From the College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska (JH); School of Basic Medical Sciences, Capital Medical University, Beijing, China (ZC); Gate Parkway Primary Care Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida (AR); and Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (ZH).
Am J Phys Med Rehabil. 2023 May 1;102(5):468-474. doi: 10.1097/PHM.0000000000002150. Epub 2022 Nov 14.
Virtual reality is an emerging technology with accumulating research and clinical evidence in the field of physical rehabilitation. This study aimed to systematically identify and examine the effects of virtual reality on motor function outcomes in patients with amputation to inform clinical decision making on amputation rehabilitation and inform further research endeavors. Five databases were searched, including PubMed, CINAHL, PsycINFO, Embase, and Scopus. After screening for 1052 records, 10 clinical studies were included in this review: four randomized controlled trials, three pre-post single-arm studies, and three case studies; all studies had fair to good methodological quality. Seven studies were for lower extremity amputation, and three were for upper extremity amputation. Results reveal the positive effects of virtual reality on improving motor function in prosthesis training, including balance, gait, and upper extremity outcomes. Participants also report enjoyment during virtual reality intervention as measured by subjective experience. However, it is unclear whether virtual reality can induce better therapeutic outcomes than conventional rehabilitation, given the limited number of controlled studies and conflicting results reported in the included studies. More properly designed randomized controlled trials with adequately powered sample sizes are warranted to elucidate the benefits of virtual reality-based rehabilitation in the amputation population.
虚拟现实是一种新兴技术,在物理康复领域积累了越来越多的研究和临床证据。本研究旨在系统地识别和检查虚拟现实对截肢患者运动功能结果的影响,为截肢康复的临床决策提供信息,并为进一步的研究努力提供信息。五个数据库(包括 PubMed、CINAHL、PsycINFO、Embase 和 Scopus)进行了搜索,共筛选出 1052 条记录,其中 10 项临床研究纳入本综述:4 项随机对照试验、3 项单臂前后研究和 3 项病例研究;所有研究的方法学质量均为中等偏上。7 项研究针对下肢截肢,3 项研究针对上肢截肢。结果表明,虚拟现实在改善假肢训练中的运动功能方面具有积极作用,包括平衡、步态和上肢结果。参与者还报告了在虚拟现实干预过程中的主观体验,即享受程度。然而,由于纳入研究报告的对照研究数量有限且结果存在冲突,尚不清楚虚拟现实是否能比传统康复带来更好的治疗效果。需要更多设计合理、样本量足够的随机对照试验来阐明基于虚拟现实的康复在截肢人群中的益处。