AP-HP, Sorbonne Université, Hôpital Charles Foix, Ivry-sur-Seine, France.
Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France.
Gerontology. 2023;69(6):757-767. doi: 10.1159/000528854. Epub 2022 Dec 29.
INTRODUCTION: Exergaming is increasingly employed in rehabilitation for older adults. However, their effects on fall rate and fall risk remain unclear. METHODS: We conducted a systematic review and meta-analysis that included randomized controlled trials (RCTs) comparing exergame-assisted rehabilitation with control groups, published in French or English, from Web of Science, CINHAL, Embase, Medline, and CENTRAL (last search in June 2021). Two reviewers independently assessed the studies. Risk of bias was assessed using RoB2, PEDRO scale, and the GRADE system. The outcomes of interest were (a) fall rate, (b) risk of falling, measured by the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), One-Leg Stance, or Berg Balance Scale (BBS), (c) fear of falling, measured with the Fall Efficacy Scale (FES-I) or the Activities-specific Balance Confidence (ABC) score. Data were pooled and mean differences (MDs) between exergame and control groups were calculated using a random-effects model. RESULTS: Twenty-seven RCTs were included (1,415 participants, including 63.9% of women, with mean age ranging from 65 to 85.2 years old). Exergame-assisted interventions were associated with a reduction in the incidence of falls (4 studies, 316 participants, MD = -0.91 falls per person per year; 95% CI: -1.65 to -0.17, p = 0.02, moderate quality). Regarding fall risk (20 studies included, low-quality evidence), SPPB did not change (MD = 0.74; 95% CI: -0.12 to 1.60, p = 0.09), but all other scores were improved: BBS (MD = 2.85; 95% CI: 1.27 to -4.43, p = 0.0004), TUG (MD = -1.46; 95% CI: -2.21 to -0.71, p = 0.0001) and One-Leg Stance (MD = 7.09; 95% CI: 4.21 to 9.98, p < 0.00001). Fear of falling scores (FES-I and ABC) showed no difference. CONCLUSION: There is moderate-quality evidence of a reduction in the fall rate with exergame-assisted rehabilitation and low-quality evidence suggesting a mild reduction in the risk of falling. Statistically significant benefits from exergame-assisted rehabilitation did not achieve clinically meaningful changes in risk of falling assessments.
简介：外游戏越来越多地用于老年人的康复治疗。然而，它们对跌倒率和跌倒风险的影响仍不清楚。
方法：我们进行了一项系统评价和荟萃分析，其中包括比较外游戏辅助康复与对照组的随机对照试验（RCT），研究发表于 Web of Science、CINHAL、Embase、Medline 和 CENTRAL（最后一次搜索时间为 2021 年 6 月）。两位评审员独立评估了这些研究。使用 RoB2、PEDRO 量表和 GRADE 系统评估偏倚风险。主要结局指标为：（a）跌倒率，（b）用短体物理表现电池（SPPB）、计时起立行走（TUG）、单腿站立或伯格平衡量表（BBS）测量的跌倒风险，（c）恐惧跌倒，用跌倒效能量表（FES-I）或活动特定平衡信心（ABC）评分测量。使用随机效应模型对数据进行汇总，并计算外游戏组和对照组之间的均数差（MDs）。
结果：共纳入 27 项 RCT（1415 名参与者，包括 63.9%的女性，平均年龄为 65 至 85.2 岁）。外游戏辅助干预与跌倒发生率降低相关（4 项研究，316 名参与者，MD=-0.91 人/年；95%CI：-1.65 至-0.17，p=0.02，中等质量）。关于跌倒风险（20 项研究，低质量证据），SPPB 无变化（MD=0.74；95%CI：-0.12 至 1.60，p=0.09），但其他所有评分均有改善：BBS（MD=2.85；95%CI：1.27 至-4.43，p=0.0004）、TUG（MD=-1.46；95%CI：-2.21 至-0.71，p=0.0001）和单腿站立（MD=7.09；95%CI：4.21 至 9.98，p < 0.00001）。恐惧跌倒评分（FES-I 和 ABC）没有差异。
结论：有中等质量证据表明外游戏辅助康复可降低跌倒率，低质量证据表明外游戏辅助康复可轻度降低跌倒风险。外游戏辅助康复的统计学显著益处并未在跌倒风险评估中达到临床有意义的变化。
Cochrane Database Syst Rev. 2022-2-1
Mult Scler. 2016-10
Cochrane Database Syst Rev. 2018-7-23
Gerontologist. 2025-3-25
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023-10-28
Zotero 插件