虚拟现实技术在脑瘫儿童和青少年家庭康复中的应用：系统评价和荟萃分析。
The application of virtual reality to home-based rehabilitation for children and adolescents with cerebral palsy: A systematic review and meta-analysis.
机构信息
Department of Health and Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, United States.
Department of Physical Medicine and Rehabilitation, Gate Parkway Primary Care Center, Jacksonville.
出版信息
Physiother Theory Pract. 2024 Jul;40(7):1588-1608. doi: 10.1080/09593985.2023.2184220. Epub 2023 Feb 27.
BACKGROUND
Home-based rehabilitation enables children and families to participate in therapeutic activities built into their daily routines without the barriers of arrangement and transportation to facilities. Virtual reality is an emerging technology which has shown promising outcomes in rehabilitation.
PURPOSE
This systematic review aims to examine the feasibility and effects of virtual reality-enhanced home rehabilitation on Body functions and structures, Activity, and Participation outcomes in children and adolescents with cerebral palsy.
METHODS
Interventional studies were searched across five biomedical databases on November 26, 2022. Two independent reviewers conducted study selection, data extraction, and quality assessment. The Physiotherapy Evidence Database scale and National Institutes of Health Study Quality Assessment Tools were used to evaluate the quality of included studies. Meta-analysis was performed to examine the effects of the intervention.
RESULTS
Eighteen studies were included in this review. Home-based virtual reality rehabilitation appears feasible with effects on upper extremity and gross motor function, strength, bone density, cognition, balance, walking, daily activity performance, and participation. Meta-analyses revealed significant improvements in hand function (SMD = 0.41, = .003), gross motor function (SMD = 0.56, = .0002), and walking capacity (SMD = 0.44, = .01) following home-based virtual reality intervention.
CONCLUSION
Home-based virtual reality may serve as an adjunct to conventional facility-based therapy to promote participation in therapeutic exercises and maximize rehabilitation outcomes. Further properly designed randomized controlled trials using valid and reliable outcome measures with adequately powered sample sizes are warranted to enhance the current body of evidence using home-based virtual reality in cerebral palsy rehabilitation.
背景
家庭康复使儿童及其家庭能够参与融入日常生活的治疗活动，而无需克服前往设施的安排和交通障碍。虚拟现实是一种新兴技术，在康复方面已显示出有前景的结果。
目的
本系统评价旨在考察虚拟现实增强家庭康复对脑瘫儿童身体功能和结构、活动和参与结果的可行性和效果。
方法
于 2022 年 11 月 26 日在五个生物医学数据库中搜索干预性研究。两名独立评审员进行了研究选择、数据提取和质量评估。使用物理治疗证据数据库量表和美国国立卫生研究院研究质量评估工具来评估纳入研究的质量。进行荟萃分析以检验干预措施的效果。
结果
本综述纳入了 18 项研究。家庭虚拟现实康复似乎具有可行性，并且对上肢和粗大运动功能、力量、骨密度、认知、平衡、行走、日常活动表现和参与有影响。荟萃分析显示，家庭虚拟现实干预后手部功能（SMD=0.41，=0.003）、粗大运动功能（SMD=0.56，=0.0002）和行走能力（SMD=0.44，=0.01）有显著改善。
结论
家庭虚拟现实可能作为常规机构治疗的辅助手段，促进参与治疗性运动并最大限度地提高康复效果。进一步需要使用有效和可靠的结局测量指标并具有足够大的样本量来进行适当设计的随机对照试验，以增强基于家庭虚拟现实在脑瘫康复中的现有证据。
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