School of Nursing, Capital Medical University, Beijing, China.
School of Nursing, University of Pittsburgh, Pittsburgh, USA.
J Adv Nurs. 2021 Aug;77(8):3255-3273. doi: 10.1111/jan.14800. Epub 2021 Mar 6.
To explore the beneficial effects of virtual reality (VR) interventions on upper- and lower-limb motor function, balance, gait, cognition and daily function outcomes in stroke patients.
A systematic review and meta-analysis of randomized controlled trials.
English databases (PubMed, EMBASE, the Cochrane Library, CINAHL, Web of Science, Physiotherapy Evidence Database, ProQuest Dissertations and Theses) and Chinese databases (Chinese BioMedical Literature Service System, WANFANG, CNKI) and the Clinical Trial Registry Platform were systematically searched from inception until December 2019. Additionally, reference lists of the included studies were manually searched.
The methodological quality of studies was scored with the Cochrane 'risk-of-bias tool' and PEDro scale from the Physiotherapy Evidence Database by two independent evaluators.
In total, 87 studies with 3540 participants were included. Stroke patients receiving VR interventions showed significant improvements in Fugl-Meyer assessment of Upper Extremity, Action Research Arm Test, Wolf Motor Function Test, Fugl-Meyer Assessment of Lower Extremity, Functional Ambulation Classification, Berg Balance Scale, Time Up and Go, Velocity, Cadence, Modified Barthel Index and Functional Independence Measure. However, differences between VR intervention and traditional rehabilitation groups were not significant for Box-Block Test, 10 m Walk Test, Auditory Continuous Performance Test, Mini-Mental State Examination and Visual Continuous Performance Test.
This review suggests that VR interventions effectively improve upper- and lower-limb motor function, balance, gait and daily function of stroke patients, but have no benefits on cognition.
This review identified the positive effects of VR-assisted rehabilitation on upper- and lower-limb motor function, balance, gait and daily function of stroke patients. And, we verified the duration of VR intervention affects some health benefits. The benefit of VR on cognitive function requires further investigation through large-scale multicentre RCTs.
探讨虚拟现实（VR）干预对上、下肢运动功能、平衡、步态、认知和日常生活功能的影响。
系统综述和荟萃分析的随机对照试验。
英文数据库（PubMed、EMBASE、Cochrane 图书馆、CINAHL、Web of Science、Physiotherapy Evidence Database、ProQuest Dissertations and Theses）和中文数据库（中国生物医学文献服务系统、万方、中国知网）以及临床试验注册平台，系统检索从开始到 2019 年 12 月的所有文献。此外，还手动检索了纳入研究的参考文献。
两名独立评估员使用 Cochrane“风险偏倚工具”和 Physiotherapy Evidence Database 的 PEDro 量表对研究的方法学质量进行评分。
共纳入 87 项研究，3540 名参与者。接受 VR 干预的脑卒中患者在 Fugl-Meyer 上肢评估、动作研究上肢测试、Wolf 运动功能测试、Fugl-Meyer 下肢评估、功能步行分类、Berg 平衡量表、时间站立和行走、速度、步频、改良巴氏指数和功能独立性测量方面均有显著改善。然而，VR 干预组与传统康复组在 Box-Block 测试、10 m 步行测试、听觉连续表现测试、简易精神状态检查和视觉连续表现测试方面的差异无统计学意义。
本综述表明，VR 干预可有效改善脑卒中患者的上下肢运动功能、平衡、步态和日常生活功能，但对认知功能无影响。
本综述确定了 VR 辅助康复对上、下肢运动功能、平衡、步态和日常生活功能的积极影响。而且，我们验证了 VR 干预的持续时间会影响一些健康获益。VR 对认知功能的影响需要通过大规模多中心 RCT 进一步研究。
