Glegg Stephanie M N, Tatla Sandy K, Holsti Liisa
Children's & Women's Health Centre of British Columbia , Vancouver, British Columbia , Canada .
Disabil Rehabil Assist Technol. 2014 Mar;9(2):89-111. doi: 10.3109/17483107.2013.799236. Epub 2013 May 29.
To identify, to map out and to appraise research examining GestureTek virtual reality (VR) use for physical and cognitive rehabilitation and to highlight areas for future research.
Scoping review methodology was used to systematically and comprehensively search the academic and grey literature for GestureTek-specific research. Consensus was achieved following two reviewers' independent inclusion screening, data extraction and appraisal.
Forty-four studies evaluated the utility and efficacy of the IREX, GX, VMall and Meal Maker software for rehabilitation across a range of populations, with few adverse events reported. Stroke and cerebral palsy research dominated, while geriatrics was largely overlooked. Efficacy research provided support for balance, mobility, upper extremity, cognitive, fitness and daily living skills outcomes for specific populations with effect sizes ranging from 0.19 to 3.34. Nevertheless, few strong quality or high-level studies are available, and no clear guidelines on optimal treatment characteristics exist. Outcomes of primary interest were at ICF body function and activity levels; evaluation of transfer of training across ICF levels is needed.
This literature provides preliminary evidence for the technology's efficacy for rehabilitation. Identified research gaps relate to study quality and design, treatment characteristics, populations and outcomes of interest, including transfer across ICF levels.
There is limited high-level evidence to support the use of the GestureTek virtual reality system for rehabilitation. Moderate to strong quality evidence exists primarily for the stroke and cerebral palsy populations, and primarily for balance, mobility and upper extremity outcomes. A lack of consistent outcome measures in this body of literature has created "silos" of research that cannot be quantitatively combined using a meta-analytic strategy.
识别、梳理并评估关于GestureTek虚拟现实（VR）用于身体和认知康复的研究，并突出未来研究的方向。
采用范围综述方法，系统全面地检索学术文献和灰色文献中与GestureTek相关的研究。经过两位审稿人独立进行纳入筛选、数据提取和评估后达成共识。
44项研究评估了IREX、GX、VMall和Meal Maker软件在一系列人群康复中的效用和效果，报告的不良事件较少。中风和脑瘫研究占主导，而老年医学研究在很大程度上被忽视。疗效研究为特定人群的平衡、移动性、上肢、认知、体能和日常生活技能等结果提供了支持，效应大小在0.19至3.34之间。然而，高质量或高水平的研究较少，且不存在关于最佳治疗特征的明确指南。主要关注的结果处于国际功能、残疾和健康分类（ICF）的身体功能和活动水平；需要评估跨ICF水平的训练迁移情况。
该文献为该技术在康复方面的疗效提供了初步证据。已确定的研究差距涉及研究质量和设计、治疗特征、人群以及感兴趣的结果，包括跨ICF水平的迁移。
支持使用GestureTek虚拟现实系统进行康复的高水平证据有限。中度至强质量的证据主要存在于中风和脑瘫人群中，主要针对平衡、移动性和上肢结果。该文献中缺乏一致的结果测量方法，形成了无法使用荟萃分析策略进行定量合并的“研究孤岛”。
