Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle.
Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle.
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DOI：
10.1161/strokeaha.110.584979
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发表时间：
2010-07
期刊：
影响因子：
8.3
通讯作者：
Stroke Outcome Research Canada (SORCan) Working Group
中科院分区：
文献类型：
--
作者：
Saposnik G;Teasell R;Mamdani M;Hall J;McIlroy W;Cheung D;Thorpe KE;Cohen LG;Bayley M;Stroke Outcome Research Canada (SORCan) Working Group
偏瘫导致上肢功能受限在中风幸存者中很常见。虽然现有的证据表明，增加中风康复治疗的强度会导致更好的运动恢复，但关于虚拟现实对中风康复的疗效的证据有限。在这项试验性、随机、单盲临床试验中，2个平行组的中风患者在2个月内，我们比较了使用任天堂Wii游戏系统（VRWii）虚拟现实与娱乐疗法（扑克牌、宾果游戏或"Jenga"）的可行性、安全性和有效性，以评估接受标准康复治疗的患者手臂运动的改善。主要可行性结局是接受干预的总时间。主要安全性结局是研究期间发生干预相关不良事件的患者比例。在干预后4周，使用Wolf运动功能测试、箱块测试和卒中影响量表评估疗效（次要结局指标）。总体而言，110例筛选患者中有22例（20%）接受了随机化。平均年龄（范围）为61.3（41 - 83）岁。两名学员在培训后退出。VRWii组10名参与者中有9名成功进行了干预，娱乐治疗组10名参与者中有8名成功进行了干预。娱乐治疗组的平均总会话时间为388分钟，VRWii组为364分钟（P = 0.75）。任何组均未发生严重不良事件。相对于娱乐治疗组，VRWii组受试者在调整年龄、基线功能状态（Wolf运动功能测试）和卒中严重程度后，平均运动功能显著改善7秒（Wolf运动功能测试，7.4秒; 95% CI，-14.5，-0.2）。VRWii游戏技术代表了一种安全、可行且潜在有效的替代方案，可促进中风后的康复治疗和运动恢复。
Hemiparesis resulting in functional limitation of an upper extremity is common among stroke survivors. Although existing evidence suggests that increasing intensity of stroke rehabilitation therapy results in better motor recovery, limited evidence is available on the efficacy of virtual reality for stroke rehabilitation. In this pilot, randomized, single-blinded clinical trial with 2 parallel groups involving stroke patients within 2 months, we compared the feasibility, safety, and efficacy of virtual reality using the Nintendo Wii gaming system (VRWii) versus recreational therapy (playing cards, bingo, or “Jenga”) among those receiving standard rehabilitation to evaluate arm motor improvement. The primary feasibility outcome was the total time receiving the intervention. The primary safety outcome was the proportion of patients experiencing intervention-related adverse events during the study period. Efficacy, a secondary outcome measure, was evaluated with the Wolf Motor Function Test, Box and Block Test, and Stroke Impact Scale at 4 weeks after intervention. Overall, 22 of 110 (20%) of screened patients were randomized. The mean age (range) was 61.3 (41 to 83) years. Two participants dropped out after a training session. The interventions were successfully delivered in 9 of 10 participants in the VRWii and 8 of 10 in the recreational therapy arm. The mean total session time was 388 minutes in the recreational therapy group compared with 364 minutes in the VRWii group (P=0.75). There were no serious adverse events in any group. Relative to the recreational therapy group, participants in the VRWii arm had a significant improvement in mean motor function of 7 seconds (Wolf Motor Function Test, 7.4 seconds; 95% CI, −14.5, −0.2) after adjustment for age, baseline functional status (Wolf Motor Function Test), and stroke severity. VRWii gaming technology represents a safe, feasible, and potentially effective alternative to facilitate rehabilitation therapy and promote motor recovery after stroke.