虚拟现实技术联合康复机器人训练对脑梗死偏瘫患者运动功能及事件相关电位的影响研究

摘要

Objective To investigate the effects of virtual reality technology ( VRT) combined with rehabilitation robot training on the motor function and event -related potentials ( ERR ) in hemiplegic patients with cerebral infarction ( CI ) . Methods We enrolled 80 patients with CI who were admitted into the Department of Neurology , the Affiliated Hospital of North China United University of Science and Technology from December 2012 to December 2013.The patients were all hemiplegic in one lower limb.Using random number table method , the patients were divided into two groups: control group ( n =40 ) and intervention group (n=40) .The two groups were administrated with conventional rehabilitation training .Control group received lower limb rehabilitation training by robot , and intervention group received training combining virtual reality technology and rehabilitation robot training .Before treatment and 8 weeks after treatment , FMA and Berg balance scale were used to evaluate the efficacy of the two groups; myoelectricity/evoked potential equipment was employed to detect the incubation period of N 100, N200, P200 and P300 and the amplitude of P300.Results Before treatment, the two groups were not significantly different (P>0.05) in the FMA score and Berg balance score , the incubation period of N100, N200, P200 and P300, and the amplitude of P300.After treatment, the two groups had higher FMA score , Berg balance score, lower incubation period of N100, N200, P200 and P300 and higer amplitude of P300 (P<0.05) than those before treatment.After treatment, compared to control group, intervention group had higher FMA score , Berg score, lower incubation period of N200, P200 and P300, and higher amplitude of P300 (P<0.05) .Conclusion VRT combined with rehabilitation robot training can improve the motor function and cognitive function of hemiplegic CI patients .%目的：探讨虚拟现实技术联合康复机器人训练对脑梗死偏瘫患者运动功能及事件相关电位（ ERP）的影响。方法选择2012年12月—2013年12月在华北理工大学附属医院神经内科住院的80例脑梗死患者为研究对象，均一侧下肢肢体偏瘫，按照随机数字表法将患者分为对照组（40例）和干预组（40例）。两组患者均给予常规康复训练，同时对照组应用下肢康复机器人训练，干预组应用虚拟现实技术联合康复机器人训练。治疗前及治疗8周后分别采用Fugl-Meyer运动功能评分量表（ FMA）、 Berg 平衡量表评价两组疗效；采用肌电诱发电位仪检测ERP N100、N200、 P200、 P300潜伏期及P300波幅变化。结果治疗前，两组患者FMA下肢运动功能评分、 Berg平衡量表评分及N100、 N200、 P200、 P300潜伏期及P300波幅比较，差异均无统计学意义（ P＞0.05）。治疗后，两组患者FMA下肢运动功能评分、 Berg平衡量表评分较治疗前增高， N100、 N200、 P200、 P300潜伏期较治疗前缩短， P300波幅较治疗前增高（ P＜0.05）。治疗后，与对照组比较，干预组FMA下肢运动功能评分、 Berg平衡量表评分增高， N200、 P200、P300潜伏期缩短， P300波幅增高（P＜0.05）。结论虚拟现实技术联合康复机器人训练可以改善脑梗死偏瘫患者运动功能，并提高患者认知功能。