基于非沉浸式虚拟现实技术的单侧脑瘫儿童治疗:初步结果。

IF 0.8 Q4 PEDIATRICS Journal of pediatric rehabilitation medicine Pub Date : 2024-01-01 DOI:10.3233/PRM-230028
Paolo Meriggi, Martina Mandalà, Mattia Randazzo, Elena Brazzoli, Anna Castagna, Valentina Di Giusto, Anna Cavallini, Alberto Marzegan, Tiziana Lencioni, Ivana Olivieri
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引用次数: 0

摘要

目的:单侧脑瘫(UCP)约占脑瘫诊断总数的 30-40%。最近的研究表明,使用虚拟现实技术(VR)可以提高患者的积极性,促进其日常生活能力的改善。这项初步研究旨在探索使用 VITAMIN 平台为 UCP 儿童提供 VR 康复治疗的可接受性和可用性。研究的另一个目的是将通常的标准化临床量表和问卷调查结果与运动学结果以及维他命平台在每次康复训练中获得的定量测量结果进行比较:招募了六名患有 UCP 的儿童(7-15 岁),对非沉浸式 VR 系统的使用情况进行初步调查。治疗每周进行 10 次,每次 45 分钟。每个儿童都玩了五种益智游戏,使用受损的上肢击打投影在宽屏幕上的虚拟物体。在治疗前和治疗结束时,采用标准化临床量表、运动学分析和调查问卷对上肢功能进行了广泛评估。五名发育正常的儿童为仪器运动学评估提供了参考:治疗结束时,所有参与者的墨尔本评估2(MA2)得分均有所提高(运动范围(ROM)平均提高19.1%,准确性提高4.6%,灵活性提高13.1%,流畅性提高10.3%)。肩部屈伸运动范围也有所改善(平均增加 + 210.5°),根据运动学分析,肩部运动与参考曲线更加相似。根据 ABILHAND-Kids 问卷的评估,患者在日常活动能力方面的普遍改善也证实了这些结果。最后,从获得的数据中可以看出,不同的测量方法和指标之间基本一致:结果表明,使用 VITAMIN 平台进行的 VR 治疗对患有 UCP 的儿童的康复具有吸引力和功能性。定性和定量测量及指标之间的良好一致性证实了这种新型治疗方法的潜力。然而,由于样本量有限且疗程次数较少,因此需要进一步开展更大规模的调查,以评估疗效并推广结果。
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Non-immersive virtual reality based treatment for children with unilateral cerebral palsy: Preliminary results.

Purpose: Unilateral cerebral palsy (UCP) represents about 30-40% of overall cerebral palsy diagnoses. Upper limb impairment has a significant negative impact on activities of daily living (ADL), and recent studies have shown that the use of virtual reality (VR) can increase motivation and promote an improvement in ADL. This preliminary study was aimed at exploring the acceptability and usability of a VR rehabilitation treatment, using the VITAMIN Platform, for children with UCP. A secondary goal of the study was to compare the results of usual standardized clinical scales and questionnaires with kinematic results as well as with the quantitative measures acquired by the VITAMIN platform in each exercise of the rehabilitation sessions.

Methods: Six children with UCP (aged 7-15) were recruited for a preliminary investigation in using a non-immersive VR system. The treatment was composed of 10 weekly sessions of 45 minutes. Each child played five types of exergames, using the impaired upper limb to hit virtual objects projected on a wide screen. Standardized clinical scales, kinematic analysis, and questionnaires were used to extensively assess upper limb function before and at the end of treatment. Five typically-developing children provided a reference for the instrumented kinematic assessment.

Results: At the end of the treatment, Melbourne Assessment 2 (MA2) scores increased for all the participants (mean increase in range of movement (ROM) + 19.1%, accuracy + 4.6%, dexterity + 13.1%, fluency + 10.3%). Shoulder flexion-extension ROM also improved (mean increase + 10.5°), and according to the kinematic analysis, shoulder movements became more similar to reference profiles. These results were confirmed by a general improvement in performing ADL, assessed by the ABILHAND-Kids questionnaire. Finally, a general agreement among the different measures and indexes emerged from the acquired data.

Conclusion: The results show that VR treatment with the VITAMIN platform could be engaging and functional for rehabilitation of children with UCP. The good agreement among the qualitative and quantitative measures and indexes confirms the potential of such novel treatment. However, due to the limited sample size and small number of sessions, further and larger investigations are required to evaluate the effectiveness and to generalize the results.

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