虚拟现实对亚急性中风患者运动预测和手部功能的影响:运动相关潜能随机试验》。

IF 3 4区 医学 Q2 NEUROSCIENCES
Neural Plasticity Pub Date : 2022-01-24 eCollection Date: 2022-01-01 DOI:10.1155/2022/7399995
Ling Chen, Yi Chen, Wen Bin Fu, Dong Feng Huang, Wai Leung Ambrose Lo
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引用次数: 0

摘要

背景:中风患者对即将到来的任务所需的控制预期认知能力受损可能会影响康复效果。目的:研究虚拟现实(VR)训练对亚急性中风患者上肢运动时运动预期的皮质兴奋性的影响:方法:共招募了 36 名在 1 至 3 个月内首次发生中风而导致上肢偏瘫的中风幸存者。参与者被随机分配到 VR 干预组或传统治疗组。采用事件相关电位(ERP)和肌电图(EMG)同时记录掌抓运动时大脑皮层的兴奋性和肌肉活动。干预前后记录了或然负变异(CNV)潜伏期和振幅、肌电图反应时间、上肢福格尔-迈耶评估(UL-FMA)、行动研究臂测试(ARAT)和美国国立卫生研究院卒中量表(NIHSS)。组间差异通过混合模型方差分析得出:结果:干预后,VR 组瘫痪手的肌电图起始时间早于对照组(t = 2.174,p = 0.039)。在瘫痪手运动时,干预后 VR 组 CNV 潜伏期的缩短幅度大于对照组(t = 2.411,p = 0.021)。在进行手部瘫痪运动时,VR 组 CNV 振幅的减少幅度大于对照组(除 C3 外,所有电极的 p 均小于 0.001)。干预后,VR 组的 ARAT 和 UL-FMA 评分明显高于对照组(分别为 p = 0.019 和 p = 0.037)。VR 组和对照组在 NIHSS 降低方面无明显差异(p = 0.072):在改善运动预期的认知神经过程和减少对侧大脑半球过度代偿性激活方面,VR 干预优于传统疗法。认知神经过程的改善与手部功能的改善相互印证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Effect of Virtual Reality on Motor Anticipation and Hand Function in Patients with Subacute Stroke: A Randomized Trial on Movement-Related Potential.

The Effect of Virtual Reality on Motor Anticipation and Hand Function in Patients with Subacute Stroke: A Randomized Trial on Movement-Related Potential.

The Effect of Virtual Reality on Motor Anticipation and Hand Function in Patients with Subacute Stroke: A Randomized Trial on Movement-Related Potential.

The Effect of Virtual Reality on Motor Anticipation and Hand Function in Patients with Subacute Stroke: A Randomized Trial on Movement-Related Potential.

Background: Impaired cognitive ability to anticipate the required control for an upcoming task in patients with stroke may affect rehabilitation outcome. The cortical excitability of task-related motor anticipation for upper limb movement induced by virtual reality (VR) training remains unclear.

Aims: To investigate the effect of VR training on the cortical excitability of motor anticipation when executing upper limb movement in patients with subacute stroke.

Methods: A total of thirty-six stroke survivors with upper limb hemiparesis resulting from the first occurrence of stroke within 1 to 3 months were recruited. Participants were randomly allocated to the VR intervention group or conventional therapy group. Event-related potentials (ERPs) and electromyography (EMG) were used to simultaneously record the cortical excitability and muscle activities during palmar grasp motion. Outcome measures of the contingent negative variation (CNV) latency and amplitude, EMG reaction time, Upper Limb Fugl-Meyer Assessment (UL-FMA), Action Research Arm Test (ARAT), and National Institutes of Health Stroke Scale (NIHSS) were recorded pre- and postintervention. The between-group difference was analysed by mixed model ANOVA.

Results: The EMG onset time of the paretic hand in the VR group was earlier than that observed in the control group (t = 2.174, p = 0.039) postintervention. CNV latency reduction postintervention was larger in the VR group than in the control group (t = 2.411, p = 0.021) during paretic hand movement. The reduction in CNV amplitude in the VR group was larger in the VR group than in the control group (p < 0.001 for all electrodes except for C3) when executing paretic hand movement. ARAT and UL-FMA scores were significantly higher in the VR group than in the control group (p = 0.019 and p = 0.037, respectively) postintervention. No significant difference in the reduction in NIHSS was found between the VR and control groups (p = 0.072).

Conclusions: VR intervention is superior to conventional therapy to improve the cognitive neural process of motor anticipation and reduce the excessive compensatory activation of the contralesional hemisphere. The improvements observed in the cognitive neural process corroborated with the improvements in hand function.

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来源期刊
Neural Plasticity
Neural Plasticity NEUROSCIENCES-
CiteScore
6.80
自引率
0.00%
发文量
77
审稿时长
16 weeks
期刊介绍: Neural Plasticity is an international, interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology. Neural Plasticity publishes research and review articles from the entire range of relevant disciplines, including basic neuroscience, behavioral neuroscience, cognitive neuroscience, biological psychology, and biological psychiatry.
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