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Mechanism of Kinect-based virtual reality training for motor functional recovery of upper limbs after subacute stroke

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Neural Regeneration Research 2013年第31期8卷 2904-2913页

作者： Xiao Bao Yurong Mao Qiang Lin Yunhai Qiu Shaozhen Chen Le Li Ryan S.Cates Shufeng Zhou Dongfeng Huang Department of Rehabilitation Medicine the First Affiliated Hospital Sun Yat-sen University Key Laboratory of Health Informatics of Chinese Academy of Sciences Shenzhen Institutes of Advanced Technology Department of Pharmaceutical Sciences College of Pharmacy University of South Florida

The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains un- clear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The FugI-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sen- sorimotor cortex.

关键词： neural regeneration neurological rehabilitation rehabilitation training neural plasticity virtual reality functional MRI stroke Kinect-based virtual reality training upper limb cerebral cortex brain activation region of interest grants-supported paper neuroregeneration

Virtual reality training improves balance function

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Neural Regeneration Research 2014年第17期9卷 1628-1634页

作者： Yurong Mao Peiming Chen Le Li Dongfeng Huang Department of Rehabilitation Medicine First Affiliated HospitalSun Yat-sen University

Virtual reality is a new technology that simulates a three-dimensional virtual world on a com- puter and enables the generation of visual, audio, and haptic feedback for the full immersion of users. Users can interact with and observe objects in three-dimensional visual space without limitation. At present, virtual reality training has been widely used in rehabilitation therapy for balance dysfunction. This paper summarizes related articles and other articles suggesting that virtual reality training can improve balance dysfunction in patients after neurological diseases. When patients perform virtual reality training, the prefrontal, parietal cortical areas and other motor cortical networks are activated. These activations may be involved in the reconstruction of neurons in the cerebral cortex. Growing evidence from clinical studies reveals that virtual reality training improves the neurological function of patients with spinal cord injury, cerebral palsy and other neurological impairments. These findings suggest that virtual reality training can acti- vate the cerebral cortex and improve the spatial orientation capacity of patients, thus facilitating the cortex to control balance and increase motion function.

关键词： nerve regeneration brain injury spinal cord injury stroke virtual reality balance dysfunction mechanism sensorimotor function neural plasticity vision vestibule proprioception somatosensory balance reviews rehabilitation NSFC grant neural regeneration

虚拟现实结合减重平板训练对脑卒中患者步行功能恢复的作用和机制:纵向功能磁共振研究

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中国医学计算机成像杂志 2014年第4期20卷 313-317页

作者：林玲江利肖湘田文硕中山大学附属第一医院放射诊断科中山大学附属第一医院康复治疗科深圳市第五人民医院(罗湖医院)康复科

目的:探讨虚拟现实结合减重平板训练(VR+BWSTT)在急性脑卒中患者步行功能早期恢复中的作用和机制。方法:将11例急性缺血性脑卒中患者随机分入跑台组(6例)和常规组(5例),分别采用不同的康复训练方案,并在康复训练前及训练后3周、3个月和... 详细信息

目的:探讨虚拟现实结合减重平板训练(VR+BWSTT)在急性脑卒中患者步行功能早期恢复中的作用和机制。方法:将11例急性缺血性脑卒中患者随机分入跑台组(6例)和常规组(5例),分别采用不同的康复训练方案,并在康复训练前及训练后3周、3个月和6个月各行一次脑功能成像和下肢运动功能评定。结果:跑台组步行速度和下肢Fugl-Meyer评分进步程度较常规组显著,跑台组进步较大的患者患肢对侧旁中央小叶(PCL)激活强度较训练前增大较明显;患肢运动激活辅助运动区(SMA)的LI值训练后3周多数为负值;跑台组6名患者中有4名训练后3周患肢运动时出现双侧前额叶皮层多发激活区。结论:VR+BWSTT对脑卒中患者步行功能的改善作用优于常规步态训练;下肢功能恢复的中枢神经机制与上肢不完全相同;VR的作用机制可能与双侧前额叶皮质有关。

关键词：脑卒中功能磁共振虚拟现实减重平板步态

亚急性期脑梗死神经网络缺损的肢体运动障碍与情绪等因素的关联及结局分析

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中国康复理论与实践 2014年第6期20卷 562-566页

作者：肖湘吕衍春蔡培强江利林玲黄东锋中山大学附属第一医院康复医学科广东广州市510080 深圳市第五人民医院(罗湖人民医院)康复医学科广东深圳市518001 中山大学附属肿瘤防治中心影像与微创介入中心广东广州市510060 中山大学附属第一医院放射科广东广州市510080

目的分析亚急性期脑梗死患者运动功能障碍与情绪、认知等因素的相关性。方法对15例亚急性期脑梗死患者采用Fugl-Meyer评定量表(FMA)、10 m步行速度、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、简易精神状态检查(MMSE)、改良Bart... 详细信息

目的分析亚急性期脑梗死患者运动功能障碍与情绪、认知等因素的相关性。方法对15例亚急性期脑梗死患者采用Fugl-Meyer评定量表(FMA)、10 m步行速度、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、简易精神状态检查(MMSE)、改良Barthel指数(MBI)、健康调查简表(SF-36)进行评测。比较患者弥散张量成像(DTI)参数:各向异性分数(FA)值、表观扩散系数(ADC)和FA指数、ADC指数,并对脑梗死患者DTI参数与情绪评估结果进行相关性分析。结果 FMA评分及10 m步行速度与HAMD、HAMA及MMSE评分无相关性。HAMD、HAMA、MMSE评分与SF-36中的情感职能相关(P<0.05),HAMA评分与SF-36中的躯体疼痛负相关(P<0.05)。双侧内囊后肢的FA值均与HAMD呈负相关(P<0.05)。结论神经网络缺损可导致脑梗死患者情绪变化。肢体运动功能障碍与情绪无关。情绪、认知功能相互关联而影响生活质量的功能结局。

关键词：脑梗死抑郁焦虑运动弥散张量成像认知生活质量