Institute for Rehabilitation Science and Engineering, 20936Madonna Rehabilitation Hospitals, Lincoln, NE, USA.
Division of Physical Therapy Education, 12284University of Nebraska Medical Center, Omaha, NE, USA.
Clin Rehabil. 2023 May;37(5):603-619. doi: 10.1177/02692155221138309. Epub 2022 Nov 10.
To systematically summarize and examine current evidence regarding the combination of virtual reality and treadmill training in patients with walking and balance impairments.
English language randomized controlled trials, participants with walking and balance impairments, intervention group used virtual reality and treadmill, control group only used treadmill with the same training frequency and number of sessions. Six bioscience and engineering databases were searched.
Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.
Sixteen randomized controlled trials including 829 participants were identified. Compared to treadmill-only training, virtual reality augmented treadmill training induced significantly faster walking ( < 0.001; standardized mean difference (SMD) = 0.55, 95%CI: 0.30 to 0.81), longer step length ( < 0.001; SMD = 0.74, 95%CI: 0.42 to 1.06), narrower step width ( = 0.03; SMD = -0.52, 95%CI: -0.97 to -0.06), longer single leg stance period ( = 0.003; SMD = 0.77, 95%CI: 0.27 to 1.27), better functional mobility ( = 0.003; SMD = -0.44, 95%CI: - 0.74 to -0.15), improved balance function ( = 0.04; SMD = 0.24, 95%CI: 0.01 to 0.47), and enhanced balance confidence ( = 0.03; SMD = 0.73, 95%CI: 0.08 to 1.37). Walking endurance did not differ significantly between groups ( = 0.21; SMD = 0.13, 95%CI: -0.07 to 0.34).
Virtual reality augmented treadmill walking training enhances outcomes compared to treadmill-only training in patients with walking and balance impairments. The results of this review support the clinical significance of combining virtual reality with treadmill training with level 1A empirical evidence.
系统总结和评估虚拟现实与跑步机训练相结合在步行和平衡障碍患者中的应用。
英文随机对照试验，参与者存在步行和平衡障碍，干预组使用虚拟现实和跑步机，对照组仅使用跑步机且训练频率和课程数量相同。检索了 6 个生物科学和工程数据库。
两名独立评审员进行研究选择、数据提取和质量评估。使用物理治疗证据数据库（PEDro）量表评估方法学质量。
共纳入 16 项随机对照试验，包括 829 名参与者。与仅使用跑步机训练相比，虚拟现实增强跑步机训练可显著提高步行速度（<0.001；标准化均数差（SMD）=0.55，95%CI：0.30 至 0.81）、步长（<0.001；SMD=0.74，95%CI：0.42 至 1.06）、步宽（=0.03；SMD=-0.52，95%CI：-0.97 至 -0.06）、单腿站立时间（=0.003；SMD=0.77，95%CI：0.27 至 1.27）、功能性移动能力（=0.003；SMD=-0.44，95%CI：-0.74 至 -0.15）、平衡功能（=0.04；SMD=0.24，95%CI：0.01 至 0.47）和平衡信心（=0.03；SMD=0.73，95%CI：0.08 至 1.37）。两组间步行耐力无显著差异（=0.21；SMD=0.13，95%CI：-0.07 至 0.34）。
与仅使用跑步机训练相比，虚拟现实增强跑步机步行训练可改善步行和平衡障碍患者的结局。本综述结果支持将虚拟现实与跑步机训练相结合的临床意义，其证据等级为 1A 级。
