康复学报2025，Vol.35Issue(4)：363-369,377,8.DOI:10.3724/SP.J.1329.2025.04005
沉浸式虚拟现实训练联合穴位针刺对脑卒中患者单侧空间忽略的影响
Effects of Immersive Virtual Reality Training Combined with Acupuncture on Patients with Unilateral Spatial Neglect after Stroke
摘要
Abstract
Objective To observe the effects of immersive virtual reality(IVR)training combined with acupuncture on patients with unilateral spatial neglect(USN)after stroke.Methods A total of 120 patients with USN after stroke who were hospitalized in the Fourth Rehabilitation Hospital of Shanghai from October 2022 to October 2024 were randomly divided into control group,IVR group,acupuncture group and combined group according to the random number sequence generated by the Stata 13.0 software,with 30 cases in each group.The control group received USN occupational therapy on the basis of conventional treatment and rehabilita-tion training,including visual scanning exercises,cross-facilitation exercises,object retrieval exercises on the neglected side,trunk rotation exercises,and activities of daily living training,30 minutes each session,twice a day,seven days a week for four weeks.The IVR group additionally received IVR training on the basis of the treatment in the control group,including shooting planes with a can-non,crossing the street,cleaning windows,whacking moles,playing softball,six minutes per game,30 minutes a day,seven days a week for four weeks.The acupuncture group additionally received acupuncture therapy at the Baihui(DU20),Fengchi(GB20),Fengfu(DU15),and Xuanzhong(GB38)acupoints on the basis of the control group's treatment,once a day,with needles retained for 20 minutes,seven days a week for four weeks.The combined group received IVR training and acupuncture therapy,following the same protocols as the IVR group and the acupuncture group,respectively.Before and after treatment,Catherine Bergego Scale(CBS),line cancellation test,star cancellation test,and clock drawing test were used to assess USN symptoms by researchers unaware of group allocation.The simplified Fugl-Meyer Assessment of Upper Extremity(FMA-UE)was used to assess the motor function of upper limb.Barthel Index(BI)was used to assess the activities of daily living.Adverse reactions such as palpitation,ver-tigo,vomiting,hematoma,orthostatic hypotension,sports injury and epileptic seizure were observed during the treatment.Results(1)USN scores:compared with those before treatment,CBS and clock drawing test scores in the control group,the IVR group,the acupuncture group and the combined group after treatment decreased significantly(P<0.05),while the line cancellation and star can-cellation test scores increased significantly,and the differences were statistically significant(P<0.05).Compared with the control group,CBS and clock drawing test scores in the IVR group,the acupuncture group and the combined group after treatment de-creased significantly(P<0.05),line cancellation and star cancellation test scores increased significantly,and the differences were sta-tistically significant(P<0.05).Compared with the control group,the IVR group and the acupuncture group,CBS and clock drawing test scores in the combined group after treatment decreased significantly(P<0.05),line cancellation and star cancellation test scores increased significantly,and the differences were statistically significant(P<0.05).(2)FMA-UE and BI scores:compared with those before treatment,FMA-UE and BI scores in the control group,the IVR group,the acupuncture group and the combined group after treatment increased significantly,and the differences were statistically significant(P<0.05).Compared with the control group,FMA-UE and BI scores in the IVR group,the acupuncture group and the combined group after treatment increased significantly,and the differences were statistically significant(P<0.05).Compared with the control group,the IVR group and acupuncture group,FMA-UE and BI scores in the combined group after treatment increased significantly,and the differences were statistically significant(P<0.05).(3)Safety:no serious adverse reactions occurred in the four groups during treatment.Conclusion IVR training combined with acupuncture can improve USN symptoms,upper limb motor function and activities of daily living in patients with USN after stroke,with good safety and worthy of clinical promotion and application.关键词
脑卒中/单侧空间忽略/虚拟现实/穴位针刺/上肢运动功能/日常生活活动能力Key words
stroke/unilateral spatial neglect/virtual reality/acupoint acupuncture/upper limb motor function/activities of daily living引用本文复制引用
袁景,林桦,许磊,徐冰,王年,刘智岚,李果,叶荣菊..沉浸式虚拟现实训练联合穴位针刺对脑卒中患者单侧空间忽略的影响[J].康复学报,2025,35(4):363-369,377,8.基金项目
上海市卫生健康委员会课题(面上201940055) （面上201940055）
上海市静安区卫生科研课题(面上2022MS15) （面上2022MS15）
