Department of Nursing, The Second Hospital of Dalian Medical University, Dalian, Liaoning, PR China.
School of Public Health, Weifang Medical University, Weifang, Shandong, PR China.
Geriatr Nurs. 2024 May-Jun;57:31-44. doi: 10.1016/j.gerinurse.2024.02.032. Epub 2024 Mar 18.
To explore the effectiveness of virtual reality (VR) exergames on physical function, cognition and depression among older nursing home residents.
A systematic review and meta-analysis were conducted. The PubMed, Ovid, Embase, Cochrane, CINAHL, and Web of Science databases were searched for relevant studies from inception until June 1, 2023. The reviewers independently completed the study selection, data extraction and quality assessment. Subgroup analyses were conducted to explore the sources of between-study heterogeneity and to determine whether participant or intervention characteristics influenced effect sizes.
Eighteen studies met the inclusion criteria and were selected for qualitative and quantitative synthesis. The overall methodological quality was relatively high, and the overall evidence grade was moderate. VR exergames had a large effect on physical function, including mobility [SMD=-0.66, P < 0.001], balance [SMD=0.95, P < 0.001], and lower limb strength [SMD=0.53, P = 0.0009]; and a moderate effect on cognition [SMD=0.48, P = 0.02] and depression [SMD=-0.72, P = 0.03]. Subgroup analyses revealed that a training frequency of 2 sessions per week and coordinating with physiotherapists yielded greater improvements in mobility (P = 0.009; P = 0.0001). VR exergames had especially beneficial effects on balance for physically fit participants (P = 0.03) and on cognition for participants with cognitive impairment (P = 0.01). Additionally, regarding the improvement of depression, commercial VR exergames were superior to self-made systems (P = 0.03).
VR exergames can provide a positive impact on physical function, cognition and depression among older nursing home residents. The study also demonstrated the different benefits of exergames between participants who were physically fit and those with cognitive impairment, which is considered as an innovative, cost-efficient and sustainable approach. Specifically, commercial VR exergame programs with a frequency of 2 sessions per week and coordinating with physiotherapists may be the most appropriate and effective option.
探索虚拟现实（VR）健身体验对养老院老年人身体机能、认知和抑郁的影响。
系统回顾和荟萃分析。检索了从建库至 2023 年 6 月 1 日的 PubMed、Ovid、Embase、Cochrane、CINAHL 和 Web of Science 数据库，以寻找相关研究。由两位审阅者独立完成研究选择、数据提取和质量评估。进行了亚组分析以探索研究间异质性的来源，并确定参与者或干预特征是否影响效应大小。
18 项研究符合纳入标准，并进行了定性和定量综合分析。整体方法学质量相对较高，整体证据等级为中等。VR 健身体验对身体机能有较大影响，包括移动能力[SMD=-0.66，P<0.001]、平衡[SMD=0.95，P<0.001]和下肢力量[SMD=0.53，P=0.0009]；对认知[SMD=0.48，P=0.02]和抑郁[SMD=-0.72，P=0.03]也有中度影响。亚组分析显示，每周 2 次的训练频率和与物理治疗师合作可以更好地提高移动能力（P=0.009；P=0.0001）。VR 健身体验对身体状况良好的参与者的平衡能力（P=0.03）和认知障碍参与者的认知能力（P=0.01）有特别有益的影响。此外，在改善抑郁方面，商业 VR 健身体验优于自制系统（P=0.03）。
VR 健身体验可以对养老院老年人的身体机能、认知和抑郁产生积极影响。研究还表明，在身体状况良好的参与者和认知障碍参与者之间，健身体验具有不同的益处，这被认为是一种创新、具有成本效益和可持续的方法。具体来说，每周 2 次、与物理治疗师合作的商业 VR 健身体验方案可能是最合适和最有效的选择。
