Parra Artimes García, Gonzalez-Medina Gloria, Perez-Cabezas Veronica, Casuso-Holgado María Jesús, Vinolo-Gil Maria Jesus, García-Muñoz Cristina
Department of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain.
Department of Physiotherapy, University of Seville, Sevilla, Spain.
J Med Syst. 2023 Apr 3;47(1):46. doi: 10.1007/s10916-023-01930-7.
Virtual reality is an effective system to train balance and gait in Parkinson's disease, but attrition of this intervention needs to be further examined. This study aims to review and meta-analyze the dropouts of participants in randomized clinical trials that used virtual reality for balance and gait training in people with Parkinson's disease. An electronic search was conducted in PubMed, Web of Science, Scopus and CINAHL. The PEDro scale and Revised Cochrane risk-of-bias tool for randomized trials 2.0 were employed to assess methodological quality. Proportions meta-analysis calculated dropout rate. Odds ratio meta-analysis under 1 indicated lower attrition in experimental participants. Meta-regression identified possible dropouts' moderators. A total of 18 studies were included. The pooled dropout rates were 5.6% (95% CI, 3.3%-9.3%) for all groups, 5.33% (95% CI, 3.03%-9.21%) in virtual reality, and 6.60% (95% CI, 3.84%-26.31%) in comparators. No statistical differences were found in the dropout occurred between the groups (OR 0.83; 95% CI, 0.62-1.12). Number of weeks was the unique moderator (coefficient 0.129, 95% CI 0.018- 0.239; p=0.02). Our overall pooled dropout should be considered in the sample size calculation of future studies. Adequate follow-up of the CONSORT guidelines in the loss report and their reasons could help design suitable retention strategies.
虚拟现实是一种训练帕金森病患者平衡能力和步态的有效系统，但这种干预措施的损耗情况仍需进一步研究。本研究旨在回顾和荟萃分析在帕金森病患者中使用虚拟现实进行平衡和步态训练的随机临床试验参与者的退出情况。在PubMed、科学网、Scopus和CINAHL数据库中进行了电子检索。采用PEDro量表和随机试验修订版Cochrane偏倚风险工具2.0评估方法学质量。采用比例荟萃分析计算退出率。比值比荟萃分析结果小于1表明实验组参与者的损耗率较低。进行荟萃回归分析以确定可能导致退出的调节因素。共纳入18项研究。所有组的合并退出率为5.6%（95%置信区间，3.3%-9.3%），虚拟现实组为5.33%（95%置信区间，3.03%-9.21%），对照组为6.60%（95%置信区间，3.84%-26.31%）。组间退出情况无统计学差异（比值比0.83；95%置信区间，0.62-1.12）。随访周数是唯一的调节因素（系数0.129，95%置信区间0.018-0.239；p=0.02）。在未来研究的样本量计算中应考虑我们总体的合并退出率。在失访报告及其原因中充分遵循CONSORT指南，有助于设计合适的保留策略。
