Department of Rehabilitation and Aged Care, Flinders University, Adelaide, South Australia.
Eur J Phys Rehabil Med. 2012 Sep;48(3):523-30. Epub 2012 Jun 20.
Virtual reality and interactive video gaming are innovative therapy approaches in the field of stroke rehabilitation. The primary objective of this review was to determine the effectiveness of virtual reality on motor function after stroke. The impact on secondary outcomes including activities of daily living was also assessed.
Randomised and quasi-randomised controlled trials that compared virtual reality with an alternative or no intervention were included in the review. The authors searched the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, electronic databases, trial registers, reference lists, Dissertation Abstracts, conference proceedings and contacted key researchers and virtual reality manufacturers. Search results were independently examined by two review authors to identify studies meeting the inclusion criteria.
Nineteen studies with a total of 565 participants were included in the review. Variation in intervention approaches and outcome data collected limited the extent to which studies could be compared. Virtual reality was found to be significantly more effective than conventional therapy in improving upper limb function (standardised mean difference, SMD) 0.53, 95% confidence intervals [CI] 0.25 to 0.81)) based on seven studies, and activities of daily living (ADL) function (SMD 0.81, 95% CI 0.39 to 1.22) based on three studies. No statistically significant effects were found for grip strength (based on two studies) or gait speed (based on three studies).
Virtual reality appears to be a promising approach however, further studies are required to confirm these findings.
虚拟现实和互动视频游戏是中风康复领域的创新治疗方法。本研究的主要目的是确定虚拟现实对中风后运动功能的疗效。同时评估对日常生活活动等次要结局的影响。
本研究纳入了比较虚拟现实与其他干预或无干预的随机和准随机对照试验。作者检索了 Cochrane 卒中组试验注册库、Cochrane 对照试验中心注册库、电子数据库、试验注册库、参考文献列表、 Dissertation Abstracts、会议论文集,并联系了主要研究人员和虚拟现实制造商。两位综述作者独立检查了检索结果,以确定符合纳入标准的研究。
本研究共纳入 19 项研究,总计 565 名参与者。干预措施和收集的结局数据的差异限制了研究之间的可比性。基于 7 项研究,虚拟现实在改善上肢功能(标准化均数差,SMD 0.53,95%置信区间[CI] 0.25 至 0.81))方面明显优于常规治疗,基于 3 项研究,在改善日常生活活动(ADL)功能(SMD 0.81,95%CI 0.39 至 1.22))方面明显优于常规治疗。但在握力(基于 2 项研究)或步行速度(基于 3 项研究)方面,未发现有统计学意义的效果。
虚拟现实似乎是一种很有前途的方法,但需要进一步的研究来证实这些发现。