Division of Physical Therapy Education, Department of Health and Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, United States.
McGoogan Health Sciences Library, University of Nebraska Medical CenterLeon S. , Omaha, NE, United States.
Physiother Theory Pract. 2023 Dec 2;39(12):2569-2588. doi: 10.1080/09593985.2022.2094302. Epub 2022 Jul 7.
Virtual reality (VR) is an emerging technology and has shown promising outcomes in stroke rehabilitation. VR can create an enriched environment, facilitate task-specific training, and provide multimodal sensorimotor feedback to augment functional recovery by driving the experience-dependent plasticity, which is prominent in the early-stage after stroke.
This review aimed to systematically identify and examine the feasibility and effectiveness of VR intervention applied within one-month after stroke on functional outcomes of patients.
Randomized controlled trials were searched across six databases published between 2000 and 2021. Two independent reviewers conducted study selection, data extraction, and quality assessment. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the quality of included studies. Qualitative synthesis and meta-analysis were conducted to compare VR-based rehabilitation and conventional rehabilitation.
Seventeen randomized controlled trials were included in this review, and all of them meet the criteria for good quality. The results confirmed the feasibility of applying VR in early stroke rehabilitation. In the meta-analyses, there were no significant differences between VR and control on upper extremity function (SMD = 0.22, P = .10), Activities of Daily Living outcomes (SMD = 0.15, P = .11), balance (SMD = 0.18, P = .86), and cognition (SMD = 0.34, P = .06).
VR is a feasible approach and demonstrates comparable effectiveness in functional outcomes with conventional rehabilitation in patients with stroke at the early-stage. Further research focusing on the application of VR in acute stroke survivors with adequate sample size, additional follow-up evaluation and valid outcome measures are warranted.
虚拟现实（VR）是一种新兴技术，在中风康复方面显示出有前景的结果。VR 可以创造丰富的环境，促进特定任务的训练，并通过驱动经验依赖性可塑性提供多模式感觉运动反馈，从而增强功能恢复，这种可塑性在中风后早期尤为明显。
本综述旨在系统地识别和评估中风后一个月内应用 VR 干预对患者功能结果的可行性和有效性。
在 2000 年至 2021 年期间，我们在六个数据库中搜索了随机对照试验。两名独立的审查员进行了研究选择、数据提取和质量评估。物理治疗证据数据库（PEDro）量表用于评估纳入研究的质量。定性综合和荟萃分析用于比较基于 VR 的康复和常规康复。
本综述纳入了 17 项随机对照试验，所有试验均符合高质量标准。结果证实了在早期中风康复中应用 VR 的可行性。荟萃分析结果显示，VR 与对照组在上肢功能（SMD=0.22，P=0.10）、日常生活活动结局（SMD=0.15，P=0.11）、平衡（SMD=0.18，P=0.86）和认知方面（SMD=0.34，P=0.06）均无显著差异。
VR 是一种可行的方法，在中风早期患者的功能结果方面与常规康复具有相当的效果。需要进一步研究，重点关注在急性中风幸存者中应用 VR，以确保足够的样本量、额外的随访评估和有效的结局测量。
