Stroke Outcomes Research Unit, Department of Medicine, 55 Queen Street East, Suite 931, St Michael's Hospital, University of Toronto, Toronto, M5C 1R6, Canada.
Stroke. 2011 May;42(5):1380-6. doi: 10.1161/STROKEAHA.110.605451. Epub 2011 Apr 7.
Approximately two thirds of stroke survivors continue to experience motor deficits of the arm resulting in diminished quality of life. Conventional rehabilitation provides modest and sometimes delayed effects. Virtual reality (VR) technology is a novel adjunctive therapy that could be applied in neurorehabilitation. We performed a meta-analysis to determine the added benefit of VR technology on arm motor recovery after stroke.
We searched Medline, EMBASE, and Cochrane literature from 1966 to July 2010 with the terms "stroke," "virtual reality," and "upper arm/extremity." We evaluated the effect of VR on motor function improvement after stroke.
From the 35 studies identified, 12 met the inclusion/exclusion criteria totaling 195 participants. Among them, there were 5 randomized clinical trials and 7 observational studies with a pre-/postintervention design. Interventions were delivered within 4 to 6 weeks in 9 of the studies and within 2 to 3 weeks in the remaining 3. Eleven of 12 studies showed a significant benefit toward VR for the selected outcomes. In the pooled analysis of all 5 randomized controlled trials, the effect of VR on motor impairment (Fugl-Meyer) was OR=4.89 (95% CI, 1.31 to 18.3). No significant difference was observed for Box and Block Test or motor function. Among observational studies, there was a 14.7% (95% CI, 8.7%-23.6%) improvement in motor impairment and a 20.1% (95% CI, 11.0%-33.8%) improvement in motor function after VR.
VR and video game applications are novel and potentially useful technologies that can be combined with conventional rehabilitation for upper arm improvement after stroke.
大约三分之二的中风幸存者仍存在手臂运动功能障碍，导致生活质量下降。传统康复治疗的效果有限，且有时起效较迟。虚拟现实（VR）技术是一种新的辅助治疗方法，可应用于神经康复。我们进行了一项荟萃分析，以确定 VR 技术对中风后手臂运动功能恢复的附加益处。
我们检索了从 1966 年到 2010 年 7 月的 Medline、EMBASE 和 Cochrane 文献，使用的检索词包括“stroke”、“virtual reality”和“upper arm/extremity”。我们评估了 VR 对中风后运动功能改善的影响。
从 35 项研究中，有 12 项符合纳入/排除标准，共纳入 195 名参与者。其中，有 5 项随机临床试验和 7 项观察性研究，采用了干预前后设计。9 项研究的干预时间在 4 至 6 周内，其余 3 项研究的干预时间在 2 至 3 周内。12 项研究中有 11 项表明 VR 对所选结果有显著益处。在所有 5 项随机对照试验的汇总分析中，VR 对运动障碍（Fugl-Meyer）的效果为 OR=4.89（95% CI，1.31-18.3）。在 Box and Block 测试或运动功能方面，未观察到显著差异。在观察性研究中，VR 后运动障碍改善了 14.7%（95% CI，8.7%-23.6%），运动功能改善了 20.1%（95% CI，11.0%-33.8%）。
VR 和视频游戏应用是新颖且具有潜在应用价值的技术，可与传统康复相结合，改善中风后的手臂功能。
