Effects of Wearable Sensor-Based Virtual Reality Game on Balance in Patients with Stroke: A Randomized Control Study

Objective: To explore the differences in effects on the balance and walking ability between training with Pablo system and functional balance training for patients with chronic stroke. Design: Patients with stroke were recruited and randomly assigned to ＂Virtual reality group＂ (n = 20), and ＂functional balance training group＂ (n = 20). The outcome measures were assessed included Berg Balance Scale, Timed Up and Go Test (cognitive), Gait analysis, Activities-specific Balance Confidence scale, and Stroke Impact Scale. The pleasure scale and adverse events were also recorded after each training session. Results: No significant difference was observed in Berg Balance Scale in both group. The virtual reality group improved significantly in gait velocity (p = .04), stride time of sound side (p = .04), ankle plantar flexion symmetry (p ≤ .01), Stroke Impact Scale-strength (p = .02), and experienced greater pleasure (p ≤ .01) relative to the functional balance training group. The functional balance training group improved significantly in stance phase symmetry (p = .01) of gait analysis, Stroke Impact Scale- activities of daily life (p = .04) and mobility (p = .02). No significant differences within or between groups were observed in other measurements. Conclusion: Patients with chronic stroke who participated in the virtual reality game intervention reported greater pleasure and the favorable tendency on the gait velocity, stride time, symmetry, and self-perceived strength.

關鍵字

Stroke ； Virtual reality ； Gait ； Quality of life

並列摘要

目的：探討Pablo虛擬實境遊戲介入是否可增加慢性中風病人的平衡及行走能力。方法：受試者從醫院門診復健的慢性中風病人中招募，隨機抽樣平均分派到實驗組（n = 20）及控制組（n = 20），兩組皆先進行標準治療30分鐘，實驗組額外加上虛擬實境介入30分鐘，控制組額外加上平衡訓練30分鐘，每周2次，共計9週。由單盲評估者於受試者參與介入前後進行評估，包括伯格式量表、功能性伸觸測驗、計時起立行走測試—認知版、步態分析、特定活動平衡信心量表、中風衝擊量表，每次介入後自評修正版身體活動愉悅量表及記錄副作用狀況。結果：實驗組在步態表現中的步速（p = .04）、健側腳完成一步態週期時間（p = .04）、腳踝蹠屈對稱性（p = .00）有顯著進步。在中風衝擊量表的自覺力量亦有顯著進步（p = .02），且相較控制組訓練時愉悅感較高（p ＜ .01）。控制組在步態表現中的站立期對稱性（p = .01）有顯著進步。在中風衝擊量表的日常生活（p = .04）及行動能力（p = .02）也有顯著進步。其他如平衡項目及平衡自信心無組內及組間顯著差異。結論：在9周介入後，虛擬實境遊戲介入加上傳統治療對慢性中風病人步態表現及自覺力量有趨近正向成效，且在介入時相較傳統治療有較佳的愉悅度。

並列關鍵字

腦中風；虛擬實境；平衡訓練；生活品質

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