| Purpose:Stroke including ischemic stroke and hemorrhagic stroke,although most patients after timely treatment can save success,but the morbidity is higher,Some patients left limb dysfunction.Especially,upper limb dysfunction in the most common,and about 85% of patients in the early onset of upper limb dysfunction,nearly 36% of the patients in onset still left upper limb dysfunction after half a year.Patients with upper limb dysfunction after stroke is the main factor of daily life activities ability,body and mind caused a huge impact on the patients.At present the clinical training method for upper limb dysfunction after stroke,Occupational Therapy(OT)was most widely used.Virtual reality(VR)technology as a kind of for nervous system disease recovery technology has been gradually applied to the clinical rehabilitation.However,at present the combination therapy of upper limb dysfunction in patients with cerebral apoplexy clinical research is still relatively small,its effectiveness of standardized hadn’t been completed.Therefore,this study used the VR training joint OT program intervention in patients with cerebral apoplexy in order to explore VR training joint OT of upper limb function rehabilitation in patients with cerebral apoplexy,so as to provide a wider range of choice for clinical rehabilitation.Methods:This study selected 41 cases of cerebral apoplexy patients of fuyang city people’s hospital,Were randomly divided into control group(n=21)and experimental group(n=20).Two groups of patients were given routine rehabilitation therapy(acupuncture therapy and physical therapy);The control group on the basis of conventional treatment were given Upper limb OT training(Frosted plate training,cylinder training,wooden nail training,ball-handling training,stick lifting exercise),every time of 25 min,2 times a day,a total of 50 min;The experimental group on the basis of conventional treatment were given Upper limb OT training and VR trainin(Sterilization war training,apple training,go to school training,the four seasons of drag training and ball-and-ball combat training and other virtual games,every game of 5 min,two games and rest for 1 min).The upper limb OT training 25 min,VR training 25 min,a total of 50 min,6 times a week,for 8 weeks.Before and after 8weeks treatment,adopting Noraxon16 telemetry muscle measuring scale,F-JDC multi-function joints,Fugl-Meyer assessment of upper extremity(FMA-UE)and Barthel index(BI),were used to evaluate the biceps and triceps Integrated electromyogmphy(IEMG),shoulder joint flexing and stretching Active Range of Motion(AROM),activities of daily living(ADL)of the two groups.Results:(1)Before the treatment,two groups of patients with biceps and triceps IEMG was no statistically significant difference(P=0.116;P=0.664);8 weeks after treatment,the control group patients biceps and triceps IEMG was(32.49±6.15μV/s)and(28.96±6.62μV/s),the experimental group patients biceps and triceps IEMG was(45.98±9.92μV/s)and(36.92±9.16μV/s),than before treatment significantly increased(P<0.05).Compared with control group,the experimental group patients biceps and triceps IEMG increased significantly(P=0.000;P=0.003).(2)Before the treatment,two groups of patients with shoulder joint flexing and stretching AROM was no statistically significant difference(P=0.926;P=0.264);8weeks after treatment,the control group patients shoulder joint flexing and stretching AROM was(98.43±9.20°)and(33.95±5.58°),the experimental group patients shoulder joint flexing and stretching AROM was(106.75±9.18°)and(37.85±6.40°),than before treatment significantly increased(P<0.05).Compared with control group,the experimental group patients shoulder joint flexing and stretching AROM increased significantly(P=0.006;P=0.044).(3)Before the treatment,two groups of patients with FMA-UE score was no statistically significant difference(P=0.320);8 weeks after treatment,the control group patients FMA-UE score was 31.71±6.09,the experimental group patients FMA-UE score was 35.80±4.88,than before treatment significantly increased(P<0.05).Compared with control group,the experimental group patients FMA-UE score increased significantly(P=0.023).(4)Before the treatment,two groups of patients with BI score was no statistically significant difference(P=0.381);8 weeks after treatment,the control group patients BI score was 59.05±7.68,the experimental group patients BI score was 66.00±7.00,than before treatment significantly increased(P<0.05).Compared with control group,the experimental group patients BI score increased significantly(P=0.004).Conclusion:Virtual scene interactive training combined with occupational therapy can complement each other’s advantages.It can significantly enhance the muscle activity of the upper limb muscles of stroke patients,improve the range of motion of the upper limb joints,improve the motor function of the upper limb and the patients’ activities of daily living,and the improvement degree is better than occupational therapy.It can not only increase the safety,taskiness,orientation and interest of the training,but also improve the patients’ enthusiasm.It demonstrates the modern rehabilitation concept of comprehensive treatment and is worthy of clinical application. |
