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沉浸式虚拟现实在老年人平衡障碍康复中的有效性:一项随机临床试验。

Immersive virtual reality is effective in the rehabilitation of older adults with balance disorders: A randomized clinical trial.

机构信息

Health Sciences from the Federal University of Alagoas, Physiotherapy Department, State University of Health Sciences of Alagoas and Cesmac University Center, Maceió, Brazil; Health Sciences Graduate Program (PPGCS), Federal University of Sergipe, Aracaju, SE, Brazil; State University of Health Sciences of Alagoas, Maceió, Brazil; Department of Physiotherapy, Cesmac University Center, Maceió, Brazil.

State University of Health Sciences of Alagoas, Maceió, Brazil.

出版信息

Exp Gerontol. 2021 Jul 1;149:111308. doi: 10.1016/j.exger.2021.111308. Epub 2021 Mar 18.

Abstract

QUESTION

What are the effects of immersive virtual reality (IVR) training compared to conventional physiotherapy on body balance and risk of falls in older adults with balance disorders?

DESIGN

A randomized controlled trial with two intervention arms, concealed allocation, per-protocol analysis, and blinded assessment.

PARTICIPANTS

Thirty-seven older adults with balance disorders and risk of falling.

INTERVENTION

Participants were randomized into two groups: a control group, which received balance training with conventional physiotherapy using multimodal circuit exercises, and an experimental group, which received balance training using immersive virtual reality. Both groups received 16 individual sessions, twice a week.

OUTCOME MEASURES

The primary outcome was functional balance. Secondary outcomes were static balance, gait speed, functional range, dizziness symptoms, and fear of falling. Safety was ensured by assessing any adverse events during the intervention.

RESULTS

After 16 sessions, in the intragroup analysis, the functional balance score in the experimental group increased by 3.00 (95% CI 1.42 to 4.57) and in the control group by 3.88 (95% CI 2.16 to 5.59). Both groups improved in assessments of sensory interaction and anterior reach. Only the experimental group presented increased mobility and reduced dizziness. After two months, there was a maintenance of gains in functional balance and a reduction of the gains in functional reach for both groups. In the intergroup comparison, there was no significant difference.

CONCLUSION

Immersive Virtual Reality training proved to be effective for balance-related outcomes, although it was not superior to conventional therapy.

TRIAL REGISTRATION

RBR-3tk7fw.

摘要

问题

沉浸式虚拟现实 (IVR) 训练与传统物理疗法相比,对平衡障碍的老年人的身体平衡和跌倒风险有什么影响?

设计

一项随机对照试验,有两个干预组,分组隐藏,按方案分析,评估设盲。

参与者

37 名有平衡障碍和跌倒风险的老年人。

干预措施

参与者随机分为两组:对照组接受常规物理疗法结合多模式电路练习的平衡训练,实验组接受沉浸式虚拟现实的平衡训练。两组均接受 16 次个体治疗,每周两次。

结局测量

主要结局是功能性平衡。次要结局是静态平衡、步态速度、功能范围、头晕症状和跌倒恐惧。通过评估干预过程中的任何不良事件来确保安全性。

结果

经过 16 次治疗后,在组内分析中,实验组的功能性平衡评分提高了 3.00(95%置信区间 1.42 至 4.57),对照组提高了 3.88(95%置信区间 2.16 至 5.59)。两组在感觉相互作用和前伸评估中均有改善。只有实验组表现出运动能力提高和头晕减轻。两个月后,两组的功能性平衡保持了收益,功能性前伸的收益减少。组间比较无显著差异。

结论

沉浸式虚拟现实训练对平衡相关结局有效,尽管它并不优于传统疗法。

试验注册号

RBR-3tk7fw。

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