de Rooij Ilona J M, van de Port Ingrid G L, Meijer Jan-Willem G
I.J.M. de Rooij, MSc, Revant Rehabilitation Centres, Breda, the Netherlands.
I.G.L. van de Port, PhD, Revant Rehabilitation Centres, Brabantlaan 1, 4817 JW, Breda, the Netherlands.
Phys Ther. 2016 Dec;96(12):1905-1918. doi: 10.2522/ptj.20160054. Epub 2016 May 12.
Virtual reality (VR) training is considered to be a promising novel therapy for balance and gait recovery in patients with stroke.
The aim of this study was to conduct a systematic literature review with meta-analysis to investigate whether balance or gait training using VR is more effective than conventional balance or gait training in patients with stroke.
A literature search was carried out in the databases PubMed, Embase, MEDLINE, and Cochrane Library up to December 1, 2015.
Randomized controlled trials that compared the effect of balance or gait training with and without VR on balance and gait ability in patients with stroke were included.
Twenty-one studies with a median PEDro score of 6.0 were included. The included studies demonstrated a significant greater effect of VR training on balance and gait recovery after stroke compared with conventional therapy as indicated with the most frequently used measures: gait speed, Berg Balance Scale, and Timed "Up & Go" Test. Virtual reality was more effective to train gait and balance than conventional training when VR interventions were added to conventional therapy and when time dose was matched.
The presence of publication bias and diversity in included studies were limitations of the study.
The results suggest that VR training is more effective than balance or gait training without VR for improving balance or gait ability in patients with stroke. Future studies are recommended to investigate the effect of VR on participation level with an adequate follow-up period. Overall, a positive and promising effect of VR training on balance and gait ability is expected.
虚拟现实（VR）训练被认为是一种有前景的新型疗法，可用于中风患者的平衡和步态恢复。
本研究旨在进行一项系统的文献综述并进行荟萃分析，以调查中风患者使用VR进行平衡或步态训练是否比传统的平衡或步态训练更有效。
截至2015年12月1日，在PubMed、Embase、MEDLINE和Cochrane图书馆数据库中进行了文献检索。
纳入比较有或无VR的平衡或步态训练对中风患者平衡和步态能力影响的随机对照试验。
纳入了21项PEDro评分中位数为6.0的研究。纳入的研究表明，与传统疗法相比，VR训练对中风后平衡和步态恢复具有显著更大的效果，这在最常用的测量指标中得到体现：步态速度、伯格平衡量表和定时起立行走测试。当将VR干预添加到传统疗法中且时间剂量匹配时，虚拟现实在训练步态和平衡方面比传统训练更有效。
纳入研究中存在发表偏倚和多样性是本研究的局限性。
结果表明，对于改善中风患者的平衡或步态能力，VR训练比无VR的平衡或步态训练更有效。建议未来的研究在足够长的随访期内调查VR对参与水平的影响。总体而言，预计VR训练对平衡和步态能力有积极且有前景的效果。
