School of Rehabilitation Science, McMaster University, Hamilton, Canada.
Disabil Rehabil Assist Technol. 2022 Jan;17(1):50-60. doi: 10.1080/17483107.2020.1755376. Epub 2020 May 2.
Virtual reality (VR) are user-computer interface platforms that implement real-time simulation of an activity or environment, allowing user interaction multiple sensory modalities. VR therapy may be an effective intervention for improving cognitive function following stroke. The aim of this systematic review was to examine the effectiveness of exercise-based VR therapy on cognition post-stroke.
Electronic databases were searched for terms related to "stroke", "virtual reality", "exercise" and "cognition". Studies were included if they: (1) were randomized-controlled trials; (2) included VR-based interventions; (3) included individuals with stroke; and (4) included outcome measures related to cognitive function. Data from included studies were synthesised qualitatively and where possible, random effects meta-analyses were performed.
Eight studies involving 196 participants were included in the review, of which five were included in meta-analyses ( = 124 participants). Studies varied in terms of type (combination of VR therapy and conventional therapy, combination of VR therapy and computer-based cognitive training, VR therapy alone) and duration of interventions (20-180 min), sample size ( = 12-42), length of the interventions (4-8 weeks), and cognitive outcomes examined. VR therapy was not more effective than control for improving global cognition ( = 5, SMD = 0.24, 95%CI:-0.30,0.78, = .38), memory ( = 2 studies, SMD= 0.00, 95%CI: -0.58, 0.59, = .99), attention ( = 2 studies, MD = 8.90, 95%CI: -27.89, 45.70, = .64) or language ( = 2 studies, SMD = 0.56, 95%CI: -0.08,1.21, = .09).
VR therapy was not superior to control interventions in improving cognition in individuals with stroke. Future research should include high-quality and adequately powered trials examining the impact of virtual reality therapy on cognition post-stroke.Implications for rehabilitationVirtual reality therapy is a promising new form of technology that has been shown to increase patient satisfaction towards stroke rehabilitation.Virtual reality therapy has the added benefits of providing instant feedback, and the difficulty can be easily modified, underscoring the user-friendliness of this form of rehabilitation.Virtual reality therapy has the potential to improve various motor, cognitive and physical deficits following stroke, highlighting its usefulness in rehabilitation settings.
虚拟现实（VR）是一种用户-计算机接口平台，可实时模拟活动或环境，允许用户通过多种感觉模式进行交互。VR 疗法可能是改善中风后认知功能的有效干预措施。本系统评价的目的是检查基于运动的 VR 疗法对中风后认知的影响。
电子数据库中检索了与“中风”、“虚拟现实”、“运动”和“认知”相关的术语。如果符合以下标准，则纳入研究：（1）为随机对照试验；（2）包含基于 VR 的干预措施；（3）包含中风患者；（4）包含与认知功能相关的结果测量。对纳入研究的数据进行定性综合，如有可能，进行随机效应荟萃分析。
本综述共纳入 8 项研究，涉及 196 名参与者，其中 5 项研究纳入荟萃分析（ = 124 名参与者）。研究在类型（VR 治疗与常规治疗相结合、VR 治疗与计算机为基础的认知训练相结合、VR 治疗单独）和干预持续时间（20-180 分钟）、样本量（ = 12-42）、干预时间（4-8 周）和评估的认知结果方面存在差异。与对照组相比，VR 治疗在改善整体认知（ = 5，SMD = 0.24，95%CI：-0.30，0.78， = .38）、记忆（ = 2 项研究，SMD = 0.00，95%CI：-0.58，0.59， = .99）、注意力（ = 2 项研究，MD = 8.90，95%CI：-27.89，45.70， = .64）或语言（ = 2 项研究，SMD = 0.56，95%CI：-0.08，1.21， = .09）方面并无优势。
VR 治疗在改善中风患者的认知方面并不优于对照组。未来的研究应包括高质量和足够大的试验，以检验虚拟现实疗法对中风后认知的影响。
虚拟现实疗法是一种很有前途的新技术，已被证明可以提高患者对中风康复的满意度。虚拟现实疗法具有提供即时反馈的额外好处，并且可以轻松修改难度，突出了这种康复形式的易用性。虚拟现实疗法有可能改善中风后的各种运动、认知和身体缺陷，凸显了其在康复环境中的有用性。
