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传统加虚拟现实康复对脑卒中幸存者预后的影响:一项随机对照试验的系统评价和荟萃分析。

Effect of Traditional Plus Virtual Reality Rehabilitation on Prognosis of Stroke Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

机构信息

From the Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; and College of Pharmacy, Fujian Medical University, Fuzhou, China.

出版信息

Am J Phys Med Rehabil. 2022 Mar 1;101(3):217-228. doi: 10.1097/PHM.0000000000001775.

DOI:10.1097/PHM.0000000000001775
PMID:33929347
Abstract

OBJECTIVE

Virtual reality technology has begun to be gradually applied to clinical stroke rehabilitation. The study aimed to evaluate the effect of traditional plus virtual reality rehabilitation on motor function recovery, balance, and activities of daily living in stroke patients.

METHOD

Studies published in English before October 2020 were retrieved from PubMed, Embase, Web of Science, and the Cochrane Library. This study used RevMan 5.3 software for meta-analysis.

RESULT

A total of 21 randomized controlled trials were included, which enrolled 619 patients. Traditional plus virtual reality rehabilitation is better than traditional rehabilitation in upper limb motor function recovery measured by Fugl-Meyer Assessment-Upper Extremity (mean difference = 3.49, 95% confidence interval = 1.24 to 5.73, P = 0.002) and manual dexterity assessed by Box and Block Test (mean difference = 6.59, 95% confidence interval = 3.45 to 9.74, P < 0.0001). However, there is no significant difference from traditional rehabilitation in activities of daily living assessed by Functional Independence Measure (mean difference = 0.38, 95% confidence interval = -0.26 to 1.02, P = 0.25) and balance assessed by Berg Balance Scale (mean difference = 2.18, 95% confidence interval = -0.35 to 4.71, P = 0.09).

CONCLUSIONS

Traditional plus virtual reality rehabilitation therapy is an effective method to improve the upper limb motor function and manual dexterity of patients with limb disorders after stroke, and immersive virtual reality rehabilitation treatment may become a new option for rehabilitation after stroke.

摘要

目的

虚拟现实技术已开始逐渐应用于临床脑卒中康复。本研究旨在评估传统加虚拟现实康复对脑卒中患者运动功能恢复、平衡和日常生活活动能力的影响。

方法

检索 PubMed、Embase、Web of Science 和 Cochrane Library 数据库中 2020 年 10 月前发表的英文文献,采用 RevMan 5.3 软件进行荟萃分析。

结果

共纳入 21 项随机对照试验,共纳入 619 例患者。传统加虚拟现实康复在 Fugl-Meyer 上肢运动功能评估(FMA)(均数差=3.49,95%置信区间=1.24 至 5.73,P=0.002)和 9 孔插板测试(BBT)(均数差=6.59,95%置信区间=3.45 至 9.74,P<0.0001)评估的上肢运动功能恢复方面优于传统康复,但在功能独立性测量(FIM)(均数差=0.38,95%置信区间=-0.26 至 1.02,P=0.25)和 Berg 平衡量表(BBS)(均数差=2.18,95%置信区间=-0.35 至 4.71,P=0.09)评估的日常生活活动能力和平衡能力方面与传统康复无显著差异。

结论

传统加虚拟现实康复治疗是改善脑卒中后肢体障碍患者上肢运动功能和手灵巧性的有效方法,沉浸式虚拟现实康复治疗可能成为脑卒中后康复的新选择。

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