虚拟现实对脑瘫儿童日常生活活动能力的影响：系统评价和荟萃分析。
Effectiveness of virtual reality on activities of daily living in children with cerebral palsy: a systematic review and meta-analysis.
机构信息
Department of Physical Therapy, Yonsei University, Wonju, Kangwondo, South Korea.
Department of Physical Therapy, Kangwon National University, Samchuk, Kangwondo, South Korea.
出版信息
PeerJ. 2023 Aug 31;11:e15964. doi: 10.7717/peerj.15964. eCollection 2023.
BACKGROUND
No meta-analysis has been conducted on the effect of specific virtual reality (VR) treatment modes on activities of daily living (ADL) in children with cerebral palsy (CP). Therefore, this study aimed to confirm whether VR therapy is effective in improving ADL in children with CP according to subgroups.
METHODOLOGY
Literature published in the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, the Physiotherapy Evidence Database (PEDro), and PubMed was reviewed, and Risk of Bias 2.0 (RoB 2) was used to evaluate the quality of the literature. A funnel plot was visually observed to confirm publication bias, supplemented with Egger's regression test. Data analysis was performed using R version 4.2.1. Subgroup analysis was performed according to the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), treatment minutes per week, treatment period, age, and RoB.
RESULTS
Eleven of 2,978 studies were included, and the overall effect size was 0.37 (95% confidence interval = 0.17-0.57). Regarding GMFCS, effect sizes of 0.41 and 0.33 was observed for the low- and high-function groups, respectively. For MACS, 0.27 and 0.43 were observed for the low and high-function groups. Regarding treatment minutes per week, the values were 0.22, 0.44, and 0.27 in the 1-100, 101-200, and 201-300 min groups, respectively. In the classification according to age, 0.29 was observed for school-age children and 0.98 for preschool children. Lastly, in the classification according to the RoB, 0.52, -0.01, and 0.23 indicated studies with low risk, some concern, and high risk, respectively.
CONCLUSIONS
The highest effect was observed when VR was applied within 6 weeks of 101-200 per week. Therefore, it is suggested that if the results of this review are applied to children with cerebral palsy in the community, it will be an effective intervention method.
SYSTEMATIC REVIEW REGISTRATION
PROPEROS (registration number CRD42023409801).
背景
目前尚无荟萃分析研究特定虚拟现实（VR）治疗模式对脑瘫儿童日常生活活动（ADL）的影响。因此，本研究旨在根据亚组确定 VR 治疗是否对脑瘫儿童的 ADL 改善有效。
方法
对 Cumulated Index to Nursing and Allied Health Literature（CINAHL）、Embase、Physiotherapy Evidence Database（PEDro）和 PubMed 中发表的文献进行综述，并使用风险偏倚 2.0（RoB 2）评估文献质量。通过视觉观察漏斗图来确认发表偏倚，并辅以 Egger 回归检验。使用 R 版本 4.2.1 进行数据分析。根据粗大运动功能分类系统（GMFCS）、手动能力分类系统（MACS）、每周治疗分钟数、治疗期、年龄和 RoB 进行亚组分析。
结果
从 2978 项研究中纳入了 11 项研究，总体效应量为 0.37（95%置信区间=0.17-0.57）。在 GMFCS 方面，低功能组和高功能组的效应量分别为 0.41 和 0.33。在 MACS 方面，低功能组和高功能组的效应量分别为 0.27 和 0.43。在每周治疗分钟数方面，1-100 分钟组、101-200 分钟组和 201-300 分钟组的数值分别为 0.22、0.44 和 0.27。在按年龄分类方面，学龄儿童为 0.29，学龄前儿童为 0.98。最后，在 RoB 分类方面，低风险、存在一些担忧和高风险的研究分别为 0.52、-0.01 和 0.23。
结论
每周治疗 101-200 分钟，持续 6 周内的 VR 应用效果最佳。因此，如果将本综述的结果应用于社区中的脑瘫儿童，这将是一种有效的干预方法。
系统评价注册
PROPEROS（注册号 CRD42023409801）。
Zotero 插件