中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (21): 4593-4601.doi: 10.12307/2025.810

• 骨与关节综述 bone and joint review • 上一篇    下一篇

虚拟现实技术在周围神经损伤功能恢复中的应用

张舒扬1,杜心愉1,赵冬临1,邢 政2,褚晓蕾2,李 奇2   

  1. 1天津体育学院运动健康学院,天津市   301617;2天津大学天津医院,天津市   300211
  • 收稿日期:2024-06-07 接受日期:2024-07-12 出版日期:2025-07-28 发布日期:2024-12-07
  • 通讯作者: 李奇,硕士生导师,副主任医师,天津大学天津医院康复医学科,天津市 300211
  • 作者简介:张舒扬,女,2001年生,江苏省无锡市人,汉族,天津体育学院在读硕士,主要从事运动康复及周围神经损伤方面的研究。
  • 基金资助:
    国家重点研发计划“生物与信息融合(BT与IT融合)”重点专项项目(2023YFF1205200),项目参与人:邢政;天津市自然科学基金面上项目(22JCYBJC00210),项目负责人:李奇;天津市自然科学基金面上项目(22JCYBJC00220),项目负责人:褚晓蕾

Application of virtual reality technology in functional recovery of peripheral nerve injury

Zhang Shuyang1, Du Xinyu1, Zhao Donglin1, Xing Zheng2, Chu Xiaolei2, Li Qi2   

  1. 1School of Sports and Health, Tianjin Institute of Physical Education, Tianjin 301617, China; 2Tianjin Hospital of Tianjin University, Tianjin 300211, China

  • Received:2024-06-07 Accepted:2024-07-12 Online:2025-07-28 Published:2024-12-07
  • Contact: Li Qi, Master’s supervisor, Associate chief physician, Tianjin Hospital of Tianjin University, Tianjin 300211, China
  • About author:Zhang Shuyang, Master candidate, School of Sports and Health, Tianjin Institute of Physical Education, Tianjin 301617, China
  • Supported by:
    Key Special Project of National Key Research & Development Program of China “Biological and Information Integration (BT and IT Integration)”, No. 2023YFF1205200 (to XZ); Tianjin Natural Science Foundation (General Project), No. 22JCYBJC00210 (to LQ); Tianjin Natural Science Foundation (General Project), No. 22JCYBJC00220 (to CXL)

摘要:

文题释义:

周围神经损伤:是指周围神经丛、神经干或其分支受到外界直接或间接暴力而发生的损伤,导致运动、感觉和自主神经功能障碍的一种常见临床疾病。
肌腱振动:是通过施加在外周肌腱上的机械振动,改变肌肉纺锤体的活动,引起振动肌肉的拉伸方向上虚幻的动觉,从而提高运动能力的一种辅助训练方法。

摘要
背景:虚拟现实技术是近年来较为热门的一项人机智能交互技术,已被广泛应用于休闲娱乐、职业培训及医疗康复等领域。
目的:旨在探索虚拟现实技术与不同疗法联合在周围神经损伤患者功能恢复中的潜力,概述其作用机制,评估其应用效果和前景,探讨其优势和不足之处,为周围神经损伤后的康复实践提供新的思路和方法。
方法:应用计算机检索中国知网、PubMed数据库建库时间至2024年5月期间的相关文献,英文检索词为“peripheral nerves injury,virtual reality,endoplasmic reticulum stress,muscle atrophy,cerebral cortex,mirror therapy,tendon vibration,treadmill training”,中文检索词为“周围神经损伤,虚拟现实,内质网应激,肌肉萎缩,大脑皮质,镜像疗法,肌腱振动,跑步机训练”,最终纳入68篇文献进行分析。
结果与结论:①虚拟现实技术作为一种新兴的辅助手段,通过模拟真实环境为患者提供沉浸式的多感官体验,不仅极大地丰富了康复训练的维度,还显著加速了周围神经损伤患者功能恢复进程;虚拟现实技术的作用机制是通过多感官刺激促进皮质可塑性,相邻的皮质区域入侵沉寂区,这些区域对其他输入作出反应或产生新的肌肉激活,从而促进功能恢复。②虚拟现实技术已与传统疗法广泛联合,展现出其独特优势。与镜像疗法联合时,虚拟现实的优势是打破了体位的限制,提前康复介入时间点;与肌腱振动联合,虚拟现实技术通过增强视觉和触觉的双重刺激增强运动错觉,显著提高患者的感知和运动能力,但也存在增加对肢体重量感知的问题;与跑步机训练联合,虚拟现实技术进一步发挥其优势,通过多感官刺激模拟现实环境进行平衡和步行功能,但晕动症等问题依旧存在。③因此,在实际应用中,由于虚拟现实与镜像疗法、肌腱振动联合都会增强患者运动错觉,更适用于康复早期,而虚拟现实与跑步机训练联合则适用于康复后期,帮助患者更好地回归日常生活。④尽管虚拟现实技术在周围神经损伤康复中已经显示出巨大的潜力,但仍存在一些问题和挑战,如晕动症、虚拟现实康复游戏的设计与应用,以及伦理方面的考量,未来的研究应着重解决这些问题,以推动虚拟现实技术在康复领域的进一步发展。


中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

关键词: 虚拟现实, 周围神经损伤, 康复, 内质网应激, 肌肉萎缩, 皮质可塑性, 镜像疗法, 肌腱振动, 跑步机训练, 机制

Abstract: BACKGROUND: Virtual reality technology is a popular human-computer intelligent interaction technology in recent years, and has been widely used in leisure and entertainment, vocational training, medical rehabilitation and other fields.
OBJECTIVE: To explore the potential of virtual reality technology combined with different therapies in functional recovery of patients with peripheral nerve injury, summarize its mechanism of action, evaluate its application effects and prospects, and discuss its advantages and disadvantages, so as to provide new ideas and methods for rehabilitation practice after peripheral nerve injury.
METHODS: The relevant literature of CNKI and PubMed database from inception to May 2024 was retrieved by computer. Chinese and English search terms were “peripheral nerves injury, virtual reality, endoplasmic reticulum stress, muscle atrophy, cerebral cortex, mirror therapy, tendon vibration, treadmill training.” Finally, 68 articles were included for analysis.
RESULTS AND CONCLUSION: (1) Virtual reality technology, as a new auxiliary means, simulates the real environment to provide immersive multi-sensory experiences for patients, greatly enriching the dimensions of rehabilitation training and significantly accelerating the recovery process of patients with peripheral nerve injury. Its mechanism of action is to promote cortical plasticity through multi-sensory stimulation, invading the dormant areas adjacent to the cortex, and these areas responding to other inputs or generating new muscle activation, thereby promoting functional recovery. (2) Virtual reality technology has been widely combined with traditional therapies, showcasing its unique advantages. When combined with mirror therapy, the advantage of virtual reality is breaking the limitation of body position and advancing the time point of rehabilitation intervention. When combined with tendon vibration, virtual reality technology enhances the dual stimulation of visual and tactile perception to enhance the illusion of movement, significantly improving the perception and motor ability of patients, but also raises the issue of increased perception of limb weight. In running machine training, virtual reality technology further leverages its advantages by simulating real-life environments through multi-sensory stimulation to enhance balance and walking function, but problems such as motion sickness still exist. (3) Therefore, in actual applications, due to the fact that virtual reality combined with mirror therapy and tendon vibration will enhance the illusion of movement for patients, it is more suitable for early stages of rehabilitation. Meanwhile, the combination of virtual reality and treadmill training is suitable for the later stage of rehabilitation, helping patients to better return to their daily lives. (4) Although virtual reality technology has shown great potential in peripheral nerve injury rehabilitation, there are still some problems and challenges, such as motion sickness, the design and application of virtual reality rehabilitation games, and ethical considerations. Future research should focus on solving these problems to further promote the development of virtual reality technology in the field of rehabilitation.

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: virtual reality, peripheral nerve injury, rehabilitation, endoplasmic reticulum stress, muscle atrophy, cortical plasticity, mirror therapy, tendon vibration, treadmill training, mechanism

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