Exercise Science and Neuroscience Unit, Department Exercise & Health, Paderborn University, Paderborn, Germany.
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Int J Med Inform. 2019 Jun;126:46-58. doi: 10.1016/j.ijmedinf.2019.03.009. Epub 2019 Mar 12.
Balance training is an important aspect in prevention and rehabilitation of musculoskeletal lower limb injuries. Virtual reality (VR) is a promising addition or alternative to traditional training. This review aims to provide a comprehensive overview of VR technology and games employed for balance prevention and rehabilitation, balance outcome measures, and effects for both balance prevention and balance rehabilitation following musculoskeletal lower limb impairments.
A systematic literature search was conducted in electronic databases to identify all related articles with a longitudinal study design on VR, balance, and prevention or musculoskeletal rehabilitation of the lower limbs in adult subjects between 19 and 65 years.
Eleven articles concerning balance prevention and five articles regarding balance rehabilitation were included. All studies used screen-based VR and off-the-shelf gaming consoles with accompanying games. The Star Excursion Balance Test (SEBT) was the most frequently used outcome measure. Two studies found positive effects of VR balance training in healthy adults, while none reported negative effects. None of the included studies showed a significant difference in balance performance after a VR balance rehabilitation intervention compared to traditional balance training.
Few studies have been published concerning musculoskeletal balance rehabilitation and balance prevention in healthy adult subjects. However, the studies published have shown that VR exercises are equally effective compared to traditional balance training for both domains of application. As there is large variability between studies, recommendations for future research are given to prospectively investigate the use of VR technology for balance training.
平衡训练是预防和康复下肢肌肉骨骼损伤的重要方面。虚拟现实（VR）是传统训练的一种有前途的补充或替代方法。本综述旨在全面概述用于预防和康复平衡的 VR 技术和游戏、平衡结果测量指标，以及针对下肢肌肉骨骼损伤后的平衡预防和平衡康复的效果。
系统地在电子数据库中进行文献检索，以确定所有关于 VR、平衡以及 19 至 65 岁成年人下肢预防或肌肉骨骼康复的纵向研究设计的相关文章。
共纳入了 11 篇关于平衡预防的文章和 5 篇关于平衡康复的文章。所有研究都使用基于屏幕的 VR 和现成的游戏控制台以及配套游戏。最常使用的结果测量指标是星型偏移平衡测试（SEBT）。有两项研究发现 VR 平衡训练对健康成年人有积极影响，而没有研究报告有负面影响。在 VR 平衡康复干预与传统平衡训练相比，在平衡表现方面，纳入的研究均未显示出显著差异。
关于健康成年人肌肉骨骼平衡康复和平衡预防的研究发表较少。然而，已发表的研究表明，VR 运动与传统平衡训练在这两个应用领域同样有效。由于研究之间存在很大的差异，因此给出了未来研究的建议，以前瞻性地研究 VR 技术在平衡训练中的应用。
