Lamichhane Pratik, Sukralia Shreya, Alam Benish, Shaikh Shawn, Farrukh Shireen, Ali Shahid, Ojha Rajeev
Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
Manipal College of Medical Sciences, Kaski, Pokhara, Nepal.
Ann Med Surg (Lond). 2023 Jun 20;85(8):4026-4032. doi: 10.1097/MS9.0000000000000986. eCollection 2023 Aug.
Augmented reality (AR) technology is being used recently in healthcare, especially for rehabilitation purposes, owing to its ability for repetition, rapid feedback, and motivation for patients. This systematic review and meta-analysis aims to compare the efficacy of AR-based interventions to conventional physical interventions in improving balance, mobility, and fall risk.
PubMed, Google Scholar, Scopus, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to January 2023. Randomized trials and observational cohort studies comparing the effects of AR-based exercises with conventional training in patients 18 years and older were included in the analysis. Studies using virtual reality, case reports and series, reviews, meta-analyses, letters, and editorials were excluded. Post-intervention data on the Berg Balance Scale (BBS) and Timed Up and Go (TUG) Test were extracted and studied. The fixed-effects inverse variance model was utilized to pool the extracted data.
Out of 438 articles, seven articles (199 participants) comparing AR-based exercise with the standard training were included in the systematic review. Six articles with sufficient data on the parameters were included in the meta-analysis. AR-based exercises resulted in a significantly higher BBS score than conventional exercise (Hedge's g=0.48, 95% CI=0.19-0.77, <0.001). The BBS value was significantly higher in AR-based training of 8 weeks or more (Hedge's g=0.88, 95% CI=0.46-1.31) when compared with trainings conducted for less than 8 weeks (Hedge's g=0.11, 95% CI=-0.30 to 0.52), =0.01). Likewise, the TUG Test score was found to be to be significantly lower in ARgroup than the controls (Hedge's g= -0.54, 95% CI=-0.85 to -0.23, <0.01).
In comparison to conventional methods, AR-based exercises had higher improvements in balance, mobility, and fall risk parameters. The use of AR technology in elderly patients can promote independence while preventing falls and associated morbidity and mortality. There is a need for a larger randomized controlled trial to provide a more accurate comparison on efficacy and safety of different modalities of training.
由于增强现实(AR)技术具有可重复性、快速反馈以及能激发患者积极性的特点,近年来该技术已应用于医疗保健领域,尤其用于康复目的。本系统评价和荟萃分析旨在比较基于AR的干预措施与传统物理干预措施在改善平衡、活动能力和跌倒风险方面的疗效。
对PubMed、谷歌学术、Scopus以及Cochrane对照试验中心注册库进行系统检索,检索时间从建库至2023年1月。分析纳入比较18岁及以上患者基于AR的运动与传统训练效果的随机试验和观察性队列研究。排除使用虚拟现实的研究、病例报告及系列、综述、荟萃分析、信函和社论。提取并研究干预后伯格平衡量表(BBS)和定时起立行走测试(TUG)的相关数据。采用固定效应逆方差模型汇总提取的数据。
在438篇文章中,系统评价纳入了7篇(199名参与者)比较基于AR的运动与标准训练的文章。荟萃分析纳入了6篇具有足够参数数据的文章。与传统运动相比,基于AR的运动使BBS评分显著更高(Hedge's g=0.48,95%CI=0.19-0.77,P<0.001)。与训练时间少于8周(Hedge's g=0.11,95%CI=-0.30至0.52,P=0.01)相比,基于AR的8周及以上训练的BBS值显著更高(Hedge's g=0.88,95%CI=0.46-1.31)。同样,发现AR组的TUG测试评分显著低于对照组(Hedge's g=-0.54,95%CI=-0.85至-0.23,P<0.01)。
与传统方法相比,基于AR的运动在平衡、活动能力和跌倒风险参数方面有更大改善。在老年患者中使用AR技术可促进其独立性,同时预防跌倒及相关发病率和死亡率。需要开展更大规模的随机对照试验,以更准确地比较不同训练方式的疗效和安全性。