Darekar Anuja, McFadyen Bradford J, Lamontagne Anouk, Fung Joyce
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Feil and Oberfeld Research Center, Jewish Rehabilitation Hospital, Research site of the Montreal Centre for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada.
J Neuroeng Rehabil. 2015 May 10;12:46. doi: 10.1186/s12984-015-0035-3.
Rehabilitation interventions involving virtual reality (VR) technology have been developed for the promotion of functional independence post stroke. A scoping review was performed to examine the efficacy of VR-based interventions on balance and mobility disorders post stroke. Twenty-four articles in the English language examining VR game-based interventions and outcomes directed at balance and mobility disorders were included. Various VR systems (customized and commercially available) were used as rehabilitation tools. Outcome measures included laboratory and clinical measures of balance and gait. Outcome measures of dynamic balance showed significant improvements following VR-based interventions as compared to other interventions. Further, it was observed that VR-based intervention may have favorable effects in improving walking speed and the ability to deal with environmental challenges, which may also facilitate independent community ambulation. VR-based therapy thus has the potential to be a useful tool for balance and gait training for stroke rehabilitation. Utilization of motor learning principles related to task-related training may have been an important factor leading to positive results. Other principles such as repetition, feedback etc. were used in studies but were not explored explicitly and may need to be investigated to further improve the strength of results. Lastly, robust study designs with appropriate attention towards the intensity and dose-response aspects of VR training, clear study objectives and suitable outcomes would further aid in determining evidence-based efficacy for VR game-based interventions in the future.
为促进中风后功能独立，已开发出涉及虚拟现实（VR）技术的康复干预措施。进行了一项范围综述，以研究基于VR的干预措施对中风后平衡和运动障碍的疗效。纳入了24篇英文文章，这些文章研究了针对平衡和运动障碍的基于VR游戏的干预措施及结果。各种VR系统（定制的和商用的）被用作康复工具。结果测量包括平衡和步态的实验室及临床测量。与其他干预措施相比，基于VR的干预措施后动态平衡的结果测量显示出显著改善。此外，观察到基于VR的干预措施可能对提高步行速度和应对环境挑战的能力有有利影响，这也可能促进独立社区行走。因此，基于VR的治疗有可能成为中风康复中平衡和步态训练的有用工具。运用与任务相关训练相关的运动学习原则可能是取得积极结果的一个重要因素。研究中还使用了重复、反馈等其他原则，但未进行明确探讨，可能需要进一步研究以增强结果的说服力。最后，具有对VR训练的强度和剂量反应方面的适当关注、明确的研究目标和合适结果的稳健研究设计，将进一步有助于确定未来基于VR游戏的干预措施的循证疗效。
