Ogourtsova Tatiana, Souza Silva Wagner, Archambault Philippe S, Lamontagne Anouk
a School of Physical and Occupational Therapy , McGill University , Montreal , Quebec H3G 1Y5 , Canada.
b Feil-Oberfeld Research Centre, Jewish Rehabilitation Hospital , Laval , Quebec H7V 1R2 , Canada.
Neuropsychol Rehabil. 2017 Apr;27(3):409-454. doi: 10.1080/09602011.2015.1113187. Epub 2015 Dec 1.
Unilateral spatial neglect (USN) is a highly prevalent post-stroke deficit. Currently, there is no gold standard USN assessment which encompasses the heterogeneity of this disorder and that is sensitive to detect mild deficits. Similarly, there is a limited number of high quality studies suggesting that conventional USN treatments are effective in improving functional outcomes and reducing disability. Virtual reality (VR) provides enhanced methods for USN assessment and treatment. To establish best-practice recommendations with respect to its use, it is necessary to appraise the existing evidence. This systematic review aimed to identify and appraise existing VR-based USN assessments; and to determine whether VR is more effective than conventional therapy. Assessment tools were critically appraised using standard criteria. The methodological quality of the treatment trials was rated by two authors. The level of evidence according to stage of recovery was determined. Findings were compiled into a VR-based USN Assessment and Treatment Toolkit (VR-ATT). Twenty-three studies were identified. The proposed VR tools augmented the conventional assessment strategies. However, most studies lacked analysis of psychometric properties. There is limited evidence that VR is more effective than conventional therapy in improving USN symptoms in patients with stroke. It was concluded that VR-ATT could facilitate identification and decision-making as to the appropriateness of VR-based USN assessments and treatments across the continuum of stroke care, but more evidence is required on treatment effectiveness.
单侧空间忽视（USN）是一种非常常见的中风后缺陷。目前，尚无涵盖该疾病异质性且能灵敏检测轻度缺陷的金标准USN评估方法。同样，仅有数量有限的高质量研究表明，传统的USN治疗方法在改善功能结局和减少残疾方面有效。虚拟现实（VR）为USN评估和治疗提供了更好的方法。为制定关于其使用的最佳实践建议，有必要评估现有证据。本系统评价旨在识别和评估现有的基于VR的USN评估方法；并确定VR是否比传统疗法更有效。使用标准标准对评估工具进行严格评价。由两位作者对治疗试验的方法学质量进行评分。根据恢复阶段确定证据水平。研究结果被汇编成一个基于VR的USN评估与治疗工具包（VR-ATT）。共识别出23项研究。所提议的VR工具增强了传统评估策略。然而，大多数研究缺乏对心理测量特性的分析。仅有有限的证据表明，在改善中风患者的USN症状方面，VR比传统疗法更有效。得出的结论是，VR-ATT有助于在中风护理的整个过程中识别基于VR的USN评估和治疗方法的适用性并做出决策，但在治疗效果方面还需要更多证据。
