虚拟现实训练对脑卒中患者运动功能的影响及机制探讨OA

Objective To observe the effects of virtual reality(VR)training on motor function in stroke patients and to explore its underlying mechanisms.Methods A total of 86 stroke patients with motor dysfunction admitted to the Department of Rehabili‐tation Medicine,General Hospital of Ningxia Medical University from January to December 2024 were enrolled and randomly allo‐cated into a control group and an experimental group using a random number table,with 43 patients in each group.Both groups re‐ceived conventional rehabilitation therapy.The control group additionally received upper and lower limb exercise training,while the experimental group additionally received VR training.Both groups were treated continuously for four weeks.Before and after treat‐ment,the Fugl-Meyer Assessment Upper Extremity(FMA-UE)and Fugl-Meyer Assessment Lower Extremity(FMA-LE)were used to evaluate upper and lower limb motor function and the Modified Barthel Index(MBI)was used to assess activities of daily living.Serum levels of brain-derived neurotrophic factor(BDNF)and vascular endothelial growth factor(VEGF)were measured by en‐zyme-linked immunosorbent assay(ELISA),and corticospinal excitability on the affected side was assessed using transcranial mag‐netic stimulation.Adverse events occurring during the treatment period were recorded in both groups.Results(1)FMA-UE,FMA-LE,and MBI scores:Compared with those before treatment,the FMA-UE,FMA-LE,and MBI scores in both groups increased sig‐nificantly after treatment(P<0.05).Compared with the control group,the FMA-UE,FMA-LE,and MBI scores in the experimental group were higher after treatment(P<0.05).(2)BDNF and VEGF levels:Compared with those before treatment,BDNF and VEGF levels in both groups increased significantly after treatment(P<0.05).Compared with the control group,the BDNF level in the ex‐perimental group was higher after treatment(P<0.05).(3)Corticospinal excitability:Compared with those before treatment,the cen‐tral motor conduction time(CMCT)in both groups shortened significantly after treatment(P<0.05),while the motor evoked poten‐tial amplitude increased significantly(P<0.05).Compared with the control group,CMCT in the experimental group was shorter after treatment(P<0.05),and amplitude was larger(P<0.05).(4)Safety:A small number participants in the experimental group experi‐enced mild dizziness and visual fatigue during VR training,which were alleviated by closing the eyes for rest and adjusting the brightness and visual field of the headset.All patients completed the scheduled intervention protocol.Conclusion VR training can effectively improve upper and lower limb motor function and activities of daily living in stroke patients.The underlying mechanism may be related to upregulating BDNF expression and enhancing corticospinal tract excitability and conduction efficiency.