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虚拟现实对脑卒中后失语症的影响:系统评价和荟萃分析。

Effects of virtual reality in post-stroke aphasia: a systematic review and meta-analysis.

机构信息

Beijing University of Chinese Medicine, Beijing, China.

Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, No.5 Haiyuncang, Dongcheng District, Beijing, 100700, China.

出版信息

Neurol Sci. 2021 Dec;42(12):5249-5259. doi: 10.1007/s10072-021-05202-5. Epub 2021 Apr 9.

Abstract

OBJECTIVE

To investigate whether virtual reality (VR) interventions have beneficial effects on the functional communication and language function of patients with post-stroke aphasia (PSA).

METHODS

We searched nine electronic literature databases and two clinical registry platforms to identify randomized controlled trials (RCTs) and quasi-RCTs performed up to September 2020. Screening, quality assessment, and data collection were performed by two authors independently, using standard protocols. Data aggregation and risk of bias evaluation were conducted using Review Manager Version 5.4. The quality of evidence was evaluated with GRADEpro.

RESULTS

A total of five studies involving 121 participants met the inclusion criteria and were appraised. Four studies were included in the quantitative synthesis. VR reduced the severity of language impairment with borderline significance [SMD (95%CI) = 0.70[0.01, 1.39], P=0.05]. The meta-analysis showed no statistical difference in functional communication [SMD (95%CI) =0.41[-0.29, 1.12], P=0.25], word finding [SMD (95%CI) =0.42[-0.24, 1.08], P=0.21], and repetition [SMD (95%CI) =0.16[-0.62, 0.94], P=0.68] between VR group and the control group.

CONCLUSION

This review demonstrated a borderline positive clinical effect of VR for the severity of language impairment when compared with conventional rehabilitation therapy. Conversely, VR had no effect on functional communication, word finding, and repetition. Further research is warranted to reach more definite conclusions.

摘要

目的

研究虚拟现实(VR)干预是否对脑卒中后失语症(PSA)患者的功能性交流和语言功能有有益影响。

方法

我们检索了 9 个电子文献数据库和 2 个临床注册平台,以确定截至 2020 年 9 月进行的随机对照试验(RCT)和准 RCT。两名作者独立进行筛选、质量评估和数据采集,使用标准方案。使用 Review Manager Version 5.4 进行数据汇总和偏倚风险评估。使用 GRADEpro 评估证据质量。

结果

共有 5 项研究(共 121 名参与者)符合纳入标准并进行了评估。有 4 项研究被纳入定量综合分析。VR 降低了语言障碍的严重程度,但有统计学意义[SMD(95%CI)=0.70[0.01, 1.39],P=0.05]。Meta 分析显示,在功能性交流[SMD(95%CI)=0.41[-0.29, 1.12],P=0.25]、词语发现[SMD(95%CI)=0.42[-0.24, 1.08],P=0.21]和复述[SMD(95%CI)=0.16[-0.62, 0.94],P=0.68]方面,VR 组与对照组之间没有统计学差异。

结论

本综述表明,与常规康复治疗相比,VR 对语言障碍的严重程度具有边缘积极的临床效果。相反,VR 对功能性交流、词语发现和复述没有影响。需要进一步研究以得出更确定的结论。

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