Division of Brain Disease Research, Department for Chronic Disease Convergence Research, Korea National Institute of Health, 187 Osongsaengmyeong2‑ro, Osong‑eup, Cheongju‑si, Chungcheongbuk‑do, 28159, Republic of Korea.
J Neuroeng Rehabil. 2023 Jul 20;20(1):94. doi: 10.1186/s12984-023-01219-3.
Virtual reality (VR) is a promising solution for individuals with Parkinson's disease (PD) who experience symptoms that affect their daily activities and independence. Through VR-based rehabilitation, patients can improve their motor skills in a safe and stress-free environment, making it an attractive alternative to traditional in-person rehabilitation during the COVID-19 pandemic. This study aimed to provide the most recent and convincing evidence on the rehabilitative effects of VR technology compared with conventional treatments.
Two investigators systematically searched Embase, MEDLINE, CINAHL, PEDro, and the Cochrane Library from their inception until May 31, 2022, to identify randomized controlled trials (RCTs) comparing the effectiveness of VR training with that of conventional treatment for patients with PD. Studies were selected based on the patient, intervention, comparator, and outcome criteria and assessed for the risk of bias using the Cochrane tool. Meta-analysis was conducted by pooling mean differences with 95% confidence intervals.
A total of 14 RCTs, involving 524 participants, were included in the meta-analysis. The results indicated that VR-based rehabilitation significantly improved balance function, as measured using the Berg balance scale (BBS) and activities-specific balance confidence. However, no statistically significant differences in gait ability, activities of daily living, motor function, and quality of life were observed between the experimental and control groups. Subgroup analysis revealed that combination therapy affected heterogeneity in the BBS analysis. Meta-regression analysis demonstrated a significant positive relationship, indicating that more recent studies have shown greater improvements in balance function.
This study's findings suggest that VR-based rehabilitation is a promising intervention for improving balance function in patients for PD compared with conventional treatment, and recent research supports its efficacy. However, future research should focus on conducting long-term follow-up studies and developing standardized protocols to comprehensively establish this intervention's potential benefits.
虚拟现实(VR)是一种有前途的解决方案,适用于患有帕金森病(PD)的个体,他们的症状会影响其日常活动和独立性。通过基于 VR 的康复,患者可以在安全且无压力的环境中改善运动技能,这在 COVID-19 大流行期间是传统面对面康复的有吸引力的替代方案。本研究旨在提供关于 VR 技术与传统治疗相比的康复效果的最新和最有说服力的证据。
两名调查员系统地搜索了 Embase、MEDLINE、CINAHL、PEDro 和 Cochrane Library,从其成立到 2022 年 5 月 31 日,以确定比较 VR 训练与 PD 患者常规治疗效果的随机对照试验(RCT)。研究根据患者、干预、比较和结局标准进行选择,并使用 Cochrane 工具评估偏倚风险。采用合并均值差和 95%置信区间进行荟萃分析。
共有 14 项 RCT 纳入荟萃分析,涉及 524 名参与者。结果表明,基于 VR 的康复显著改善了平衡功能,使用 Berg 平衡量表(BBS)和活动特定平衡信心进行测量。然而,实验组和对照组在步态能力、日常生活活动、运动功能和生活质量方面没有统计学上的显著差异。亚组分析表明,联合治疗影响了 BBS 分析的异质性。元回归分析表明,两者之间存在显著的正相关关系,表明较新的研究表明平衡功能的改善更大。
本研究结果表明,与传统治疗相比,基于 VR 的康复是改善 PD 患者平衡功能的一种有前途的干预措施,并且最近的研究支持其疗效。然而,未来的研究应该侧重于进行长期随访研究并制定标准化方案,以全面确定这种干预措施的潜在益处。