Gumaa Mohammed, Khaireldin Alaaeldin, Rehan Youssef Aliaa
Department of Physical Therapy for Musculoskeletal Disorders and Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
TRUST Research Center, Cairo, Egypt.
Curr Rev Musculoskelet Med. 2021 Apr;14(2):130-144. doi: 10.1007/s12178-021-09696-6. Epub 2021 Jan 29.
Assessment of the musculoskeletal system requires consideration of its integrated function with the nervous system. This may be assisted by using valid and reliable methods that simulate real-life situations. Interactive virtual reality (VR) technology may introduce various auditory and visual inputs that mimic real-life scenarios. However, evidence supporting the quality and strength of evidence regarding the adequacy of its psychometric properties in assessing the musculoskeletal function has not been evaluated yet. Therefore, this study reviewed the validity and reliability of VR games and real-time feedback in assessing the musculoskeletal system.
Nine studies were included in quality assessment. Based on outcome measures, studies were categorized into range of motion (ROM), balance, reaction time, and cervical motion velocity and accuracy. The majority of the studies were of moderate quality and provided evidence of VR adequate concurrent and, in some cases, known-groups validity. Also, VR showed high intra-rater reliability for most of the measured outcomes. Based on the included studies, there is a limited promising evidence that interactive VR using games or real-time feedback is highly valid and reliable in assessing ROM in asymptomatic participants and patients with chronic neck pain and radial fracture. For the remaining outcomes, evidence is limited to draw a robust conclusion. Future studies are recommended to test VR psychometric properties in different patients' population using a rigor research methodology.
对肌肉骨骼系统的评估需要考虑其与神经系统的整合功能。这可以通过使用有效且可靠的方法来模拟现实生活情境来辅助。交互式虚拟现实（VR）技术可能会引入各种模仿现实生活场景的听觉和视觉输入。然而，关于其在评估肌肉骨骼功能时心理测量特性的充分性的证据质量和强度尚未得到评估。因此，本研究回顾了VR游戏和实时反馈在评估肌肉骨骼系统方面的有效性和可靠性。
质量评估纳入了9项研究。根据结果测量指标，研究分为运动范围（ROM）、平衡、反应时间以及颈椎运动速度和准确性几类。大多数研究质量中等，提供了VR具有足够的同时效度的证据，在某些情况下还具有已知组效度。此外，对于大多数测量结果，VR显示出较高的评分者内信度。基于纳入的研究，有有限的但有前景的证据表明，使用游戏或实时反馈的交互式VR在评估无症状参与者、慢性颈部疼痛患者和桡骨骨折患者的ROM方面是高度有效且可靠的。对于其余结果，证据有限，无法得出有力结论。建议未来的研究使用严谨的研究方法在不同患者群体中测试VR的心理测量特性。
