中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (11): 1823-1831.doi: 10.4103/1673-5374.219043

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

基于Leap Motion虚拟现实技术改善亚急性脑卒中患者上肢运动功能及脑功能重组

  

  • 收稿日期:2017-10-27 出版日期:2017-11-15 发布日期:2017-11-15
  • 基金资助:

     十二五计划项目（2011BAI08B11），中国康复研究中心研究项目（2014-3）

Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients

Zun-rong Wang1, Ping Wang2, Liang Xing1, Li-ping Mei1, Jun Zhao1, Tong Zhang1   

  1. 1 Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing, China
    2 Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
  • Received:2017-10-27 Online:2017-11-15 Published:2017-11-15
  • Contact: Tong Zhang, M.D., Ph.D.,wangzunrong@126.com or Tom611@126.com.
  • Supported by:

    This study was financially supported by the Sub-Project under National “Twelfth Five-Year” Plan for Science & Technology Support Project in China, No. 2011BAI08B11; and the Research Project of China Rehabilitation Research Center, No. 2014-3.

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摘要：

虚拟现实技术是一种促进脑卒中患者运动能力恢复的新技术，但目前大多数研究只涉及慢性卒中患者，而急性和亚急性期患者的脑可塑性较强。大多数虚拟现实系统跟踪能力有限，只适用于手臂，而手部功能恢复才是卒中后偏瘫康复中最为困难的。最近新出现的基于Leap Motion的虚拟现实技术可以跟踪和捕捉手和手指的细微动作。因此作者拟探索Leap Motion系统对亚急性脑卒中患者康复的作用效果。试验在中国北京博爱医院招募了26例亚急性脑卒中患者，随机等分为试验组(n=13; male:female 11:2; average age 55.33±8.40 years)和对照组(n=13; male:female 11:2; average age 53.38 ± 7.65 years)，分别接受Leap Motion系统+常规康复治疗和单独常规康复治疗。以Wolf运动功能测试来评估病侧上肢运动功能，同时以功能性磁共振成像评估患者大脑皮质的激活情况。结果发现，经过4周治疗后，所有患者的上肢运动功能均有显著改善，Wolf运动功能测试质量分级评分，试验组改善效果显著。研究表明，试验组患者Wolf运动功能测试的动作时间明显减少。此外, 在两组中，对侧初级感觉运动皮质的活化强度和初级感觉运动皮质偏侧化指数均增加，最后，试验组患者感觉虚拟现实康复训练比常规康复疗法更有趣，患者更乐于参与虚拟现实康复训练。这些结果说明基于Leap Motion的虚拟现实康复训练是一种有前途的、可行的辅助性康复干预措施，可以促进亚急性脑卒中患者的运动功能的恢复。试验已在中国临床试验注册中心注册，注册号为ChiCTR-OCH-12002238。

orcid:0000-0001-8245-0029(Tong Zhang)

关键词: 神经再生, 虚拟现实, Wolf运动功能测试, 功能磁共振成像, 脑卒中, leap Motion, 康复, 上肢, 神经重组

Abstract:

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 function 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 performance 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).

Key words: nerve regeneration, virtual reality, Wolf motor function test, functional magnetic resonance imaging, stroke, Leap Motion, rehabilitation, upper limb, neural reorganization, neural regeneration