虚拟现实健身游戏干预对长期护理机构中老年人的影响：一项系统评价与 Meta 分析。
VR exergame interventions among older adults living in long-term care facilities: A systematic review with Meta-analysis.
机构信息
Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1(st) Rd., Sanmin District, Kaohsiung, Taiwan 80708.
Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1(st) Rd., Sanmin District, Kaohsiung, Taiwan 80708; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
出版信息
Ann Phys Rehabil Med. 2023 Apr;66(3):101702. doi: 10.1016/j.rehab.2022.101702. Epub 2022 Dec 1.
BACKGROUND
To improve the motivation toward exercise in older adults, exergames have shifted from entertainment to rehabilitation.
OBJECTIVES
To review the training focus of exergames and analyze the effectiveness of exergame training on physical, psychological, or cognitive outcomes among older adults in long-term care facilities (LTCFs).
METHODS
This review followed the PRISMA guidelines. By searching 7 electronic databases up to April 30, 2022, studies were included if they 1) involved adults ≥65 years old residing in LTCFs, 2) were randomized controlled trials (RCTs) with virtual reality-based exergames as the intervention, 3) compared the effects of exergames to usual care or conventional exercises, and 4) reported physical, psychological, or cognitive outcomes. The Cochrane Risk-of-Bias tool for randomized trials version 2 (RoB 2) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to evaluate the methodological quality of studies and levels of evidence for outcomes. The meta-analysis was conducted with Review Manager 5.4. Results are presented as standardized mean differences (SMDs) and 95% confidence intervals (CIs).
RESULTS
A total of 12 RCTs were included in the systematic review and meta-analysis. For overall methodological quality, 10 studies showed some concerns and 2 studies showed high risk. Levels of evidence for outcomes were assessed as low (n = 8) and very low (n = 4). The studies involved a total of 482 older adults. Most studies implemented balance exercise as the exergame intervention. Older adults who completed exergame interventions showed improvements in cognitive outcomes (SMD 0.90, 95%CI 0.61-1.19, p<0.001) and in balance self-efficacy (SMD 1.04, 95%CI 0.47-1.61, p<0.001) as compared with those in usual care. They also showed improvements in balance (SMD 0.49, 95%CI 0.20-0.78, p<0.001) as compared with those in conventional exercise programs. Overall, exergames had a positive effect on balance (SMD 0.62, 95%CI 0.29-0.95, p<0.001).
CONCLUSION
This review revealed that exergames can improve the balance ability of older adults in LTCFs.
背景
为了提高老年人对运动的积极性，健身游戏已从娱乐转向康复。
目的
综述健身游戏的训练重点，并分析老年人长期护理机构（LTCF）中健身游戏训练对身体、心理或认知结果的影响。
方法
本研究遵循 PRISMA 指南。通过搜索截至 2022 年 4 月 30 日的 7 个电子数据库，纳入了 1）年龄≥65 岁、居住在 LTCF 的成年人，2）以虚拟现实为基础的健身游戏作为干预的随机对照试验（RCT），3）比较健身游戏与常规护理或常规运动的效果，以及 4）报告身体、心理或认知结果的研究。使用 Cochrane 偏倚风险评估工具（RoB 2）和推荐评估、制定与评价（GRADE）对研究的方法学质量和结果的证据水平进行评估。使用 Review Manager 5.4 进行荟萃分析。结果以标准化均数差（SMD）和 95%置信区间（CI）表示。
结果
本系统评价和荟萃分析共纳入 12 项 RCT。关于整体方法学质量，有 10 项研究存在一些问题，2 项研究存在高风险。结果的证据水平评估为低（n=8）和极低（n=4）。这些研究共涉及 482 名老年人。大多数研究都采用平衡运动作为健身游戏干预。与常规护理相比，完成健身游戏干预的老年人在认知结果（SMD 0.90，95%CI 0.61-1.19，p<0.001）和平衡自我效能感（SMD 1.04，95%CI 0.47-1.61，p<0.001）方面有所改善。与常规运动方案相比，他们在平衡方面也有所改善（SMD 0.49，95%CI 0.20-0.78，p<0.001）。总体而言，健身游戏对平衡有积极影响（SMD 0.62，95%CI 0.29-0.95，p<0.001）。
结论
本综述表明，健身游戏可以提高 LTCF 中老年人的平衡能力。
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