Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Cairo University, Cairo, Egypt.
Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Cairo University, 24 Mohammed Korium St, 6th District, Nasr City, Cairo, Egypt.
Phys Ther. 2019 Oct 28;99(10):1304-1325. doi: 10.1093/ptj/pzz093.
Virtual reality (VR) is an interactive technology that allows customized treatment and may help in delivering effective person-centered rehabilitation.
The purpose of this review was to systematically review and critically appraise the controlled clinical trials that investigated VR effectiveness in orthopedic rehabilitation.
Pubmed, CINAHL, Embase, PEDro, REHABDATA, and Sage publications were searched up to September 2018. In addition, manual searching and snowballing using Scopus and Web of Science were done.
Two reviewers screened studies for eligibility first by title and abstract and then full text.
Articles were categorized into general or region-specific (upper limbs, lower limbs, and spine) orthopedic disorders. Study quality was assessed using the Evaluation Guidelines for Rating the Quality of an Intervention Study scoring. Meta-analysis quantified VR effectiveness, compared with no treatment, in back pain.
Nineteen studies were included in the quality assessment. The majority of the studies were of moderate quality. Fourteen studies showed that VR did not differ compared with exercises. Compared with the no-treatment control, 5 studies favored VR and 3 other studies showed no differences. For low back pain, the meta-analysis revealed no significant difference between VR and no-treatment control (n = 116; standardized mean difference = -0.21; 95% confidence interval = -0.58 to 0.15).
Limitations included heterogeneity in interventions and the outcome measures of reviewed studies. Only articles in English were included.
The evidence of VR effectiveness is promising in chronic neck pain and shoulder impingement syndrome. VR and exercises have similar effects in rheumatoid arthritis, knee arthritis, ankle instability, and post-anterior cruciate reconstruction. For fibromyalgia and back pain, as well as after knee arthroplasty, the evidence of VR effectiveness compared with exercise is absent or inconclusive.
虚拟现实（VR）是一种交互式技术，它允许定制治疗，并可能有助于提供有效的以患者为中心的康复。
本综述的目的是系统地回顾和批判性评估那些调查 VR 在骨科康复中有效性的对照临床试验。
截至 2018 年 9 月，PubMed、CINAHL、Embase、PEDro、REHABDATA 和 Sage 出版物被检索。此外，还使用 Scopus 和 Web of Science 进行了手动搜索和滚雪球搜索。
两名审查员首先通过标题和摘要筛选研究，然后通过全文筛选。
文章被分为一般或特定区域（上肢、下肢和脊柱）的骨科疾病。使用干预研究评分的评估指南对文章质量进行评估。Meta 分析量化了 VR 与无治疗相比在腰痛方面的有效性。
19 项研究被纳入质量评估。大多数研究的质量为中等。14 项研究表明 VR 与运动治疗没有差异。与无治疗对照组相比，5 项研究支持 VR，3 项其他研究则显示无差异。对于腰痛，Meta 分析显示 VR 与无治疗对照组之间无显著差异（n=116；标准化均数差=-0.21；95%置信区间=-0.58 至 0.15）。
研究的局限性包括干预措施和被综述研究的结果测量指标的异质性。仅纳入了英语文章。
VR 在慢性颈痛和肩撞击综合征方面的有效性证据很有前景。VR 和运动治疗在类风湿关节炎、膝关节炎、踝关节不稳定和前交叉韧带重建后具有相似的效果。对于纤维肌痛和腰痛以及膝关节置换术后，与运动治疗相比，VR 有效性的证据不存在或不明确。
