虚拟现实运动在膝关节骨关节炎康复中的疗效：一项系统评价和荟萃分析。
Efficacy of virtual reality exercise in knee osteoarthritis rehabilitation: a systematic review and meta-analysis.
作者信息
Wei Wei, Tang Haiting, Luo Yu, Yan Shichang, Ji Qipei, Liu Zhixiang, Li Huaqiang, Wu Fei, Yang Shenqiao, Yang Xin
机构信息
School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Foreign Languages, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
Front Physiol. 2024 Jun 19;15:1424815. doi: 10.3389/fphys.2024.1424815. eCollection 2024.
BACKGROUND
This systematic review and meta-analysis aims to investigate the effects of virtual reality (VR) exercise compared to traditional rehabilitation on pain, function, and muscle strength in patients with knee osteoarthritis (KOA). Additionally, the study explores the mechanisms by which VR exercise contributes to the rehabilitation of KOA patients.
METHODS
We systematically searched PubMed, the Cochrane Library, Embase, Web of Science, Scopus, and PEDro according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search spanned from the library construction to 24 May 2024, focusing on randomized controlled trials Primary outcomes included pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and muscle strength. Meta-analysis was conducted using RevMan (version 5.4) and Stata (version 14.0). The bias risk of included studies was assessed using the Cochrane RoB 2.0 tool, while the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
This meta-analysis and systematic review included nine studies involving 456 KOA patients. The results indicated that VR exercise significantly improved pain scores (SMD, -1.53; 95% CI: -2.50 to -0.55; = 0.002), WOMAC total score (MD, -14.79; 95% CI: -28.26 to -1.33; = 0.03), WOMAC pain score (MD, -0.93; 95% CI: -1.52 to -0.34; = 0.002), knee extensor strength (SMD, 0.51; 95% CI: 0.14 to 0.87; = 0.006), and knee flexor strength (SMD, 0.65; 95% CI: 0.28 to 1.01; = 0.0005), but not significantly for WOMAC stiffness (MD, -0.01; 95% CI: -1.21 to 1.19; = 0.99) and physical function (MD, -0.35; 95% CI: -0.79 to -0.09; = 0.12).
CONCLUSION
VR exercise significantly alleviates pain, enhances muscle strength and WOMAC total score in KOA patients, but improvements in joint stiffness and physical function are not significant. However, the current number of studies is limited, necessitating further research to expand on the present findings.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024540061, identifier CRD42024540061.
背景
本系统评价和荟萃分析旨在研究与传统康复相比，虚拟现实（VR）运动对膝骨关节炎（KOA）患者疼痛、功能和肌肉力量的影响。此外，该研究还探讨了VR运动有助于KOA患者康复的机制。
方法
我们根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，系统检索了PubMed、Cochrane图书馆、Embase、科学网、Scopus和PEDro。检索时间跨度从建库至2024年5月24日，重点关注随机对照试验。主要结局包括疼痛、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及肌肉力量。使用RevMan（5.4版）和Stata（14.0版）进行荟萃分析。使用Cochrane RoB 2.0工具评估纳入研究的偏倚风险，同时使用推荐分级、评估、制定和评价（GRADE）方法评估证据质量。
结果
该荟萃分析和系统评价纳入了9项研究，涉及456例KOA患者。结果表明VR运动显著改善了疼痛评分（标准化均数差，-1.53；95%置信区间：-2.50至-0.55；P = 0.002）、WOMAC总分（均数差，-14.79；95%置信区间：-28.26至-1.33；P = 0.03）、WOMAC疼痛评分（均数差，-0.93；95%置信区间：-1.52至-0.34；P = 0.002）、膝关节伸肌力量（标准化均数差，0.51；95%置信区间：0.14至0.87；P = 0.006）和膝关节屈肌力量（标准化均数差，0.65；95%置信区间：0.28至1.01；P = 0.0005），但对于WOMAC僵硬程度（均数差，-0.01；95%置信区间：-1.21至1.19；P = 0.99）和身体功能（均数差，-0.35；95%置信区间：-0.79至-0.09；P = 0.12）改善不显著。
结论
VR运动可显著减轻KOA患者的疼痛，增强肌肉力量和WOMAC总分，但关节僵硬程度和身体功能的改善不显著。然而，目前研究数量有限，需要进一步研究以拓展现有发现。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024540061，标识符CRD42024540061。
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