Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
Braz J Phys Ther. 2021 Jul-Aug;25(4):369-386. doi: 10.1016/j.bjpt.2020.11.003. Epub 2020 Dec 5.
Cerebral palsy (CP) is one of the main causes of disability in childhood. Virtual reality (VR) has been used as a treatment option in this population, however its effectiveness is unclear.
To evaluate the effectiveness of VR in patients with CP.
We conducted electronic searches in EMBASE, MEDLINE, Cochrane library, PEDro, AMED, PsycoINFO, and LILACS databases and trial site registries such as ClinicalTrials.gov and ICTRP. We included randomized controlled trials that tested the use of VR alone or in combination with other interventions compared to more conventional rehabilitation or usual care in individuals with CP. The primary outcomes were upper and lower limb function, postural control, and balance. The secondary outcomes included global motor function, perception, cognition and spatial functions, motivation, motor learning, and adverse events. Two independent reviewers extracted and assessed included articles for risk of bias using the Cochrane risk of bias tool. We use a meta-analysis with random effect model whenever possible. We analyzed the quality of evidence using theGRADE approach.
We included 38 trials (pooled n = 1233 participants) in this review. There is very low quality of evidence that VR plus conventional rehabilitation is better than conventional rehabilitation for upper limb function. There is also very low quality evidence that VR alone is no better than conventional rehabilitation for upper and lower limb function. No adverse events were observed among the 10 trials that provided information on this outcome.
At present we have very limited to limited confidence in effect estimation for utilization of VR in this population. Future studies may change our confidence in results and effect estimates.
PROSPERO CRD 42018102759.
脑瘫（CP）是儿童残疾的主要原因之一。虚拟现实（VR）已被用作该人群的治疗选择，但其疗效尚不清楚。
评估 VR 在 CP 患者中的疗效。
我们在 EMBASE、MEDLINE、Cochrane 图书馆、PEDro、AMED、PsycoINFO 和 LILACS 数据库以及临床试验注册处（如 ClinicalTrials.gov 和 ICTRP）进行了电子检索。我们纳入了单独使用 VR 或与其他干预措施联合使用的随机对照试验，与 CP 患者的常规康复或常规护理相比。主要结局是上肢和下肢功能、姿势控制和平衡。次要结局包括整体运动功能、感知、认知和空间功能、动机、运动学习和不良事件。两名独立评审员使用 Cochrane 偏倚风险工具提取并评估了纳入文章的偏倚风险。只要有可能，我们就使用随机效应模型进行荟萃分析。我们使用 GRADE 方法分析证据质量。
本综述纳入了 38 项试验（汇总 n = 1233 名参与者）。有非常低质量的证据表明，VR 联合常规康复治疗优于常规康复治疗上肢功能。还有非常低质量的证据表明，单独使用 VR 与常规康复治疗相比，上肢和下肢功能没有改善。在提供有关此结局信息的 10 项试验中，没有观察到不良事件。
目前，我们对 VR 在该人群中的应用的效果评估的信心非常有限。未来的研究可能会改变我们对结果和效果估计的信心。
PROSPERO CRD 42018102759。
