Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
BMC Med Inform Decis Mak. 2024 May 24;24(1):135. doi: 10.1186/s12911-024-02534-y.
Stroke frequently gives rise to incapacitating motor impairments in the upper limb. Virtual reality (VR) rehabilitation has exhibited potential for augmenting upper extremity recovery; nonetheless, the optimal techniques for such interventions remain a topic of uncertainty. The present systematic review and meta-analysis were undertaken to comprehensively compare VR-based rehabilitation with conventional occupational therapy across a spectrum of immersion levels and outcome domains.
A systematic search was conducted in PubMed, IEEE, Scopus, Web of Science, and PsycNET databases to identify randomized controlled trials about upper limb rehabilitation in stroke patients utilizing VR interventions. The search encompassed studies published in the English language up to March 2023. The identified studies were stratified into different categories based on the degree of immersion employed: non-immersive, semi-immersive, and fully-immersive settings. Subsequent meta-analyses were executed to assess the impact of VR interventions on various outcome measures.
Of the 11,834 studies screened, 55 studies with 2142 patients met the predefined inclusion criteria. VR conferred benefits over conventional therapy for upper limb motor function, functional independence, Quality of life, Spasticity, and dexterity. Fully immersive VR showed the greatest gains in gross motor function, while non-immersive approaches enhanced fine dexterity. Interventions exceeding six weeks elicited superior results, and initiating VR within six months post-stroke optimized outcomes.
This systematic review and meta-analysis demonstrates that adjunctive VR-based rehabilitation enhances upper limb motor recovery across multiple functional domains compared to conventional occupational therapy alone after stroke. Optimal paradigms likely integrate VR's immersive capacity with conventional techniques.
This systematic review and meta-analysis retrospectively registered in the OSF registry under the identifier [ https://doi.org/10.17605/OSF.IO/YK2RJ ].
中风常导致上肢运动功能障碍。虚拟现实（VR）康复在增强上肢恢复方面显示出了潜力；然而，这种干预的最佳技术仍然是一个不确定的话题。本系统评价和荟萃分析旨在全面比较基于 VR 的康复与传统职业治疗在不同沉浸度和结果领域的上肢康复效果。
在 PubMed、IEEE、Scopus、Web of Science 和 PsycNET 数据库中进行了系统检索，以确定使用 VR 干预治疗中风患者上肢康复的随机对照试验。检索涵盖了截至 2023 年 3 月以英语发表的研究。根据使用的沉浸度程度，将确定的研究分为不同类别：非沉浸式、半沉浸式和完全沉浸式设置。随后进行荟萃分析，以评估 VR 干预对各种结果测量的影响。
在筛选的 11834 项研究中，有 55 项研究共 2142 名患者符合预设的纳入标准。与传统治疗相比，VR 对上肢运动功能、功能独立性、生活质量、痉挛和灵巧性均有获益。完全沉浸式 VR 对粗大运动功能的改善最大，而非沉浸式方法则增强了精细灵巧性。干预时间超过六周的效果更好，中风后六个月内开始 VR 治疗可优化结果。
本系统评价和荟萃分析表明，与单独使用传统职业治疗相比，辅助基于 VR 的康复可增强中风后多个功能领域的上肢运动恢复。最佳的方案可能是将 VR 的沉浸感与传统技术相结合。
本系统评价和荟萃分析在 OSF 注册中心以标识符 [ https://doi.org/10.17605/OSF.IO/YK2RJ ] 进行了回顾性注册。
