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[虚拟现实对多发性硬化症平衡和步态的疗效。随机对照试验的系统评价]

[Efficacy of virtual reality on balance and gait in multiple sclerosis. Systematic review of randomized controlled trials].

作者信息

Moreno-Verdu M, Ferreira-Sanchez M R, Cano-de-la-Cuerda R, Jimenez-Antona C

机构信息

Asociacion Parkinson Madrid, Madrid, Espana.

Universidad Rey Juan Carlos, 28922 Alcorcon, Espana.

出版信息

Rev Neurol. 2019 May 1;68(9):357-368. doi: 10.33588/rn.6809.2018350.

Abstract

INTRODUCTION

Multiple sclerosis (MS) is a neurodegenerative disease that causes gait abnormalities and a deficit in balance control in the vast majority of people affected by it. Virtual reality has been proposed as a complementary approach to conventional physiotherapeutic treatment as a way of improving these variables.

AIM

To assess the real efficacy of this approach compared to other neurorehabilitation therapies, or no intervention, in MS.

PATIENTS AND METHODS

A systematic review of randomized controlled trials was conducted. Studies of the last five years that compare virtual reality with conventional treatment or no intervention, on balance and/or gait, in adults with MS, were included. PEDro scale was used to assess methodological quality and the Oxford scale to determine the level of evidence and grades of recommendations.

RESULTS

Eight studies met the eligibility criteria. For balance, the efficacy of virtual reality is, at least, comparable as conventional training. For gait, virtual reality seems not to be superior in improving the speed, compared with the other types of interventions assessed. Methodological quality of studies was low-moderate.

CONCLUSIONS

Virtual reality is as effective as conventional training for improving balance in people with MS. No data suggests that virtual reality is superior to other interventions in improving gait speed. For other gait parameters, virtual reality's efficacy remains unknown.

摘要

引言

多发性硬化症(MS)是一种神经退行性疾病,绝大多数患者会出现步态异常和平衡控制缺陷。虚拟现实已被提议作为传统物理治疗的一种补充方法,以改善这些变量。

目的

评估与其他神经康复疗法或不进行干预相比,这种方法在MS治疗中的实际疗效。

患者和方法

进行了一项随机对照试验的系统评价。纳入了过去五年中比较虚拟现实与传统治疗或不干预对成年MS患者平衡和/或步态影响的研究。使用PEDro量表评估方法学质量,牛津量表确定证据水平和推荐等级。

结果

八项研究符合纳入标准。对于平衡,虚拟现实的疗效至少与传统训练相当。对于步态,与其他评估的干预类型相比,虚拟现实在提高速度方面似乎并不优越。研究的方法学质量为低-中度。

结论

虚拟现实在改善MS患者平衡方面与传统训练同样有效。没有数据表明虚拟现实在提高步态速度方面优于其他干预措施。对于其他步态参数,虚拟现实的疗效尚不清楚。

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