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虚拟现实疗法对脑卒中患者认知和心理健康的影响：系统评价和荟萃分析。

Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis.

机构信息

School of Nursing, Peking University, Beijing, China.

Department of Computer Science, Aberystwyth University, Wales, United Kingdom.

出版信息

J Med Internet Res. 2021 Nov 17;23(11):e31007. doi: 10.2196/31007.

DOI:10.2196/31007
PMID:34787571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8663637/
Abstract

BACKGROUND: Stroke remains one of the major chronic illnesses worldwide that health care organizations will need to address for the next several decades. Individuals poststroke are subject to levels of cognitive impairment and mental health problems. Virtual reality (VR)-based therapies are new technologies used for cognitive rehabilitation and the management of psychological outcomes. OBJECTIVE: This study performed a meta-analysis to evaluate the effects of VR-based therapies on cognitive function and mental health in patients with stroke. METHODS: A comprehensive database search was performed using PubMed, MEDLINE (Ovid), Embase, Cochrane Library, and APA PsycINFO databases for randomized controlled trials (RCTs) that studied the effects of VR on patients with stroke. We included trials published up to April 15, 2021, that fulfilled our inclusion and exclusion criteria. The literature was screened, data were extracted, and the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3 software. RESULTS: A total of 894 patients from 23 RCTs were included in our meta-analysis. Compared to traditional rehabilitation therapies, the executive function (standard mean difference [SMD]=0.88, 95% confidence interval [CI]=0.06-1.70, P=.03), memory (SMD=1.44, 95% CI=0.21-2.68, P=.02), and visuospatial function (SMD=0.78, 95% CI=0.23-1.33, P=.006) significantly improved among patients after VR intervention. However, there were no significant differences observed in global cognitive function, attention, verbal fluency, depression, and the quality of life (QoL). CONCLUSIONS: The findings of our meta-analysis showed that VR-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke. For global cognitive function, attention, verbal fluency, depression, and the QoL, further research is required. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021252788; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788.

摘要

背景：中风仍然是全球主要的慢性疾病之一，在未来几十年，医疗保健组织将需要解决这一问题。中风后患者会出现不同程度的认知障碍和心理健康问题。基于虚拟现实（VR）的疗法是用于认知康复和管理心理结果的新技术。 目的：本研究进行了荟萃分析，以评估基于 VR 的疗法对中风患者认知功能和心理健康的影响。 方法：使用 PubMed、MEDLINE（Ovid）、Embase、Cochrane 图书馆和 APA PsycINFO 数据库对截至 2021 年 4 月 15 日的随机对照试验（RCT）进行了全面的数据库搜索，这些试验研究了 VR 对中风患者的影响。我们纳入了符合纳入和排除标准的试验。筛选文献、提取数据，并评估纳入试验的方法学质量。使用 RevMan 5.3 软件进行荟萃分析。 结果：共有 23 项 RCT 的 894 名患者纳入本荟萃分析。与传统康复疗法相比，执行功能（标准均数差 [SMD]=0.88，95%置信区间 [CI]=0.06-1.70，P=.03）、记忆（SMD=1.44，95% CI=0.21-2.68，P=.02）和视空间功能（SMD=0.78，95% CI=0.23-1.33，P=.006）在 VR 干预后患者显著改善。然而，在整体认知功能、注意力、言语流畅性、抑郁和生活质量（QoL）方面没有观察到显著差异。 结论：本荟萃分析结果表明，基于 VR 的疗法在改善中风患者的执行功能、记忆和视空间功能方面是有效的。对于整体认知功能、注意力、言语流畅性、抑郁和 QoL，需要进一步的研究。 试验注册：PROSPERO 国际前瞻性系统评价注册中心 CRD42021252788；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/8c443ed6f14a/jmir_v23i11e31007_fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/aa7799aad503/jmir_v23i11e31007_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/919c3469f39f/jmir_v23i11e31007_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/6c4658ed8dfc/jmir_v23i11e31007_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/93607cd5d43b/jmir_v23i11e31007_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/5e9c3f116a2d/jmir_v23i11e31007_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/3491c1b025be/jmir_v23i11e31007_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/6b558270df3a/jmir_v23i11e31007_fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/8c443ed6f14a/jmir_v23i11e31007_fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/aa7799aad503/jmir_v23i11e31007_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/919c3469f39f/jmir_v23i11e31007_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/6c4658ed8dfc/jmir_v23i11e31007_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/93607cd5d43b/jmir_v23i11e31007_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/5e9c3f116a2d/jmir_v23i11e31007_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/3491c1b025be/jmir_v23i11e31007_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/6b558270df3a/jmir_v23i11e31007_fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/8663637/8c443ed6f14a/jmir_v23i11e31007_fig8.jpg

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[5]
Use of Virtual Reality to Improve Spatial Orientation in Alzheimer's Disease and Mild Cognitive Impairment: A Systematic Review.

Curr Alzheimer Res. 2024

[6]
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[7]
Stroke survivor and caregiver experiences of virtual reality gaming to promote social participation: A qualitative study.

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[8]
The effectiveness of digital technology interventions for cognitive function in older adults: a systematic review and meta-analysis of randomized controlled trials.

Geroscience. 2025-2

[9]
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[10]
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本文引用的文献

[1]
Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: A systematic review and meta-analysis.

J Adv Nurs. 2021-8

[2]
Parkinson's disease and virtual reality rehabilitation: cognitive reserve influences the walking and balance outcome.

Neurol Sci. 2021-11

[3]
Validity and reliability of the Mandarin version of the Treatment Burden Questionnaire among stroke patients in Mainland China.

Fam Pract. 2021-7-28

[4]
The Effectiveness of Virtual Reality in Managing Acute Pain and Anxiety for Medical Inpatients: Systematic Review.

J Med Internet Res. 2020-11-2

[5]
Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence.

J Clin Med. 2020-10-21

[6]
Current Cognition Tests, Potential Virtual Reality Applications, and Serious Games in Cognitive Assessment and Non-Pharmacological Therapy for Neurocognitive Disorders.

J Clin Med. 2020-10-13

[7]
Effectiveness of a Participatory and Interactive Virtual Reality Intervention in Patients With Social Anxiety Disorder: Longitudinal Questionnaire Study.

J Med Internet Res. 2020-10-6

[8]
Virtual reality in neurorehabilitation: a review of its effects on multiple cognitive domains.

Expert Rev Med Devices. 2020-10-6

[9]
Evidence on Virtual Reality-Based Therapies for Psychiatric Disorders: Meta-Review of Meta-Analyses.

J Med Internet Res. 2020-8-19

[10]
A Virtual Reality-Supported Intervention for Pulmonary Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease: Mixed Methods Study.

J Med Internet Res. 2020-7-7

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