目的 观察虚拟现实（VR）训练对痉挛型双瘫脑瘫患儿上肢精细运动和下肢粗大运动的影响。方法 选取痉挛型双瘫脑瘫患儿35 例，随机分为VR 训练组（n=19）和常规训练组（n=16），常规训练组给予3 个月的常规运动疗法和作业疗法训练；VR 训练组给予3 个月的VR 训练和作业疗法训练。采用Peabody 运动发育量表的抓握、视觉-运动整合分测试对患儿治疗前后精细运动进行评价，采用88 项粗大运动功能量表（GMFM-88）的D 区及E 区、改良Ashworth 量表（MAS）、Berg 平衡量表（BBS）对患儿治疗前后粗大运动进行评价。结果 治疗前两组患儿抓握、视觉-运动整合、精细运动发育商、GMFM-88 之D 区、E 区评分、MAS评分、BBS 评分无明显差异（P > 0.05）；治疗后，VR 训练组抓握、视觉-运动整合、精细运动发育商、GMFM-88D 区评分、E 区评分、BBS 评分、MAS 评分较常规训练组明显改善（P < 0.05）。结论 VR 训练可有效提高痉挛型双瘫脑瘫患儿上肢精细运动功能和下肢粗大运动功能。
Abstract
Objective To study the effects of virtual reality (VR) training on the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy. Methods Thirtyfive children with spastic diplegia cerebral palsy were randomly assigned to VR training group (n=19) and conventional training group (n=16). The conventional training group received conventional physical therapy and occupational therapy for three months. The VR training group received VR training and occupational therapy for three months. Grip and visual-motor integration subtests in Peabody Developmental Motor Scales-2 were used to evaluate the fine movement in patients before and after treatment. The D and E domains of the 88-item version of the Gross Motor Function Measure (GMFM-88), Modified Ashworth Scale (MAS), and Berg Balance Scale (BBS) were used to evaluate the gross movement in patients before and after treatment. Results Before treatment, there were no significant differences in grip, visual-motor integration, fine motor development quotient, scores of D and E domains of GMFM-88, MAS score, or BBS score between the two groups (P > 0.05). After treatment, all the indices were significantly improved in the VR training group compared with the conventional training group (P < 0.05). Conclusions VR training can effectively improve the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.
关键词
虚拟现实训练 /
痉挛型双瘫 /
精细运动 /
粗大运动 /
儿童
Key words
Virtual reality /
Spastic diplegia cerebral palsy /
Fine motor function /
Gross motor function /
Child
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基金
四川省医学会科研项目（S15088）；四川省教育厅科研项目（16ZB0530）；自贡市科技局科研项目（2014ZC12）。
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