虚拟现实为基础的治疗可改善多发性硬化症患者的疲劳、影响和生活质量：一项系统评价与荟萃分析。
Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis.
机构信息
Granada Northeast Health District, Andalusian Health Service, Street San Miguel 2, 18500 Guadix, Granada, Spain.
Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Jaén, Spain.
出版信息
Sensors (Basel). 2021 Nov 6;21(21):7389. doi: 10.3390/s21217389.
UNLABELLED
Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS.
METHODS
A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen's standardized mean difference with a 95% confidence interval (95% CI).
RESULTS
Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD -0.33; 95% CI -0.61, -0.06), lowering the impact of MS (SMD -0.3; 95% CI -0.55, -0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD -0.4; 95% CI -0.7, -0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD -0.61; 95% CI -0.97, -0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL.
CONCLUSION
VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.
目的
评估虚拟现实为基础的治疗（VRBT）对多发性硬化症（MS）患者疲劳、MS 影响和生活质量（QoL）的影响。
方法
通过对 PubMed、Scopus、Web of Science 和 PEDro 数据库进行文献检索，对截止到 2021 年 4 月的基于虚拟现实的治疗（VRBT）与常规治疗（包括物理疗法、平衡和力量训练以及伸展或体育活动等）或简单观察治疗多发性硬化症患者的随机对照试验（RCT）进行系统评价和荟萃分析，以评估疲劳、MS 影响和 QoL。使用 Cohen 的标准化均数差和 95%置信区间（95%CI）来计算效应大小。
结果
纳入了 12 项 RCT，共纳入 606 名多发性硬化症患者（42.83±6.86 岁，70%为女性）。根据 PEDro 量表，方法学质量的平均值为 5.83±0.83 分。我们的综合研究结果表明，VRBT 可有效降低疲劳（SMD-0.33；95%CI-0.61，-0.06）、降低 MS 影响（SMD-0.3；95%CI-0.55，-0.04）和提高整体 QoL（0.5；95%CI0.23，0.76）。亚组分析显示：（1）VRBT 在降低疲劳（SMD-0.4；95%CI-0.7，-0.11）和改善 QoL 的心理维度（SMD0.51；95%CI0.02，1）方面优于 CT；（2）VRBT 在降低 MS 影响（SMD-0.61；95%CI-0.97，-0.23）和提高整体 QoL（SMD0.79；95%CI0.3，1.28）方面优于单纯观察；（3）与 CT 联合使用时，VRBT 在改善整体（SMD0.6；95%CI0.13，1.07）、身体（SMD0.87；95%CI0.3，1.43）和心理维度（SMD0.6；95%CI0.08，1.11）的 QoL 方面比 CT 更有效。
结论
VRBT 可有效降低多发性硬化症患者的疲劳和 MS 影响，提高 QoL。
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