi:10.3969/j.issn.1006-9771.2024.01.008

Abstract

Abstract:

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, the ΔFA 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.

Key words: stroke, upper limb, virtual reality, diffusion tensor imaging

CLC Number:

R743.3

LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.

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References 36

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(梗死/出血)/n	病灶侧(左/右)/n
对照组	38	27/11	62.05±9.43	28.50(22.50, 44.25)	23/15	18/20
试验组	38	32/6	57.32±12.52	31.50(22.25, 53.25)	17/21	24/14
χ²/t/Z值		1.894	1.863	0.270	1.900	1.916
P值		0.169	0.066	0.787	0.168	0.166

组别	n	治疗前	治疗4周	随访4周	F值	P值
对照组	38	31.47±4.38	37.61±4.77^a	42.18±5.26^a,b	4.345	< 0.001
试验组	38	30.18±5.70	40.37±5.67^a	45.71±6.75^a,b	5.744	< 0.001
t值		1.105	2.297	2.542
P值		0.273	0.024	0.013

组别	n	治疗前	治疗4周	随访4周	F值	P值
对照组	38	27.42±6.43	34.16±5.39^a	38.74±5.85^a,b	4.190	< 0.001
试验组	38	26.89±6.24	37.39±5.36^a	42.13±5.89^a,b	2.790	< 0.001
t值		0.362	2.627	2.520
P值		0.718	0.010	0.014

组别	n	治疗前	治疗4周	t值	P值
对照组	38	0.474±0.087	0.482±0.082	1.855	0.072
试验组	38	0.477±0.067	0.481±0.067	1.794	0.081
t值		0.196	0.058
P值		0.845	0.954

组别	n	治疗前	治疗4周	t值	P值
对照组	38	0.371±0.064	0.422±0.070	56.919	< 0.001
试验组	38	0.366±0.047	0.465±0.062	31.452	< 0.001
t值		0.355	2.810
P值		0.724	0.006

Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging

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组别	n	治疗前	治疗4周	t值	P值
对照组	38	0.498±0.051	0.501±0.052	1.852	0.072
试验组	38	0.495±0.055	0.504±0.061	1.962	0.057
t值		0.232	0.130
P值		0.817	0.897

组别	n	治疗前	治疗4周	t值	P值
对照组	38	0.440±0.058	0.463±0.058	21.013	< 0.001
试验组	38	0.422±0.054	0.487±0.060	21.393	< 0.001
t值		1.342	2.006
P值		0.184	0.048

组别	部位	ΔFA		ΔRA
组别	部位	r值	P值	r值	P值
对照组	大脑脚	0.086	0.609	0.188	0.260
对照组	内囊后肢	0.406	0.012	0.243	0.142
试验组	大脑脚	0.079	0.637	0.116	0.487
	内囊后肢	0.362	0.026	0.005	0.974

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