Jin Minxia, Pei Junjie, Bai Zhongfei, Zhang Jiaqi, He Ting, Xu Xiaojing, Zhu Feifei, Yu Dan, Zhang Ziwei
School of Medicine, Tongji University, Shanghai YangZhi Rehabilitation Hospital (435846Shanghai Sunshine Rehabilitation Center), Shanghai, China.
Department of Rehabilitation Sciences, 26680The Hong Kong Polytechnic University, Hong Kong.
Clin Rehabil. 2022 May;36(5):573-596. doi: 10.1177/02692155211066534. Epub 2021 Dec 13.
To investigate the effect of virtual reality on arm motor impairment, activity limitation, participation restriction, and quality of life in patients with stroke. To determine potential moderators that affect the efficacy of virtual reality.
CINAHL, Medline, PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, and Wanfang Data from inception to October 23, 2021.
Randomized controlled trials that investigated the effect of virtual reality on arm recovery in adult patients with stroke compared to conventional therapy or sham control were included. Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study.
Forty studies with 2018 participants were identified. Quality of included studies was fair to high. Virtual reality exhibited better effects on overall arm function ( = 0.28, < 0.001), motor impairment ( = 0.36, < 0.001) and activity limitation (daily living) ( = 0.24, < 0.001) compared with the control group. No significant improvement was observed in participation restriction and activity limitation (specific task). The result for quality of life was described qualitatively. Subgroup analyses demonstrated that immersive virtual reality produced a greater beneficial effect ( = 0.60, < 0.001). Patients with moderate to severe arm paresis could make more progress after training ( = 0.71, < 0.001).
Virtual reality is recommended for improving motor impairment and activities of daily living after stroke and is favorable to patients with moderate to severe paresis. An immersive design could produce greater improvement.
探讨虚拟现实对中风患者上肢运动功能障碍、活动受限、参与受限及生活质量的影响。确定影响虚拟现实疗效的潜在调节因素。
CINAHL、Medline、PubMed、EMBASE、Cochrane图书馆、中国知网和万方数据，检索时间从建库至2021年10月23日。
纳入研究虚拟现实对成年中风患者上肢恢复的影响并与传统治疗或假对照进行比较的随机对照试验。使用物理治疗证据数据库量表评估每项研究的方法学质量。
共纳入40项研究，涉及2018名参与者。纳入研究的质量为中等至高。与对照组相比，虚拟现实在整体上肢功能（标准化均数差=0.28，P<0.001）、运动功能障碍（标准化均数差=0.36，P<0.001）和活动受限（日常生活）（标准化均数差=0.24，P<0.001）方面表现出更好的效果。在参与受限和活动受限（特定任务）方面未观察到显著改善。生活质量结果进行了定性描述。亚组分析表明，沉浸式虚拟现实产生了更大的有益效果（标准化均数差=0.60，P<0.001）。中度至重度上肢麻痹患者训练后进步更大（标准化均数差=0.71，P<0.001）。
推荐使用虚拟现实改善中风后的运动功能障碍和日常生活活动，对中度至重度麻痹患者有益。沉浸式设计可能会带来更大改善。
